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Westlake Legal Group > Posts tagged "United States"

Rob Sutton: Kamala Harris is an uninspiring choice for Vice President

Rob Sutton is a junior doctor in Wales and a former Parliamentary staffer. He is a recent graduate of the University of Oxford Medical School.

Former Vice president Joe Biden has announced Senator Kamala Harris will be his running mate for the November presidential election. Harris was previously in the running for the presidential nomination and will be the first woman of colour to run for Vice President on a major party’s ticket.

The choice comes as a surprise to no-one. Biden announced he would choose a woman months ago, and Harris has been a consistent favourite for betting markets and pundits. Photos of Biden’s notes at a campaign stop recently prompted further speculation that she would ultimately get the nod. Yet on closer inspection, the decision is at best uninspired, and at worst a liability.

A presidential nominee’s choice of VP is generally considered through a strategic lens. Members of the campaign team will ask how a potential nominee could aid the campaign by shoring up support in key states and target demographics. They should be a unifying force within the party. It is also helpful if they are a close ally of the presidential nominee and an effective campaigner themselves.

On none of these points in Harris an unqualified success. The state she represents, California, is a safe state for the Democrats, so her popularity there adds little. The question of demographic is more difficult. The nominee should be both popular and inspiring enough to get voters to turn out. It is often noted that Hillary Clinton’s loss in 2016 was a consequence of disinterested voters in key demographics not turning out to vote.

As a black woman, one might think that she is a natural choice to turn out two groups the Democrats will be targeting: women and black voters. Yet these were two groups which she failed to gain much momentum with during her run for the presidential nomination. Furthermore, these are two groups Biden is already performing well with. Women and black voters were key to his primary success. It is therefore not evident that she will be able to add much in delivering their votes.

Prominent black Democrats reportedly pushed hard for Biden to pick an African American woman. In a party which is increasingly shifting to left and defined by its activist elements, Harris is a potential liability. Her former career as a public prosecutor will not sit well with anti-police activists following the death of George Floyd. And the Leftists within the party would have preferred Elizabeth Warren. When your opponent is well versed in exploiting divisions, there is a real risk that Harris’ background will haunt her all the way up to November 3rd, and Trump has wasted no time going on the offensive.

Harris and Biden do not have a close relationship, and he reportedly clicked better with other potential candidates. Their exchanges during debates for the presidential nomination have been tense and memorable. Given her chaotic run, it is unlikely she will add organisational excellence for a veteran like Biden.

The decision to pick Harris is perhaps symptomatic of a broader trend within the Biden campaign. As a nominee, Biden is viewed as safe but does little to excite voters or activists. His decisions have seemed uncertain and slow – both his choice of VP and his announcement that he would be running came late. Harris might be a compromise candidate in an increasingly fractious Democratic party, but by perpetually taking the middle of the road, Biden risks isolating many and inspiring none.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

How the US Has Uniquely Failed to Control the Coronavirus

Nearly every country has struggled to contain the coronavirus and made mistakes along the way.

China committed the first major failure, silencing doctors who tried to raise alarms about the virus and allowing it to escape from Wuhan. Much of Europe went next, failing to avoid enormous outbreaks. Today, many countries — Japan, Canada, France, Australia and more — are coping with new increases in cases after reopening parts of society.

Yet even with all of these problems, one country stands alone, as the only affluent nation to have suffered a severe, sustained outbreak for more than four months: the United States.

When it comes to the virus, the United States has come to resemble not the wealthy and powerful countries to which it is often compared but instead to far poorer countries, like Brazil, Peru and South Africa, or those with large migrant populations, like Bahrain and Oman.

As in several of those other countries, the toll of the virus in the United States has fallen disproportionately on poorer people and groups that have long suffered discrimination. Black and Latino residents of the United States have contracted the virus at roughly three times as high of a rate as white residents.

How did this happen? The New York Times set out to reconstruct the unique failure of the United States, through numerous interviews with scientists and public health experts around the world. The reporting points to two central themes.

First, the United States faced longstanding challenges in confronting a major pandemic. It is a large country at the nexus of the global economy, with a tradition of prioritizing individualism over government restrictions. That tradition is one reason the United States suffers from an unequal health care system that has long produced worse medical outcomes — including higher infant mortality and diabetes rates and lower life expectancy — than in most other rich countries.

“As an American, I think there is a lot of good to be said about our libertarian tradition,” Dr. Jared Baeten, an epidemiologist and vice dean at the University of Washington School of Public Health, said. “But this is the consequence — we don’t succeed as well as a collective.”

The second major theme is one that public health experts often find uncomfortable to discuss because many try to steer clear of partisan politics. But many agree that the poor results in the United States stem in substantial measure from the performance of the Trump administration.

In no other high-income country — and in only a few countries, period — have political leaders departed from expert advice as frequently and significantly as the Trump administration. President Trump has said the virus was not serious; predicted it would disappear; spent weeks questioning the need for masks; encouraged states to reopen even with large and growing caseloads; and promoted medical disinformation.

In recent days, Mr. Trump has continued the theme, offering a torrent of misleading statistics in his public appearances that make the situation sound less dire than it is.

Some Republican governors have followed his lead and also played down the virus, while others have largely followed the science. Democratic governors have more reliably heeded scientific advice, but their performance in containing the virus has been uneven.

“In many of the countries that have been very successful they had a much crisper strategic direction and really had a vision,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security, who wrote a guide to reopening safely for the American Enterprise Institute, a conservative research group. “I’m not sure we ever really had a plan or a strategy — or at least it wasn’t public.”

Together, the national skepticism toward collective action and the Trump administration’s scattered response to the virus have contributed to several specific failures and missed opportunities, Times reporting shows:

  • a lack of effective travel restrictions;

  • repeated breakdowns in testing;

  • confusing advice about masks;

  • a misunderstanding of the relationship between the virus and the economy;

  • and inconsistent messages from public officials.

Already, the American death toll is of a different order of magnitude than in most other countries. With only 4 percent of the world’s population, the United States has accounted for 22 percent of coronavirus deaths. Canada, a rich country that neighbors the United States, has a per capita death rate about half as large. And these gaps may worsen in coming weeks, given the lag between new cases and deaths.


Daily deaths per million in wealthy countries

Source: New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

For many Americans who survive the virus or do not contract it, the future will bring other problems. Many schools will struggle to open. And the normal activities of life — family visits, social gatherings, restaurant meals, sporting events — may be more difficult in the United States than in any other affluent country.

In retrospect, one of Mr. Trump’s first policy responses to the virus appears to have been one of his most promising.

On Jan. 31, his administration announced that it was restricting entry to the United States from China: Many foreign nationals — be they citizens of China or other countries — would not be allowed into the United States if they had been to China in the previous two weeks.

It was still early in the spread of the virus. The first cases in Wuhan, China, had been diagnosed about a month before, and the first announced case in the United States had come on Jan. 21. In announcing the new travel policy, Alex M. Azar II, the secretary of health and human services, declared that the virus posed “a public health emergency.” Mr. Trump described the policy as his “China ban.”

After the Trump administration acted, several other countries quickly announced their own restrictions on travel from China, including Japan, Vietnam and Australia.

But it quickly became clear that the United States’ policy was full of holes. It did not apply to immediate family members of American citizens and permanent residents returning from China, for example. In the two months after the policy went into place, almost 40,000 people arrived in the United States on direct flights from China.

Even more important, the policy failed to take into account that the virus had spread well beyond China by early February. Later data would show that many infected people arriving in the United States came from Europe. (The Trump administration did not restrict travel from Europe until March and exempted Britain from that ban despite a high infection rate there.)

The administration’s policy also did little to create quarantines for people who entered the United States and may have had the virus.

Authorities in some other places took a far more rigorous approach to travel restrictions.

South Korea, Hong Kong and Taiwan largely restricted entry to residents returning home. Those residents then had to quarantine for two weeks upon arrival, with the government keeping close tabs to ensure they did not leave their home or hotel. South Korea and Hong Kong also tested for the virus at the airport and transferred anyone who was positive to a government facility.

Australia offers a telling comparison. Like the United States, it is separated from China by an ocean and is run by a conservative leader — Scott Morrison, the prime minister. Unlike the United States, it put travel restrictions at the center of its virus response.

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Updated 2020-08-06T22:21:25.187Z

Australian officials noticed in March that the travel restrictions they had announced on Feb. 1 were not preventing the virus from spreading. So they went further.

On March 27, Mr. Morrison announced that Australia would no longer trust travelers to isolate themselves voluntarily. The country would instead mandate that everyone arriving from overseas, including Australian citizens, spend two weeks quarantined in a hotel.

The protocols were strict. As people arrived at an airport, the authorities transported them directly to hotels nearby. People were not even allowed to leave their hotel to exercise. The Australian military helped enforce the rules.

Around the same time, several Australian states with minor outbreaks shut their own borders to keep out Australians from regions with higher rates of infection. That hardening of internal boundaries had not happened since the 1918 flu pandemic, said Ian Mackay, a virologist in Queensland, one of the first states to block entry from other areas.

The United States, by comparison, imposed few travel restrictions, either for foreigners or American citizens. Individual states did little to enforce the rules they did impose.

“People need a bit more than a suggestion to look after their own health,” said Dr. Mackay, who has been working with Australian officials on their pandemic response. “They need guidelines, they need rules — and they need to be enforced.”

Travel restrictions and quarantines were central to the success in controlling the virus in South Korea, Hong Kong, Taiwan and Australia, as well as New Zealand, many epidemiologists believe. In Australia, the number of new cases per day fell more than 90 percent in April. It remained near zero through May and early June, even as the virus surged across much of the United States.

In the past six weeks, Australia has begun to have a resurgence — which itself points to the importance of travel rules. The latest outbreak stems in large part from problems with the quarantine in the city of Melbourne. Compared with other parts of Australia, Melbourne relied more on private security contractors who employed temporary workers — some of whom lacked training and failed to follow guidelines — to enforce quarantines at local hotels. Officials have responded by banning out-of-state travel again and imposing new lockdowns.

Still, the tolls in Australia and the United States remain vastly different. Fewer than 300 Australians have died of complications from Covid-19, the illness caused by the virus. If the United States had the same per capita death rate, about 3,300 Americans would have died, rather than 158,000.

Enacting tough travel restrictions in the United States would not have been easy. It is more integrated into the global economy than Australia is, has a tradition of local policy decisions and borders two other large countries. But there is a good chance that a different version of Mr. Trump’s restrictions — one with fewer holes and stronger quarantines — would have meaningfully slowed the virus’s spread.

Traditionally, public health experts had not seen travel restrictions as central to fighting a pandemic, given their economic costs and the availability of other options, like testing, quarantining and contact tracing, Dr. Baeten, the University of Washington epidemiologist, said. But he added that travel restrictions had been successful enough in fighting the coronavirus around the world that those views may need to be revisited.

“Travel,” he said, “is the hallmark of the spread of this virus around the world.”

ImageWestlake Legal Group merlin_175041549_f4134f61-d95b-4dc5-af99-dfff4e1d68c9-articleLarge How the US Has Uniquely Failed to Control the Coronavirus United States Economy United States Trump, Donald J Tests (Medical) Quarantines Masks Georgia Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV)
Credit…Eve Edelheit for The New York Times

On Jan. 16, nearly a week before the first announced case of the coronavirus in the United States, a German hospital made an announcement. Its researchers had developed a test for the virus, which they described as the world’s first.

The researchers posted the formula for the test online and said they expected that countries with strong public health systems would soon be able to produce their own tests. “We’re more concerned about labs in countries where it’s not that easy to transport samples, or staff aren’t trained that thoroughly, or if there is a large number of patients who have to be tested,” Dr. Christian Drosten, the director of the Institute for Virology at the hospital, known as Charité, in Berlin.

It turned out, however, that the testing problems would not be limited to less-developed countries.

In the United States, the Centers for Disease Control and Prevention developed their own test four days after the German lab did. C.D.C. officials claimed that the American test would be more accurate than the German one, by using three genetic sequences to detect the virus rather than two. The federal government quickly began distributing the American test to state officials.

But the test had a flaw. The third genetic sequence produced inconclusive results, so the C.D.C. told state labs to pause their work. In meetings of the White House’s coronavirus task force, Dr. Robert R. Redfield, the C.D.C. director, played down the problem and said it would soon be solved.

Instead, it took weeks to fix. During that time, the United States had to restrict testing to people who had clear reason to think they had the virus. All the while, the virus was quietly spreading.

By early March, with the testing delays still unresolved, the New York region became a global center of the virus — without people realizing it until weeks later. More widespread testing could have made a major difference, experts said, leading to earlier lockdowns and social distancing and ultimately less sickness and death.

“You can’t stop it if you can’t see it,” Dr. Bruce Aylward, a senior adviser to the director general at the World Health Organization, said.

While the C.D.C. was struggling to solve its testing flaws, Germany was rapidly building up its ability to test. Chancellor Angela Merkel, a chemist by training, and other political leaders were watching the virus sweep across northern Italy, not far from southern Germany, and pushed for a big expansion of testing.

By the time the virus became a problem in Germany, labs around the country had thousands of test kits ready to use. From the beginning, the government covered the cost of the tests. American laboratories often charge patients about $100 for a test.

Without free tests, Dr. Hendrik Streeck, director of the Institute of Virology at the University Hospital Bonn, said at the time, “a young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people.”

Germany was soon far ahead of other countries in testing. It was able to diagnose asymptomatic cases, trace the contacts of new patients and isolate people before they could spread the virus. The country has still suffered a significant outbreak. But it has had many fewer cases per capita than Italy, Spain, France, Britain or Canada — and about one-fifth the rate of the United States.

The United States eventually made up ground on tests. In recent weeks, it has been conducting more per capita than any other country, according to Johns Hopkins researchers.

But now there is a new problem: The virus has grown even more rapidly than testing capacity. In recent weeks, Americans have often had to wait in long lines, sometimes in scorching heat, to be tested.

One measure of the continuing troubles with testing is the percentage of tests that come back positive. In a country that has the virus under control, fewer than 5 percent of tests come back positive, according to World Health Organization guidelines. Many countries have reached that benchmark. The United States, even with the large recent volume of tests, has not.


Percent of coronavirus tests that come back positive

Seven-day averages. Source: Our World in Data. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

“We do have a lot of testing,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “The problem is we also have a lot of cases.”

The huge demand for tests has overwhelmed medical laboratories, and many need days — or even up to two weeks — to produce results. “That really is not useful for public health and medical management,” Ms. Rivers added. While people are waiting for their results, many are also spreading the virus.

In Belgium recently, test results have typically come back in 48 to 72 hours. In Germany and Greece, it is two days. In France, the wait is often 24 hours.

For the first few months of the pandemic, public health experts could not agree on a consistent message about masks. Some said masks reduced the spread of the virus. Many experts, however, discouraged the use of masks, saying — somewhat contradictorily — that their benefits were modest and that they should be reserved for medical workers.

“We don’t generally recommend the wearing of masks in public by otherwise well individuals because it has not been up to now associated with any particular benefit,” Dr. Michael Ryan, a World Health Organization official, said at a March 30 news conference.

His colleague Dr. Maria Van Kerkhove explained that it was important to “prioritize the use of masks for those who need them most.”

The conflicting advice, echoed by the C.D.C. and others, led to relatively little mask wearing in many countries early in the pandemic. But several Asian countries were exceptions, partly because they had a tradition of mask wearing to avoid sickness or minimize the effects of pollution.

By January, mask wearing in Japan was widespread, as it often had been during a typical flu season. Masks also quickly became the norm in much of South Korea, Thailand, Vietnam, Taiwan and China.

In the following months, scientists around the world began to report two strands of evidence that both pointed to the importance of masks: Research showed that the virus could be transmitted through droplets that hang in the air, and several studies found that the virus spread less frequently in places where people were wearing masks.

On one cruise ship that gave passengers masks after somebody got sick, for example, many fewer people became ill than on a different cruise where people did not wear masks.

Consistent with that evidence was Asia’s success in holding down the number of cases (after China’s initial failure to do so). In South Korea, the per capita death rate is about one-eightieth as large as in the United States; Japan, despite being slow to enact social distancing, has a death rate about one-sixtieth as large.

“We should have told people to wear cloth masks right off the bat,” Dr. George Rutherford of the University of California, San Francisco, said.

In many countries, officials reacted to the emerging evidence with a clear message: Wear a mask.

Prime Minister Justin Trudeau of Canada began wearing one in May. During a visit to an elementary school, President Emmanuel Macron of France wore a French-made blue mask that complemented his suit and tie. Zuzana Caputova, the president of Slovakia, created a social media sensation by wearing a fuchsia-colored mask that matched her dress.

In the United States, however, masks did not become a fashion symbol. They became a political symbol.

Mr. Trump avoided wearing one in public for months. He poked fun at a reporter who wore one to a news conference, asking the reporter to take it off and saying that wearing one was “politically correct.” He described former Vice President Joseph R. Biden Jr.’s decision to wear one outdoors as “very unusual.”

Many other Republicans and conservative news outlets, like Fox News, echoed his position. Mask wearing, as a result, became yet another partisan divide in a highly polarized country.

Throughout much of the Northeast and the West Coast, more than 80 percent of people wore masks when within six feet of someone else. In more conservative areas, like the Southeast, the share was closer to 50 percent.

A March survey found that partisanship was the biggest predictor of whether Americans regularly wore masks — bigger than their age or whether they lived in a region with a high number of virus cases. In many of the places where people adopted a hostile view of masks, including Texas and the Southeast, the number of virus cases began to soar this spring.

Credit…Anna Moneymaker for The New York Times

Throughout March and April, Gov. Brian Kemp of Georgia and staff members held long meetings inside a conference room at the State Capitol in Atlanta. They ordered takeout lunches from local restaurants like the Varsity and held two daily conference calls with the public health department, the National Guard and other officials.

One of the main subjects of the meetings was when to end Georgia’s lockdown and reopen the state’s economy. By late April, Mr. Kemp decided that it was time.

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Georgia had not met the reopening criteria laid out by the Trump administration (and many outside health experts considered those criteria too lax). The state was reporting about 700 new cases a day, more than when it shut down on April 3.

Nonetheless, Mr. Kemp went ahead. He said that Georgia’s economy could not wait any longer, and it became one of the first states to reopen.

“I don’t give a damn about politics right now,” he said at an April 20 news conference announcing the reopening. He went on to describe business owners with employees at home who were “going broke, worried about whether they can feed their children, make the mortgage payment.”

Four days later, across Georgia, barbers returned to their chairs, wearing face masks and latex gloves. Gyms and bowling alleys were allowed to reopen, followed by restaurants on April 27. The stay-at-home order expired at 11:59 p.m. on April 30.

Mr. Kemp’s decision was part of a pattern: Across the United States, caseloads were typically much higher when the economy reopened than in other countries.


The United States reopened with more cases

Other countries relaxed their restrictions to America’s current level with far fewer cases per million.

Source: Oxford Covid-19 Government Response Tracker, New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 that have a population of at least 10 million people. Japan and Sweden never reached a high enough stringency level to be included.

As the United States endured weeks of closed stores and rising unemployment this spring, many politicians — particularly Republicans, like Mr. Kemp — argued that there was an unavoidable trade-off between public health and economic health. And if crushing the virus meant ruining the economy, maybe the side effects of the treatment were worse than the disease.

Dan Patrick, the Republican lieutenant governor of Texas, put the case most bluntly, and became an object of scorn, especially from the political left, for doing so. “There are more important things than living,” Mr. Patrick said in a television interview the same week that Mr. Kemp reopened Georgia.

It may have been an inartful line, but Mr. Patrick’s full argument was not wholly dismissive of human life. He was instead suggesting that the human costs of shutting down the economy — the losses of jobs and income and the associated damages to living standards and people’s health — were greater than the costs of a virus that kills only a small percentage of people who get it.

“We are crushing the economy,” he said, citing the damage to his own children and grandchildren. “We’ve got to take some risks and get back in the game and get this country back up and running.”

The trouble with the argument, epidemiologists and economists agree, was that public health and the economy’s health were not really in conflict.

Early in the pandemic, Austan Goolsbee, a University of Chicago economist and former Obama administration official, proposed what he called the first rule of virus economics: “The best way to fix the economy is to get control of the virus,” he said. Until the virus was under control, many people would be afraid to resume normal life and the economy would not function normally.

The events of the last few months have borne out Mr. Goolsbee’s prediction. Even before states announced shutdown orders in the spring, many families began sharply reducing their spending. They were responding to their own worries about the virus, not any official government policy.

And the end of lockdowns, like Georgia’s, did not fix the economy’s problems. It instead led to a brief increase in spending and hiring that soon faded.

In the weeks after states reopened, the virus began surging. Those that opened earliest tended to have worse outbreaks, according to a Times analysis. The Southeast fared especially badly.

States that reopened earlier are seeing bigger outbreaks

⟵ Reopened later Reopened earlier ⟶ //x Axis //yAxis 50 days since reopening 70 90 110 100 200 300 400Avg. new cases per million now Alabama Arizona California Florida Georgia Louisiana Michigan Mississippi Missouri Nevada New Jersey New York Oklahoma Texas

In June and July, Georgia reported more than 125,000 new virus cases, turning it into one of the globe’s new hot spots. That was more new cases than Canada, France, Germany, Italy, Japan and Australia combined during that time frame.

Americans, frightened by the virus’s resurgence, responded by visiting restaurants and stores less often. The number of Americans filing new claims for unemployment benefits has stopped falling. The economy’s brief recovery in April and May seems to have petered out in June and July.

In large parts of the United States, officials chose to reopen before medical experts thought it wise, in an attempt to put people back to work and spark the economy. Instead, the United States sparked a huge new virus outbreak — and the economy did not seem to benefit.

“Politicians are not in control,” Mr. Goolsbee said. “They got all the illness and still didn’t fix their economies.”

The situation is different in the European Union and other regions that have had more success reducing new virus cases. Their economies have begun showing some promising signs, albeit tentative ones. In Germany, retail sales and industrial production have risen, and the most recent unemployment rate was 6.4 percent. In the United States, it was 11.1 percent.

Credit…Hiroko Masuike/The New York Times

The United States has not performed uniquely poorly on every measure of the virus response.

Mask wearing is more common than throughout much of Scandinavia and Australia, according to surveys by YouGov and Imperial College London. The total death rate is still higher in Spain, Italy and Britain.

But there is one way — in addition to the scale of the continuing outbreaks and deaths — that the United States stands apart: In no other high-income country have the messages from political leaders been nearly so mixed and confusing.

These messages, in turn, have been amplified by television stations and websites friendly to the Republican Party, especially Fox News and the Sinclair Broadcast Group, which operates almost 200 local stations. To anybody listening to the country’s politicians or watching these television stations, it would have been difficult to know how to respond to the virus.

Mr. Trump’s comments, in particular, have regularly contradicted the views of scientists and medical experts.

The day after the first American case was diagnosed, he said, “We have it totally under control.” In late February, he said: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” Later, he incorrectly stated that any American who wanted a test could get one. On July 28, he falsely proclaimed that “large portions of our country” were “corona-free.”

He has also promoted medical misinformation about the virus. In March, Mr. Trump called it “very mild” and suggested it was less deadly than the common flu. He has encouraged Americans to treat it with the antimalarial drug hydroxychloroquine, despite a lack of evidence about its effectiveness and concerns about its safety. At one White House briefing, he mused aloud about injecting people with disinfectant to treat the virus.

These comments have helped create a large partisan divide in the country, with Republican-leaning voters less willing to wear masks or remain socially distant. Some Democratic-leaning voters and less political Americans, in turn, have decided that if everybody is not taking the virus seriously, they will not either. State leaders from both parties have sometimes created so many exceptions about which workplaces can continue operating normally that their stay-at-home orders have had only modest effects.

“It doesn’t seem we have had the same unity of purpose that I would have expected,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “You need everyone to come together to accomplish something big.”

Across much of Europe and Asia, as well as in Canada, Australia and elsewhere, leaders have delivered a consistent message: The world is facing a deadly virus, and only careful, consistent action will protect people.

Many of those leaders have then pursued aggressive action. Mr. Trump and his top aides, by contrast, persuaded themselves in April that the virus was fading. They have also declined to design a national strategy for testing or other virus responses, leading to a chaotic mix of state policies.

“If you had to summarize our approach, it’s really poor federal leadership — disorganization and denial,” said Andy Slavitt, who ran Medicare and Medicaid from 2015 to 2017. “Watch Angela Merkel. Watch how she communicates with the public. Watch how Jacinda Ardern in New Zealand does it. They’re very clear. They’re very consistent about what the most important priorities are.”

New York — both the city and the state — offers a useful case study. Like much of Europe, New York responded too slowly to the first wave of the virus. As late as March 15, Mayor Bill de Blasio encouraged people to go to their neighborhood bar.

Soon, the city and state were overwhelmed. Ambulances wailed day and night. Hospitals filled to the breaking point. Gov. Andrew M. Cuomo — a Democrat, like Mr. de Blasio — was slow to protect nursing home residents, and thousands died. Earlier action in New York could have saved a significant number of lives, epidemiologists say.

By late March, however, New York’s leaders understood the threat, and they reversed course.

They insisted that people stay home. They repeated the message every day, often on television. When other states began reopening, New York did not. “You look at the states that opened fast without metrics, without guardrails, it’s a boomerang,” Mr. Cuomo said on June 4.

The lockdowns and the consistent messages had a big effect. By June, New York and surrounding states had some of the lowest rates of virus spread in the country. Across much of the Southeast, Southwest and West Coast, on the other hand, the pandemic was raging.

Many experts now say that the most disappointing part of the country’s failure is that the outcome was avoidable.

What may not have been avoidable was the initial surge of the virus: The world’s success in containing previous viruses, like SARS, had lulled many people into thinking a devastating pandemic was unlikely. That complacency helps explains China’s early mistakes, as well as the terrible death tolls in the New York region, Italy, Spain, Belgium, Britain and other parts of Europe.

But these countries and dozens more — as well as New York — have since shown that keeping the virus in check is feasible.

For all of the continuing uncertainty about how this new coronavirus is transmitted and how it affects the human body, much has become clear. It often spreads indoors, with close human contact. Talking, singing, sneezing and coughing play a major role in transmission. Masks reduce the risk. Restarting normal activity almost always leads to new cases that require quick action — testing, tracing of patients and quarantining — to keep the virus in check.

When countries and cities have heeded these lessons, they have rapidly reduced the spread of the virus and been able to move back, gingerly, toward normal life. In South Korea, fans have been able to attend baseball games in recent weeks. In Denmark, Italy and other parts of Europe, children have returned to school.

In the United States, the virus continues to overwhelm daily life.

“This isn’t actually rocket science,” said Dr. Thomas R. Frieden, who ran the New York City health department and the C.D.C. for a combined 15 years. “We know what to do, and we’re not doing it.”

Contributing reporting were Damien Cave, J. David Goodman, Sarah Mervosh, Monika Pronczuk and Motoko Rich.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

The Unique U.S. Failure to Control the Virus

Nearly every country has struggled to contain the coronavirus and made mistakes along the way.

China committed the first major failure, silencing doctors who tried to raise alarms about the virus and allowing it to escape from Wuhan. Much of Europe went next, failing to avoid enormous outbreaks. Today, many countries — Japan, Canada, France, Australia and more — are coping with new increases in cases after reopening parts of society.

Yet even with all of these problems, one country stands alone, as the only affluent nation to have suffered a severe, sustained outbreak for more than four months: the United States.

When it comes to the virus, the United States has come to resemble not the wealthy and powerful countries to which it is often compared but instead to far poorer countries, like Brazil, Peru and South Africa, or those with large migrant populations, like Bahrain and Oman.

As in several of those other countries, the toll of the virus in the United States has fallen disproportionately on poorer people and groups that have long suffered discrimination. Black and Latino residents of the United States have contracted the virus at roughly three times as high of a rate as white residents.

How did this happen? The New York Times set out to reconstruct the unique failure of the United States, through numerous interviews with scientists and public health experts around the world. The reporting points to two central themes.

First, the United States faced longstanding challenges in confronting a major pandemic. It is a large country at the nexus of the global economy, with a tradition of prioritizing individualism over government restrictions. That tradition is one reason the United States suffers from an unequal health care system that has long produced worse medical outcomes — including higher infant mortality and diabetes rates and lower life expectancy — than in most other rich countries.

“As an American, I think there is a lot of good to be said about our libertarian tradition,” Dr. Jared Baeten, an epidemiologist and vice dean at the University of Washington School of Public Health, said. “But this is the consequence — we don’t succeed as well as a collective.”

The second major theme is one that public health experts often find uncomfortable to discuss because many try to steer clear of partisan politics. But many agree that the poor results in the United States stem in substantial measure from the performance of the Trump administration.

In no other high-income country — and in only a few countries, period — have political leaders departed from expert advice as frequently and significantly as the Trump administration. President Trump has said the virus was not serious; predicted it would disappear; spent weeks questioning the need for masks; encouraged states to reopen even with large and growing caseloads; and promoted medical disinformation.

In recent days, Mr. Trump has continued the theme, offering a torrent of misleading statistics in his public appearances that make the situation sound less dire than it is.

Some Republican governors have followed his lead and also played down the virus, while others have largely followed the science. Democratic governors have more reliably heeded scientific advice, but their performance in containing the virus has been uneven.

“In many of the countries that have been very successful they had a much crisper strategic direction and really had a vision,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security, who wrote a guide to reopening safely for the American Enterprise Institute, a conservative research group. “I’m not sure we ever really had a plan or a strategy — or at least it wasn’t public.”

Together, the national skepticism toward collective action and the Trump administration’s scattered response to the virus have contributed to several specific failures and missed opportunities, Times reporting shows:

  • a lack of effective travel restrictions;

  • repeated breakdowns in testing;

  • confusing advice about masks;

  • a misunderstanding of the relationship between the virus and the economy;

  • and inconsistent messages from public officials.

Already, the American death toll is of a different order of magnitude than in most other countries. With only 4 percent of the world’s population, the United States has accounted for 22 percent of coronavirus deaths. Canada, a rich country that neighbors the United States, has a per capita death rate about half as large. And these gaps may worsen in coming weeks, given the lag between new cases and deaths.


Daily deaths per million in wealthy countries

Source: New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

For many Americans who survive the virus or do not contract it, the future will bring other problems. Many schools will struggle to open. And the normal activities of life — family visits, social gatherings, restaurant meals, sporting events — may be more difficult in the United States than in any other affluent country.

In retrospect, one of Mr. Trump’s first policy responses to the virus appears to have been one of his most promising.

On Jan. 31, his administration announced that it was restricting entry to the United States from China: Many foreign nationals — be they citizens of China or other countries — would not be allowed into the United States if they had been to China in the previous two weeks.

It was still early in the spread of the virus. The first cases in Wuhan, China, had been diagnosed about a month before, and the first announced case in the United States had come on Jan. 21. In announcing the new travel policy, Alex M. Azar II, the secretary of health and human services, declared that the virus posed “a public health emergency.” Mr. Trump described the policy as his “China ban.”

After the Trump administration acted, several other countries quickly announced their own restrictions on travel from China, including Japan, Vietnam and Australia.

But it quickly became clear that the United States’ policy was full of holes. It did not apply to immediate family members of American citizens and permanent residents returning from China, for example. In the two months after the policy went into place, almost 40,000 people arrived in the United States on direct flights from China.

Even more important, the policy failed to take into account that the virus had spread well beyond China by early February. Later data would show that many infected people arriving in the United States came from Europe. (The Trump administration did not restrict travel from Europe until March and exempted Britain from that ban despite a high infection rate there.)

The administration’s policy also did little to create quarantines for people who entered the United States and may have had the virus.

Authorities in some other places took a far more rigorous approach to travel restrictions.

South Korea, Hong Kong and Taiwan largely restricted entry to residents returning home. Those residents then had to quarantine for two weeks upon arrival, with the government keeping close tabs to ensure they did not leave their home or hotel. South Korea and Hong Kong also tested for the virus at the airport and transferred anyone who was positive to a government facility.

Australia offers a telling comparison. Like the United States, it is separated from China by an ocean and is run by a conservative leader — Scott Morrison, the prime minister. Unlike the United States, it put travel restrictions at the center of its virus response.

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Updated 2020-08-06T10:04:45.639Z

Australian officials noticed in March that the travel restrictions they had announced on Feb. 1 were not preventing the virus from spreading. So they went further.

On March 27, Mr. Morrison announced that Australia would no longer trust travelers to isolate themselves voluntarily. The country would instead mandate that everyone arriving from overseas, including Australian citizens, spend two weeks quarantined in a hotel.

The protocols were strict. As people arrived at an airport, the authorities transported them directly to hotels nearby. People were not even allowed to leave their hotel to exercise. The Australian military helped enforce the rules.

Around the same time, several Australian states with minor outbreaks shut their own borders to keep out Australians from regions with higher rates of infection. That hardening of internal boundaries had not happened since the 1918 flu pandemic, said Ian Mackay, a virologist in Queensland, one of the first states to block entry from other areas.

The United States, by comparison, imposed few travel restrictions, either for foreigners or American citizens. Individual states did little to enforce the rules they did impose.

“People need a bit more than a suggestion to look after their own health,” said Dr. Mackay, who has been working with Australian officials on their pandemic response. “They need guidelines, they need rules — and they need to be enforced.”

Travel restrictions and quarantines were central to the success in controlling the virus in South Korea, Hong Kong, Taiwan and Australia, as well as New Zealand, many epidemiologists believe. In Australia, the number of new cases per day fell more than 90 percent in April. It remained near zero through May and early June, even as the virus surged across much of the United States.

In the past six weeks, Australia has begun to have a resurgence — which itself points to the importance of travel rules. The latest outbreak stems in large part from problems with the quarantine in the city of Melbourne. Compared with other parts of Australia, Melbourne relied more on private security contractors who employed temporary workers — some of whom lacked training and failed to follow guidelines — to enforce quarantines at local hotels. Officials have responded by banning out-of-state travel again and imposing new lockdowns.

Still, the tolls in Australia and the United States remain vastly different. Fewer than 300 Australians have died of complications from Covid-19, the illness caused by the virus. If the United States had the same per capita death rate, about 3,300 Americans would have died, rather than 158,000.

Enacting tough travel restrictions in the United States would not have been easy. It is more integrated into the global economy than Australia is, has a tradition of local policy decisions and borders two other large countries. But there is a good chance that a different version of Mr. Trump’s restrictions — one with fewer holes and stronger quarantines — would have meaningfully slowed the virus’s spread.

Traditionally, public health experts had not seen travel restrictions as central to fighting a pandemic, given their economic costs and the availability of other options, like testing, quarantining and contact tracing, Dr. Baeten, the University of Washington epidemiologist, said. But he added that travel restrictions had been successful enough in fighting the coronavirus around the world that those views may need to be revisited.

“Travel,” he said, “is the hallmark of the spread of this virus around the world.”

ImageWestlake Legal Group merlin_175041549_f4134f61-d95b-4dc5-af99-dfff4e1d68c9-articleLarge The Unique U.S. Failure to Control the Virus United States Trump, Donald J Tests (Medical) Quarantines Masks Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV)
Credit…Eve Edelheit for The New York Times

On Jan. 16, nearly a week before the first announced case of the coronavirus in the United States, a German hospital made an announcement. Its researchers had developed a test for the virus, which they described as the world’s first.

The researchers posted the formula for the test online and said they expected that countries with strong public health systems would soon be able to produce their own tests. “We’re more concerned about labs in countries where it’s not that easy to transport samples, or staff aren’t trained that thoroughly, or if there is a large number of patients who have to be tested,” Dr. Christian Drosten, the director of the Institute for Virology at the hospital, known as Charite, in Berlin.

It turned out, however, that the testing problems would not be limited to less-developed countries.

In the United States, the Centers for Disease Control and Prevention developed their own test four days after the German lab did. C.D.C. officials claimed that the American test would be more accurate than the German one, by using three genetic sequences to detect the virus rather than two. The federal government quickly began distributing the American test to state officials.

But the test had a flaw. The third genetic sequence produced inconclusive results, so the C.D.C. told state labs to pause their work. In meetings of the White House’s coronavirus task force, Dr. Robert R. Redfield, the C.D.C. director, played down the problem and said it would soon be solved.

Instead, it took weeks to fix. During that time, the United States had to restrict testing to people who had clear reason to think they had the virus. All the while, the virus was quietly spreading.

By early March, with the testing delays still unresolved, the New York region became a global center of the virus — without people realizing it until weeks later. More widespread testing could have made a major difference, experts said, leading to earlier lockdowns and social distancing and ultimately less sickness and death.

“You can’t stop it if you can’t see it,” Dr. Bruce Aylward, a senior adviser to the director general at the World Health Organization, said.

While the C.D.C. was struggling to solve its testing flaws, Germany was rapidly building up its ability to test. Chancellor Angela Merkel, a chemist by training, and other political leaders were watching the virus sweep across northern Italy, not far from southern Germany, and pushed for a big expansion of testing.

By the time the virus became a problem in Germany, labs around the country had thousands of test kits ready to use. From the beginning, the government covered the cost of the tests. American laboratories often charge patients about $100 for a test.

Without free tests, Dr. Hendrik Streeck, director of the Institute of Virology at the University Hospital Bonn, said at the time, “a young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people.”

Germany was soon far ahead of other countries in testing. It was able to diagnose asymptomatic cases, trace the contacts of new patients and isolate people before they could spread the virus. The country has still suffered a significant outbreak. But it has had many fewer cases per capita than Italy, Spain, France, Britain or Canada — and about one-fifth the rate of the United States.

The United States eventually made up ground on tests. In recent weeks, it has been conducting more per capita than any other country, according to Johns Hopkins researchers.

But now there is a new problem: The virus has grown even more rapidly than testing capacity. In recent weeks, Americans have often had to wait in long lines, sometimes in scorching heat, to be tested.

One measure of the continuing troubles with testing is the percentage of tests that come back positive. In a country that has the virus under control, fewer than 5 percent of tests come back positive, according to World Health Organization guidelines. Many countries have reached that benchmark. The United States, even with the large recent volume of tests, has not.


Percent of coronavirus tests that come back positive

Seven-day averages. Source: Our World in Data. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

“We do have a lot of testing,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “The problem is we also have a lot of cases.”

The huge demand for tests has overwhelmed medical laboratories, and many need days — or even up to two weeks — to produce results. “That really is not useful for public health and medical management,” Ms. Rivers added. While people are waiting for their results, many are also spreading the virus.

In Belgium recently, test results have typically come back in 48 to 72 hours. In Germany and Greece, it is two days. In France, the wait is often 24 hours.

For the first few months of the pandemic, public health experts could not agree on a consistent message about masks. Some said masks reduced the spread of the virus. Many experts, however, discouraged the use of masks, saying — somewhat contradictorily — that their benefits were modest and that they should be reserved for medical workers.

“We don’t generally recommend the wearing of masks in public by otherwise well individuals because it has not been up to now associated with any particular benefit,” Dr. Michael Ryan, a World Health Organization official, said at a March 30 news conference.

His colleague Dr. Maria Van Kerkhove explained that it was important to “prioritize the use of masks for those who need them most.”

The conflicting advice, echoed by the C.D.C. and others, led to relatively little mask wearing in many countries early in the pandemic. But several Asian countries were exceptions, partly because they had a tradition of mask wearing to avoid sickness or minimize the effects of pollution.

By January, mask wearing in Japan was widespread, as it often had been during a typical flu season. Masks also quickly became the norm in much of South Korea, Thailand, Vietnam, Taiwan and China.

In the following months, scientists around the world began to report two strands of evidence that both pointed to the importance of masks: Research showed that the virus could be transmitted through droplets that hang in the air, and several studies found that the virus spread less frequently in places where people were wearing masks.

On one cruise ship that gave passengers masks after somebody got sick, for example, many fewer people became ill than on a different cruise where people did not wear masks.

Consistent with that evidence was Asia’s success in holding down the number of cases (after China’s initial failure to do so). In South Korea, the per capita death rate is about one-eightieth as large as in the United States; Japan, despite being slow to enact social distancing, has a death rate about one-sixtieth as large.

“We should have told people to wear cloth masks right off the bat,” Dr. George Rutherford of the University of California, San Francisco, said.

In many countries, officials reacted to the emerging evidence with a clear message: Wear a mask.

Prime Minister Justin Trudeau of Canada began wearing one in May. During a visit to an elementary school, President Emmanuel Macron of France wore a French-made blue mask that complemented his suit and tie. Zuzana Caputova, the president of Slovakia, created a social media sensation by wearing a fuchsia-colored mask that matched her dress.

In the United States, however, masks did not become a fashion symbol. They became a political symbol.

Mr. Trump avoided wearing one in public for months. He poked fun at a reporter who wore one to a news conference, asking the reporter to take it off and saying that wearing one was “politically correct.” He described former Vice President Joseph R. Biden Jr.’s decision to wear one outdoors as “very unusual.”

Many other Republicans and conservative news outlets, like Fox News, echoed his position. Mask wearing, as a result, became yet another partisan divide in a highly polarized country.

Throughout much of the Northeast and the West Coast, more than 80 percent of people wore masks when within six feet of someone else. In more conservative areas, like the Southeast, the share was closer to 50 percent.

A March survey found that partisanship was the biggest predictor of whether Americans regularly wore masks — bigger than their age or whether they lived in a region with a high number of virus cases. In many of the places where people adopted a hostile view of masks, including Texas and the Southeast, the number of virus cases began to soar this spring.

Credit…Anna Moneymaker for The New York Times

Throughout March and April, Gov. Brian Kemp of Georgia and staff members held long meetings inside a conference room at the State Capitol in Atlanta. They ordered takeout lunches from local restaurants like the Varsity and held two daily conference calls with the public health department, the National Guard and other officials.

One of the main subjects of the meetings was when to end Georgia’s lockdown and reopen the state’s economy. By late April, Mr. Kemp decided that it was time.

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Georgia had not met the reopening criteria laid out by the Trump administration (and many outside health experts considered those criteria too lax). The state was reporting about 700 new cases a day, more than when it shut down on April 3.

Nonetheless, Mr. Kemp went ahead. He said that Georgia’s economy could not wait any longer, and it became one of the first states to reopen.

“I don’t give a damn about politics right now,” he said at an April 20 news conference announcing the reopening. He went on to describe business owners with employees at home who were “going broke, worried about whether they can feed their children, make the mortgage payment.”

Four days later, across Georgia, barbers returned to their chairs, wearing face masks and latex gloves. Gyms and bowling alleys were allowed to reopen, followed by restaurants on April 27. The stay-at-home order expired at 11:59 p.m. on April 30.

Mr. Kemp’s decision was part of a pattern: Across the United States, caseloads were typically much higher when the economy reopened than in other countries.


The United States reopened with more cases

Other countries relaxed their restrictions to America’s current level with far fewer cases per million.

Source: Oxford Covid-19 Government Response Tracker, New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 that have a population of at least 10 million people. Japan and Sweden never reached a high enough stringency level to be included.

As the United States endured weeks of closed stores and rising unemployment this spring, many politicians — particularly Republicans, like Mr. Kemp — argued that there was an unavoidable trade-off between public health and economic health. And if crushing the virus meant ruining the economy, maybe the side effects of the treatment were worse than the disease.

Dan Patrick, the Republican lieutenant governor of Texas, put the case most bluntly, and became an object of scorn, especially from the political left, for doing so. “There are more important things than living,” Mr. Patrick said in a television interview the same week that Mr. Kemp reopened Georgia.

It may have been an inartful line, but Mr. Patrick’s full argument was not wholly dismissive of human life. He was instead suggesting that the human costs of shutting down the economy — the losses of jobs and income and the associated damages to living standards and people’s health — were greater than the costs of a virus that kills only a small percentage of people who get it.

“We are crushing the economy,” he said, citing the damage to his own children and grandchildren. “We’ve got to take some risks and get back in the game and get this country back up and running.”

The trouble with the argument, epidemiologists and economists agree, was that public health and the economy’s health were not really in conflict.

Early in the pandemic, Austan Goolsbee, a University of Chicago economist and former Obama administration official, proposed what he called the first rule of virus economics: “The best way to fix the economy is to get control of the virus,” he said. Until the virus was under control, many people would be afraid to resume normal life and the economy would not function normally.

The events of the last few months have borne out Mr. Goolsbee’s prediction. Even before states announced shutdown orders in the spring, many families began sharply reducing their spending. They were responding to their own worries about the virus, not any official government policy.

And the end of lockdowns, like Georgia’s, did not fix the economy’s problems. It instead led to a brief increase in spending and hiring that soon faded.

In the weeks after states reopened, the virus began surging. Those that opened earliest tended to have worse outbreaks, according to a Times analysis. The Southeast fared especially badly.

States that reopened earlier are seeing bigger outbreaks

⟵ Reopened later Reopened earlier ⟶ //x Axis //yAxis 50 days since reopening 70 90 110 100 200 300 400Avg. new cases per million now Alabama Arizona California Florida Georgia Louisiana Michigan Mississippi Missouri Nevada New Jersey New York Oklahoma Texas

In June and July, Georgia reported more than 125,000 new virus cases, turning it into one of the globe’s new hot spots. That was more new cases than Canada, France, Germany, Italy, Japan and Australia combined during that time frame.

Americans, frightened by the virus’s resurgence, responded by visiting restaurants and stores less often. The number of Americans filing new claims for unemployment benefits has stopped falling. The economy’s brief recovery in April and May seems to have petered out in June and July.

In large parts of the United States, officials chose to reopen before medical experts thought it wise, in an attempt to put people back to work and spark the economy. Instead, the United States sparked a huge new virus outbreak — and the economy did not seem to benefit.

“Politicians are not in control,” Mr. Goolsbee said. “They got all the illness and still didn’t fix their economies.”

The situation is different in the European Union and other regions that have had more success reducing new virus cases. Their economies have begun showing some promising signs, albeit tentative ones. In Germany, retail sales and industrial production have risen, and the most recent unemployment rate was 6.4 percent. In the United States, it was 11.1 percent.

Credit…Hiroko Masuike/The New York Times

The United States has not performed uniquely poorly on every measure of the virus response.

Mask wearing is more common than throughout much of Scandinavia and Australia, according to surveys by YouGov and Imperial College London. The total death rate is still higher in Spain, Italy and Britain.

But there is one way — in addition to the scale of the continuing outbreaks and deaths — that the United States stands apart: In no other high-income country have the messages from political leaders been nearly so mixed and confusing.

These messages, in turn, have been amplified by television stations and websites friendly to the Republican Party, especially Fox News and the Sinclair Broadcast Group, which operates almost 200 local stations. To anybody listening to the country’s politicians or watching these television stations, it would have been difficult to know how to respond to the virus.

Mr. Trump’s comments, in particular, have regularly contradicted the views of scientists and medical experts.

The day after the first American case was diagnosed, he said, “We have it totally under control.” In late February, he said: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” Later, he incorrectly stated that any American who wanted a test could get one. On July 28, he falsely proclaimed that “large portions of our country” were “corona-free.”

He has also promoted medical misinformation about the virus. In March, Mr. Trump called it “very mild” and suggested it was less deadly than the common flu. He has encouraged Americans to treat it with the antimalarial drug hydroxychloroquine, despite a lack of evidence about its effectiveness and concerns about its safety. At one White House briefing, he mused aloud about injecting people with disinfectant to treat the virus.

These comments have helped create a large partisan divide in the country, with Republican-leaning voters less willing to wear masks or remain socially distant. Some Democratic-leaning voters and less political Americans, in turn, have decided that if everybody is not taking the virus seriously, they will not either. State leaders from both parties have sometimes created so many exceptions about which workplaces can continue operating normally that their stay-at-home orders have had only modest effects.

“It doesn’t seem we have had the same unity of purpose that I would have expected,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “You need everyone to come together to accomplish something big.”

Across much of Europe and Asia, as well as in Canada, Australia and elsewhere, leaders have delivered a consistent message: The world is facing a deadly virus, and only careful, consistent action will protect people.

Many of those leaders have then pursued aggressive action. Mr. Trump and his top aides, by contrast, persuaded themselves in April that the virus was fading. They have also declined to design a national strategy for testing or other virus responses, leading to a chaotic mix of state policies.

“If you had to summarize our approach, it’s really poor federal leadership — disorganization and denial,” said Andy Slavitt, who ran Medicare and Medicaid from 2015 to 2017. “Watch Angela Merkel. Watch how she communicates with the public. Watch how Jacinda Ardern in New Zealand does it. They’re very clear. They’re very consistent about what the most important priorities are.”

New York — both the city and the state — offers a useful case study. Like much of Europe, New York responded too slowly to the first wave of the virus. As late as March 15, Mayor Bill de Blasio encouraged people to go to their neighborhood bar.

Soon, the city and state were overwhelmed. Ambulances wailed day and night. Hospitals filled to the breaking point. Gov. Andrew M. Cuomo — a Democrat, like Mr. de Blasio — was slow to protect nursing home residents, and thousands died. Earlier action in New York could have saved a significant number of lives, epidemiologists say.

By late March, however, New York’s leaders understood the threat, and they reversed course.

They insisted that people stay home. They repeated the message every day, often on television. When other states began reopening, New York did not. “You look at the states that opened fast without metrics, without guardrails, it’s a boomerang,” Mr. Cuomo said on June 4.

The lockdowns and the consistent messages had a big effect. By June, New York and surrounding states had some of the lowest rates of virus spread in the country. Across much of the Southeast, Southwest and West Coast, on the other hand, the pandemic was raging.

Many experts now say that the most disappointing part of the country’s failure is that the outcome was avoidable.

What may not have been avoidable was the initial surge of the virus: The world’s success in containing previous viruses, like SARS, had lulled many people into thinking a devastating pandemic was unlikely. That complacency helps explains China’s early mistakes, as well as the terrible death tolls in the New York region, Italy, Spain, Belgium, Britain and other parts of Europe.

But these countries and dozens more — as well as New York — have since shown that keeping the virus in check is feasible.

For all of the continuing uncertainty about how this new coronavirus is transmitted and how it affects the human body, much has become clear. It often spreads indoors, with close human contact. Talking, singing, sneezing and coughing play a major role in transmission. Masks reduce the risk. Restarting normal activity almost always leads to new cases that require quick action — testing, tracing of patients and quarantining — to keep the virus in check.

When countries and cities have heeded these lessons, they have rapidly reduced the spread of the virus and been able to move back, gingerly, toward normal life. In South Korea, fans have been able to attend baseball games in recent weeks. In Denmark, Italy and other parts of Europe, children have returned to school.

In the United States, the virus continues to overwhelm daily life.

“This isn’t actually rocket science,” said Dr. Thomas R. Frieden, who ran the New York City health department and the C.D.C. for a combined 15 years. “We know what to do, and we’re not doing it.”

Contributing reporting were Damien Cave, J. David Goodman, Sarah Mervosh, Monika Pronczuk and Motoko Rich.

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Stephen Booth: The UK’s parallel trade negotiations are of unprecedented ambition

Stephen Booth is Head of the Britain in the World Project at Policy Exchange.

Brexit is necessarily reshaping Britain’s trade relationship with the EU. Meanwhile, the UK is simultaneously trying to ensure continuity of, or build upon, existing trade agreements with non-EU countries, such as Japan, and reach entirely new deals with partners including the United States, Australia and New Zealand.

The UK also intends to accede to the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP), which currently includes 11 countries on the Pacific rim including Japan, Australia, New Zealand and Canada.

Predictably, the EU negotiations are set to go down to the wire. Since Boris Johnson became Prime Minister all signs have pointed to a so-called “skinny” free trade agreement (FTA) or none at all. For this Government, Brexit is primarily about establishing sovereign independence, while the EU has sought to underline and assert its role as the dominant regulatory and economic power.

It is no wonder that politics has trumped economics throughout the Brexit process. The EU is a political endeavour pursued by economic means. The €750bn economic recovery plan agreed by EU leaders last month illustrates the extent to which the UK’s preference for confining deeper political and economic integration to the Eurozone faced an uphill struggle had it remained in the bloc. It is impossible to imagine any British government agreeing to such a dramatic expansion of the EU’s financial firepower or the precedent it has set for further moves towards a common EU fiscal policy.

Nevertheless, there are reasons to be cautiously optimistic about a UK-EU deal being reached. The latest negotiating round appeared to mark a breakthrough on governance issues. David Frost’s statement welcomed the EU’s “more pragmatic approach” on the Court of Justice and suggested the UK was ready to consider the EU’s preference for one set of governance arrangements, rather than a suite of separate arrangements.

The remaining sticking points are fishing and state aid. Fishing is not significant in terms of GDP but is politically totemic in the UK and certain EU member states. Therefore, a deal must be left to the last minute. Establishing a “level-playing field” on state aid is proving to be the biggest substantive issue to resolve. The EU is moving away from its request for dynamic alignment and the issue now is what domestic regime the UK will propose.

Negotiations with the US appear to have got off to a good start. However, both sides accept that a deal cannot now be reached until after the US elections in November. Therefore, the most difficult areas, such as agriculture, will not be addressed until later in the year at the earliest.

The most pressing issue Liz Truss, the Trade Secretary, discussed on her trip to Washington earlier this week is the removal of US retaliatory tariffs as part of the ongoing Airbus/Boeing dispute, which sits outside the FTA negotiations. The US has levied tariffs on whisky and further tariffs could be extended to gin and other products if the dispute is not resolved.

The prospect of delay with the US has made UK engagement with the Asia-Pacific countries all the more important and pushed accession to the CPTPP up the agenda. Toshimitsu Motegi, the Japanese Foreign Minister, is in London this week in an attempt to finalise talks on the UK-Japan FTA.

The Japan deal is an important stepping stone towards CPTPP accession, since Japan is the biggest economy within the agreement. The Japan negotiations are working to a condensed timetable because the parties are aiming to ensure a successor to the EU-Japan FTA is in place before the end of the Brexit transition period on January 1, 2021.

The time constraints mean that a UK-Japan deal will be largely modelled on the EU precedent. However, media reports have suggested Japan might be prepared to accelerate tariff cuts for British pork, and Japan is seeking the immediate elimination of car tariffs. The major opportunities for innovation in UK-Japan trade relations is on regulatory cooperation in the services and digital sectors. The FTA can provide the architecture but domestic regulators will need to work together to realise long-term gains.

Another reason why the CPTPP may become increasingly important is that Joe Biden has indicated that he might be prepared to (re-)join the CPTPP if his presidential bid is successful. President Trump pulled out of its previous iteration, the Trans-Pacific Partnership, spearheaded by President Obama. However, this could be a slow process, since Biden’s campaign has also emphasised that his primary focus will be on domestic investment and he has previously suggested he would seek to renegotiate CPTPP if the US were to re-join.

Some have suggested that engaging with the US via the CPTPP rather than bilaterally would defuse some of the thorniest issues, such as agricultural standards on chlorine-washed chicken or hormone-treated beef. However, the reality is that while the optics might be different, the UK will face many of the same substantive trade-offs whoever is president.

The CPTPP rulebook is much closer to the US approach – indeed the World Trade Organisation’s (WTO) approach – to regulating agriculture than we have inherited from the EU. Blanket bans on agricultural imports, not supported by scientific evidence, will not only be viewed as a protectionist move by the US but potentially by other members of the CPTPP.

The question of agricultural liberalisation cannot be ducked for much longer. Equally, as we noted in the recent Policy Exchange paper, The art of the UK-US trade deal, the issue need not be as stark as some of the hyperbole has suggested. The starting points should be to promote consumer choice, while ensuring consumer safety. The UK already has the right, under WTO rules, to prohibit the import of unsafe food. Labelling, either via domestic legislation or voluntary certifications, can be used to inform consumers of food production methods.

The UK’s domestic and international policies must also work in tandem. UK tariff liberalisation can be phased in gradually, giving UK producers time to adjust to new trading conditions. This would reflect the gradual introduction of the UK’s Environmental Land Management scheme, replacing the EU’s Common Agricultural Policy. Meanwhile, it should also be remembered that agricultural liberalisation is an export opportunity for high quality UK products, particularly beef and lamb.

In today’s world, trade agreements do not merely set tariffs or regulate cross-border investment. For medium-sized powers in particular, they are important building blocks for wider political relationships and alliances. However, in order to unlock these relationships, the UK must be willing to live up to its rhetoric on free trade.

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Microsoft Says It’ll Continue Pursuit of TikTok

Westlake Legal Group 02dc-tiktok1-facebookJumbo Microsoft Says It’ll Continue Pursuit of TikTok United States Trump, Donald J Treasury Department TikTok (ByteDance) Social Media Committee on Foreign Investment in the United States (CFIUS) China

Microsoft said on Sunday that it would continue to pursue the purchase of TikTok in the United States after consulting with President Trump, clearing the way for a potential blockbuster deal between the software giant and the viral social media phenomenon.

The announcement came as Mr. Trump has expressed repeated concerns about TikTok and concerns around national security in recent weeks; on Friday, Mr. Trump threatened to ban the app entirely within the United States.

Those plans appeared to change after Satya Nadella, the chief executive of Microsoft, spoke over the weekend with the president, assuaging his worries over the safety of the app.

“Microsoft fully appreciates the importance of addressing the president’s concerns,” the company said in a statement. “It is committed to acquiring TikTok subject to a complete security review and providing proper economic benefits to the United States, including the United States Treasury.”

Microsoft said it would pursue the deal over the coming weeks, and expected to complete the discussions no later than Sept. 15. Such a deal would involve purchasing TikTok offices in the United States, Canada, Australia and New Zealand; ByteDance, the parent company of TikTok, would continue to own the social media app’s offices in Beijing. Microsoft may also bring on a series of outside investors, which would hold minority stakes in any deal.

Tensions among Republican lawmakers, business and the administration spilled into the open over the weekend as Washington awaited a decision from Mr. Trump.

Such a move would have been the latest in a series of punitive actions the Trump administration has taken against China, which the president blames for allowing the coronavirus pandemic to spread and damage the American economy, diminishing his re-election chances. As the election nears, Mr. Trump has increasingly challenged China over security, technology and commercial relations in an attempt to persuade voters that he will be tougher in taking on Beijing than former Vice President Joseph R. Biden Jr.

But a ban on TikTok, which could target its presence in the Apple and Google app stores, would have come with other difficulties, including irking millions of young Americans who share viral videos and dance clips on the service. It also most likely would have prompted legal challenges, angered prominent Republican lawmakers and dismayed the business community.

Several prominent lawmakers and business leaders over the weekend defended Microsoft’s proposed purchase, in a bid to sway the president.

“I was among the first to warn of danger posed by TikTok last year,” Senator Marco Rubio, Republican of Florida, wrote on Twitter on Sunday. “As I have shared with POTUS & @WhiteHouse if the company & data can be purchased & secured by a trusted U.S. company that would be a positive & acceptable outcome.”

Senator Lindsey Graham, Republican of South Carolina, also underlined his concerns with the app’s security, tweeting on Saturday, “President Trump is right to want to make sure that the Chinese Communist Party doesn’t own TikTok and most importantly — all of your private data.”

He added: “What’s the right answer? Have an American company like Microsoft take over TikTok. Win-win. Keeps competition alive and data out of the hands of the Chinese Communist Party.”

Myron Brilliant, the executive vice president of the U.S. Chamber of Commerce, tweeted Sunday that a sale would “be a good solution that helps to address some security concerns, strengthens the US #digitaleconomy, and preserves an app enjoyed by millions of Americans.”

Some of Mr. Trump’s closest political advisers, including Treasury Secretary Steven Mnuchin and Larry Kudlow, the chief of the National Economic Council, had urged the president to allow a sale of TikTok.

On Friday, one senior administration official said the main objection raised internally was Chinese ownership of TikTok. He said he could not explain why there would be objections to any American owner, including Microsoft, as long as the data was stored outside China, and did not run across Chinese switches. Microsoft has a close relationship with the U.S. government, winning a $10 billion cloud computing contract to help modernize the Pentagon last year.

But other administration officials, including some of Mr. Trump’s most hawkish advisers, objected to TikTok’s sale, seeing the moment as an opportunity to push through more expansive measures that could curtail the influence of Chinese apps more broadly.

Speaking on Fox News on Saturday night, Peter Navarro, the White House trade adviser and a noted China critic, criticized the attempted acquisition by Microsoft, saying that Microsoft was “the software that the People’s Liberation Army and Chinese government run on” and that Microsoft helped China build its Great Firewall.

“What this president and the White House is going to be doing is look at any kind of software that sends the information for Americans back to servers in China,” Mr. Navarro said. “They’re going to come under scrutiny.”

David E. Sanger, Alan Rappeport and Maggie Haberman contributed reporting.

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Despite Historic Plunge, Europe’s Economy Flashes Signs of Recovery

Westlake Legal Group despite-historic-plunge-europes-economy-flashes-signs-of-recovery Despite Historic Plunge, Europe’s Economy Flashes Signs of Recovery United States Economy United States International Trade and World Market Europe Economic Conditions and Trends Coronavirus (2019-nCoV)

LONDON — Before the pandemic, a traditional state of play prevailed in the enormous economies on the opposite sides of the Atlantic. Europe — full of older people, and rife with bickering over policy — appeared stagnant. The United States, ruled by innovation and risk-taking, seemed set to grow faster.

But that alignment has been reordered by contrasting approaches to a terrifying global crisis. Europe has generally gotten a handle on the spread of the coronavirus, enabling many economies to reopen while protecting workers whose livelihoods have been menaced. The United States has become a symbol of fecklessness and discord in the face of a grave emergency, yielding deepening worries about the fate of jobs and sustenance.

On Friday, Europe released economic numbers that on their face were terrible. The 19 nations that share the euro currency contracted by 12.1 percent from April to June from the previous quarter — the sharpest decline since 1995, when the data was first collected. Spain fell by a staggering 18.5 percent, and France, one of the eurozone’s largest economies, declined 13.8 percent. Italy shrunk by 12.4 percent.





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Westlake Legal Group eu-gdp-Artboard_1 Despite Historic Plunge, Europe’s Economy Flashes Signs of Recovery United States Economy United States International Trade and World Market Europe Economic Conditions and Trends Coronavirus (2019-nCoV)

Eurozone G.D.P.

Percentage change from previous quarter

Westlake Legal Group eu-gdp-Artboard_2 Despite Historic Plunge, Europe’s Economy Flashes Signs of Recovery United States Economy United States International Trade and World Market Europe Economic Conditions and Trends Coronavirus (2019-nCoV)

Eurozone G.D.P.

Percentage change from previous quarter


Note: Adjusted for inflation and seasonality.

Source: Eurostat

By The New York Times

Europe appeared even worse than the United States, which the day before recorded the single-worst three-month stretch in its history, tumbling by 9.5 percent in the second quarter.

But beneath the headline figures, Europe flashed promising signs of strength.

Germany saw a drop in the numbers of unemployed, surveys found evidence of growing confidence amid an expansion in factory production, while the euro continued to strengthen against the dollar as investment flowed into European markets — signs of improving sentiment.

These contrasting fortunes underscored a central truth of a pandemic that has killed more than 670,000 people worldwide: The most significant cause of the economic pain is the virus itself. Governments that have more adeptly controlled its spread have commanded greater confidence from their citizens and investors, putting their economies in better position to recuperate from the worst global downturn since the Great Depression.

“There is no economic recovery without a controlled health situation,” said Ángel Talavera, lead eurozone economist at Oxford Economics in London. “It’s not a choice between the two.”

ImageWestlake Legal Group merlin_175146681_a203d848-e364-4e08-a9e3-d22cc3a647d6-articleLarge Despite Historic Plunge, Europe’s Economy Flashes Signs of Recovery United States Economy United States International Trade and World Market Europe Economic Conditions and Trends Coronavirus (2019-nCoV)
Credit…Andrew Testa for The New York Times

European confidence has been bolstered by a groundbreaking agreement struck in July within the European Union to sell 750 million euro ($892 million) worth of bonds that are backed collectively by its members. Those funds will be deployed to the hardest hit countries like Italy and Spain.

The deal transcended years of opposition from parsimonious northern European countries like Germany and the Netherlands against issuing common debt. They have balked at putting their taxpayers on the line to bail out southern neighbors like Greece while indulging in crude stereotypes of Mediterranean profligacy. The animosity perpetuated the sense that Europe was a union in name only — a critique that has been muted.

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The United States has spent more than Europe on programs to limit the economic damage of the pandemic. But much of the spending has benefited investors, spurring a substantial recovery in the stock market. Emergency unemployment benefits have proved crucial, enabling tens of millions of jobless Americans to pay rent and buy groceries. But they were set to expire on Friday and there were few signs that Congress would extend them.

Europe’s experience has underscored the virtues of its more generous social welfare programs, including national health care systems.

Americans feel compelled to go to work, even at dangerous places like meatpacking plants, and even when they are ill, because many lack paid sick leave. Yet they also feel pressure to avoid shops, restaurants and other crowded places of business because millions lack health insurance, making hospitalization a financial catastrophe.

Credit…Joseph Rushmore for The New York Times

“Europe has really benefited from having this system that is more heavily dominated by welfare systems than the U.S.,” said Kjersti Haugland, chief economist at DNB Markets, an investment bank in Oslo. “It keeps people less fearful.”

The more promising situation in Europe is neither certain nor comprehensive. Spain remains a grave concern, with the virus spreading, threatening lives and livelihoods. Italy has emerged from the grim calculus of mass death to the chronic condition of persistent economic troubles. Britain’s tragic mishandling of the pandemic has shaken faith in the government.

If short-term factors look more beneficial to European economies, longer-term forces may favor the United States, with its younger population and greater productivity.

A sense of European-American rivalry has been provoked by the bombast of a nationalist American president, making the pandemic a morbid opportunity to keep score.

“There is a certain amount of triumphalism,” said Peter Dixon, a global financial economist at Commerzbank in London. “People are saying, ‘Our economy has survived, we are doing OK.’ There’s a certain amount of European schadenfreude, if I can use that word, given everything that Trump has said about the U.S.”

Credit…Samuel Aranda for The New York Times

But for now, Europe’s moment of confidence is palpable, most prominently in Germany, the continent’s largest economy.

Though the German economy shrank by 10.1 percent from March to June — its worst drop in at least half a century — the number of officially jobless people fell in July, in part because of government programs that have subsidized furloughed workers.

Surveys show that German managers — not a group inclined toward sunny optimism — have seen expectations for future sales return to nearly pre-virus levels. That buoyancy translates directly into growth, emboldening companies to rehire furloughed workers.

Ziehl-Abegg, a maker of ventilation systems for hospitals, factories and large buildings, recently broke ground on a 16 million euro ($19 million) expansion at a factory in southern Germany.

“If we wait to invest until the market recovers, that’s too late,” said Peter Fenkl, the company’s chief executive. “There are billions of dollars in the market ready to be invested and just waiting for the signal to kick off.”

The euro has gained more than 5 percent against the dollar so far this year, according to FactSet. European markets have been lifted by international money flowing into so-called exchange-traded funds that purchase European stocks. The Stoxx 600, an index made up of companies in 17 European countries, appears set for a second straight month of gains outpacing the S&P 500.

Credit…Lena Mucha for The New York Times

The French oil giant Total saw demand for its products in Europe drop by nearly one third in the second quarter of the year, but a powerful recovery has been gaining momentum, said the company’s chairman and chief executive, Patrick Pouyanné.

“Since June, we have seen a rebound here in Europe,” he said during a call with analysts. “Activity in our marketing networks is back to, I would say, 90 percent of the pre-Covid levels.”

France, Europe’s second largest economy, has been buttressed by aggressive government spending. President Emmanuel Macron has mobilized more than 400 billion euros ($476 million) in emergency aid and loan guarantees since the start of the crisis, and is preparing an autumn package worth another 100 billion euros.

Those funds paid businesses not to lay off workers, allowing more than 14 million employees to go on paid furlough, stay in their homes, accumulate modest savings and continue spending. Delayed deadlines for business taxes and loan payments spared companies from collapse.

In the second quarter, when France was still partially locked down, the country’s economy contracted by nearly 14 percent. Tourism, retail and manufacturing, the main pillars of the economy, ground to a halt.

But services, industrial activity and consumer spending have all shown signs of improvement. The Banque de France, which originally expected the economy to shrink more than 10 percent this year, recently forecast less damage.

Credit…Christophe Archambault/Agence France-Presse — Getty Images

In Spain, a sense of recovery remains distant. Its economy shrunk by nearly 19 percent from April to June. The nation’s unemployment rate exceeds 15 percent, and could surge higher if a wage subsidy program for furloughed workers is allowed to expire in September.

Spain officially ended its coronavirus state of emergency on June 21, but has since suffered an increase in infections. The economic impacts have been compounded by Britain’s decision to force travelers returning from Spain to quarantine for two weeks. Tourism accounts for 12 percent of Spain’s economy.

Italy is also highly exposed to tourism. Its industry is concentrated in the north of the country, which saw the worst of coronavirus. The central bank expects the Italian economy to contract by nearly 10 percent this year.

But exports surged more than one-third in May compared with the previous month. That left them below pre-pandemic levels, yet on par with German and American competitors, according to Confindustria, an Italian trade association.

Credit…Alberto Pizzoli/Agence France-Presse — Getty Images

“We are starting to slowly recover after the most violent downfall in the last 70 years,” said Francesco Daveri, an economist at Bocconi University in Milan.

Europe’s fortunes appear on the mend because its people are more likely to trust their governments.

Denmark acted early, imposing a strict lockdown while paying wage subsidies that limited unemployment. Denmark suffered far fewer deaths per capita than the United States and Britain.

With the virus largely controlled, Denmark lifted restrictions earlier, while Danes heeded the call to resume commercial life. The Danish economy is expected to contract by 5.25 percent this year, according to the European Commission, with a substantial improvement in the second half of the year.

In the United States, people have wearied of bewildering and conflicting advice from on high against a backdrop of more than 150,000 deaths.

Credit…Ritzau Scanpix/via Reuters

The result has been record surges of new cases along with a syndrome likely to persist — an aversion to being near other people. That spells leaner prospects for retail, hotels, restaurants and other job-rich areas of the American economy.

Liz Alderman reported from Paris. Emma Bubola contributed reporting from Milan, Raphael Minder from Madrid and Stanley Reed and Eshe Nelson from London.

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More Than Just a Tweet: Trump’s Campaign to Undercut Democracy

Westlake Legal Group 31dc-trump-democracy-facebookJumbo More Than Just a Tweet: Trump’s Campaign to Undercut Democracy Voter Fraud (Election Fraud) United States Politics and Government United States Trump, Donald J Roosevelt, Franklin Delano Presidential Election of 2020 Lincoln, Abraham elections Democracy (Theory and Philosophy) Constitution (US) Clinton, Hillary Rodham Biden, Joseph R Jr

Nothing in the Constitution gives President Trump the power to delay the November election, and even fellow Republicans dismissed it out of hand when he broached it on Thursday. But that was not the point. With a possible defeat looming, the point was to tell Americans that they should not trust their own democracy.

The idea of putting off the vote was the culmination of months of discrediting an election that polls suggest Mr. Trump is currently losing by a wide margin. He has repeatedly predicted “RIGGED ELECTIONS” and a “substantially fraudulent” vote and “the most corrupt election in the history of our country,” all based on false, unfounded or exaggerated claims.

It is the kind of language resonant of conspiracy theorists, cranks and defeated candidates, not an incumbent living in the White House. Never before has a sitting president of the United States sought to undermine public faith in the election system the way Mr. Trump has. He has refused to commit to respecting the results and, even after his election-delay trial balloon was panned by Republican allies, he raised the specter on Thursday evening of months of lawsuits challenging the outcome.

Mr. Trump has put on the line not merely the outcome of this fall’s contest but the credibility of the system as a whole, according to even scholars and operatives normally sympathetic to the president. Just floating the possibility of postponing a presidential election, an idea anathema in America and reminiscent of authoritarian countries without the rule of law, risks eroding the most important ingredient in a democracy — the belief by most Americans that, whatever its manifest flaws, the election result will be fundamentally fair.

“It undermines the faith of the public in our electoral process,” said Jonathan Turley, a George Washington University law professor who testified on Mr. Trump’s side last year during the House impeachment hearings. “Any constitutional system is ultimately held together by a leap of faith. Citizens must trust the process if you want them to yield to it. What the president is doing is seeding distrust about the legitimacy of even the holding of the election.”

Michael J. Gerhardt, a constitutional scholar at the University of North Carolina who testified on the other side in those hearings, said Mr. Trump’s statements were part of a pattern of disdain for the norms that have defined the United States for generations.

“In the long term, I think there’s going to be a lot of institutional damage,” he said, “and the rule of law is going to be undermined to a very large extent.”

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Updated 2020-07-31T00:45:00.642Z

Even some of Mr. Trump’s own current and former advisers see his attacks on the election system as a reflection of fear that he may lose and as a transparent effort to create a narrative to explain that away. Sam Nunberg, an adviser on Mr. Trump’s 2016 campaign, said the president was “trying to get ahead of a potential loss” by blaming it on external factors like the coronavirus.

“What President Trump does not seem to understand is that unlike past experiences where he was able to frame a defeat as a win, there is no spin for losing a re-election as an incumbent president and taking down the Republican Party with him,” Mr. Nunberg said. “Despite what he may believe, even the overwhelming majority of the president’s supporters are not interested in this claptrap.”

He added: “Republican voters and conservative media will ultimately feel that if you cannot beat Joe Biden, you do not deserve another term.”

As recently as April, a Republican National Committee official said former Vice President Joseph R. Biden Jr. was “off his rocker” to suggest that Mr. Trump might seek to “kick back the election somehow.” But in fact, Mr. Trump has a long history of sowing doubt in election results that do not go the way he wants them to go.

When he appeared to be losing to Hillary Clinton in 2016, he repeatedly suggested that the election was being rigged and would not commit to accepting the results — until he won, that is. And even after winning the Electoral College, he insisted that he had actually won the popular vote, too, because three million illegal immigrants had supposedly voted for Mrs. Clinton, a claim seemingly made up out of thin air and one for which his own commission found no evidence.

In 2020 alone, Mr. Trump has already made public comments, posted Twitter messages or reposted others suggesting election fraud 91 times, according to data compiled for The New Yorker by Factba.se, a service that collects and analyzes data on his presidency. Going back to 2012, Factba.se counted 713 instances when Mr. Trump cited vote fraud, spiking especially in 2016 and 2018 before elections in which he had a stake.

Some of Mr. Trump’s allies have said that he has justifiable reasons to raise concerns about widespread mail-in voting being employed in light of the coronavirus pandemic, even though there is a long history of its use without evidence of widespread fraud. And they accuse the Democrats of being the ones unwilling to accept election results when they lose, pointing to the yearslong effort to investigate Russian interference in the 2016 campaign and any ties to Mr. Trump’s organization.

In an interview last year with CBS News, Mrs. Clinton made clear that she considered Mr. Trump’s election shady. “I believe he knows he’s an illegitimate president,” she said.

She is hardly the only defeated candidate to see injustice in her loss. Going back to the early days of the republic, questions have been raised about the legitimacy of presidential victories from those on the losing side.

Andrew Jackson, who won the popular vote and had the most Electoral College votes in 1824 but not a majority in a four-way race, ended up losing to John Quincy Adams when the House decided the matter. Jackson spent the next four years accusing Adams of a making a “corrupt bargain” to secure the support of the third-place candidate, Henry Clay, in exchange for appointment as secretary of state. Jackson got his revenge by beating Adams in an 1828 rematch.

Likewise, Democrats complained when Rutherford B. Hayes won in a disputed election in 1876, calling him Rutherfraud B. Hayes and His Fraudulency. Republicans suspected that John F. Kennedy beat Richard M. Nixon in 1960 thanks to vote fraud in Texas and Illinois, and many Democrats never accepted George W. Bush’s victory over Al Gore in 2000 after the Florida recount was halted by the Supreme Court.

But the complaints do not typically come from the Oval Office, especially before an election has even been held. And no sitting president has made a serious effort to delay his own re-election, not even Abraham Lincoln in 1864 during the Civil War or Franklin D. Roosevelt in 1944 during World War II. Elections were held as scheduled during the pandemics of 1918 and 1968, as well.

Ronald C. White, a prominent Lincoln biographer, noted that the 16th president did not try to postpone the election even though he thought he was likely to lose. Instead, he made it possible for soldiers in the field to cast their ballots, recognizing that they might support their former general, George B. McClellan, who was his Democratic challenger.

“Even as the pandemic, economic collapse and racial protests have Trump calling himself a wartime president, the real wartime president, Lincoln, determined that the election of 1864 must go forward as a sign that the Union would go forward,” Mr. White said.

Jill Lepore, a Harvard University professor and the author of “These Truths: A History of the United States,” said presidents bear a responsibility to foster faith in democracy.

“Far from undermining public confidence in the democracy over which he presides, it is the obligation of every president to cultivate that confidence by guaranteeing voting rights, by condemning foreign interference in American political campaigns, by promoting free, safe and secure elections, and by abiding by their outcome,” she said.

Mr. Trump has for years been drawn to leaders of other countries who did not share that view, especially autocrats like Presidents Vladimir V. Putin of Russia, Recep Tayyip Erdogan of Turkey and Xi Jinping of China. He has expressed admiration for their leadership and envy that in their systems they can be decisive without bureaucratic or political impediments while avoiding criticism of their crackdowns on internal dissent.

For Americans who have made it their mission to encourage free and fair elections in countries like those and elsewhere, Mr. Trump’s suggestion to delay the November vote and his drumbeat of criticism leading up to it sounded like what they confront abroad, not at home

“I have never seen such an effort to sow distrust in our elections,” said Michael J. Abramowitz, the president of Freedom House, a nonpartisan organization that promotes democracy around the world. “We are used to seeing this kind of behavior from authoritarians around the globe, but it is particularly disturbing coming from the president of the United States.”

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European Markets Offering an Alternative to the S&P 500

Westlake Legal Group europe-markets-promo-facebookJumbo European Markets Offering an Alternative to the S&P 500 US Dollar (Currency) United States Stoxx 600 Stocks and Bonds Standard&Poor's 500-Stock Index Futures and Options Trading Europe Euro (Currency) Currency Coronavirus (2019-nCoV)

Scott Thiel can’t remember the last time BlackRock Investment Institute had a positive view on European stocks. It’s been that long.

At the end of June, the research arm of the world’s largest asset manager upgraded its view on European equities to overweight, from underweight, recommending that investors buy more of these stocks. “It’s been a very long time,” said Mr. Thiel, the institute’s chief fixed income strategist.

Europe has a bad rep with investors. For years, asset managers and bank strategists have characterized the region by its anemic growth rate and shaky political union, and steered investors away. Now, a crisis has turned into an unlikely investment opportunity as the region appears to have handled the pandemic better than some other parts of the world. In the past few months, European assets have staged a comeback.

The euro rose to its highest level in more than two years against the U.S. dollar this week, and the region’s benchmark index, the Stoxx 600, is set for a second straight month of gains greater than those of the S&P 500 index, in dollar terms, according to data from FactSet.

The most important reason for this upswing, analysts say, is that Europe is recording far fewer new cases of coronavirus. There are still occasional spikes in Europe, and some early signs that the infection rate is starting to level off in the United States. But there are about 65,000 new cases each day in the United States, compared with fewer than 10,000 new cases across the Atlantic.

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The next reason is politics. When European leaders reached an agreement last week on a 750 billion euro ($888 billion) recovery fund, it wasn’t the size of the deal that impressed investors, but the fact that it happened after four long nights of negotiations. The decision to raise money collectively and give grants to the countries hit hardest by the pandemic was a message that there is some political will left to further the project that created the euro two decades ago. European unity could still be found in an emergency, despite fraying on the edges caused by the exit of Britain from the European Union, budget fights with Italy, and concerns about the dismantling of democracy in Hungary.

“The E.U. recovery fund is a gigantic step forward for Europe,” Mr. Thiel said. “The E.U. has always been an organization that has reacted in times of crises. That’s how they move forward.” This week, the euro climbed to more than $1.18, the highest since June 2018, as demand for the currency and other European assets increased amid expectations that normal economic activity would resume more quickly in the region.

The euro has gained more than 5 percent against the dollar so far this year, according to FactSet data. One way to predict whether this trend will continue is to look at the positions taken by speculative traders — those who seek to make money from short-term market moves — rather than longer-term investors, such as hedge funds.

At the moment, there are far more bets that the euro will rise than bets that the currency will depreciate. This net long position, as it is called, is the largest it has been in more than two years, according to data from the Commodity Futures Trading Commission. As recently as March, traders’ bets that the euro would decline outnumbered those expecting an appreciation.

The recovery fund and expectations of closer fiscal integration should be “a long-term positive” for the euro, Valentin Marinov, a currency strategist at Crédit Agricole, said.

Money from overseas is flowing into exchange-traded funds that buy European stocks, and there are signs that European investors are returning to their home markets and selling dollar-denominated assets, which is strengthening the euro, Mr. Marinov added.

It’s a welcome change for Marcus Morris-Eyton, an asset manager at Allianz Global Investors. “Frustratingly for us, Europe has underperformed for quite a number of years now,” he said. Investors have generally shied away from European stocks, while buying U.S. shares. “That has shown tentative signs of reversing in the last couple of months,” Mr. Morris-Eyton said.

Since late May, Europe’s stock market has recorded stronger gains than the S&P 500 index, after taking the strength of the euro into account.

But over a longer time period, European markets still have a lot of catching up to do. Year to date, the S&P 500 is slightly positive, whereas the Stoxx 600 is down 13.5 percent when calculated in euros, and more than 7 percent in U.S. dollars.

While investors are starting to take advantage of the relative cheapness of European equities, a sustained recovery in either stock market will depend on consumer and business confidence returning, which would in turn stir economic activity. After record-breaking slumps in American and German G.D.P. in the second quarter, economists are watching more recent indicators to see how quickly a recovery might take hold. Even though consumer confidence fell again in July, after rebounding the previous month, in both the euro area and the United States, early signs still favor Europe, several analysts said.

“The U.S., and a number of Asian investors, have turned their eyes toward Europe,” said Sheila Patel, chairman of Goldman Sachs Asset Management. Europe has “been able to deal with the early stages of the crisis and now seems to be containing outbreaks more readily.”

That said, new coronavirus outbreaks are still emerging and raising anxiety about a second pandemic wave in Europe. The number of new cases in Spain led the British government last weekend to suddenly put the country and its surrounding islands back on a quarantine list, even catching off guard a government minister on holiday there. And Germany recorded more than 3,000 new cases in the past week.

This has the potential to undo Europe’s nascent gains. “Public health isn’t just about throwing money at a problem,” Ms. Patel said.

Matt Phillips contributed reporting.

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Ben Roback: Trump’s facing an uphill battle to convince voters he’s the man to bring the US out of the pandemic

Ben Roback is Head of Trade and International Policy at Cicero Group.

There are now fewer than 100 days to go until the November 3rd election. Donald Trump and Joe Biden will invariably describe it as the most important election in a generation, in the same way that Donald Trump and Hillary Clinton did in 2016. This time around, the candidates might be right. The challenges facing the next leader of the free world are stark.

A global health pandemic that continues to ravage the United States; a rampant China and a resurgent Russia; domestic social and racial unrest that is bubbling over now after decades of suppression; an increasingly angry population split more than ever by political anger and culture wars over age-old issues like abortion and LGBT rights and newer dividing lines like monuments and masks.

In that respect, whilst the job for the next President of the United States is daunting, the opportunities are vast. To try and bring the country together is the immediate task for the victor come November. To rally the nation behind a domestic and international strategy for the four years that follow is the great challenge.

With under 100 days until the election, there are three major trends to look out for:

A ‘new Trump’ or the same old ways?

The President is facing an uphill battle to convince voters that he is the man to bring the United States out of the Coronavirus pandemic – evidenced by the firing of Brad Parscale, the President’s election campaign manager. In simpler terms, you don’t sack Jurgen Klopp if his side are top of the Premier League. It was the first major recognition from the White House that their re-election campaign was stuttering. Instead, Bill Stepien, a field director for the 2016 Trump campaign, is tasked with plotting a path to re-election.

Since Stepien’s tenure began, we have seen hints of a different side to the President on COVID-19. Political commentators have flocked to describe the President’s ‘new tone’. They have evidence. Trump has described wearing masks as “patriotic” having previously refrained from doing so in public resolutely. On the resumption of the daily White House COVID-19 press briefings, the President warned the virus may “get worse before it gets better”. His message discipline at the Presidential podium has seemed tighter, with fewer musings seemingly offered at random.

But will it last?

Only yesterday, the President returned to the anti-malarial drug hydroxychloroquine as a way to prevent Coronavirus, contradicting the consistent advice of his own public health officials. Social media posts shared by the President and his son advocating the drug were removed by Facebook and Twitter on the grounds of misinformation. After a period of détente, Dr Anthony Fauci, a lead member of the White House Coronavirus Task Force, has returned as the subject of the President’s indignation. A presidential retweet criticising Fauci for having “misled the public on many issues” remains visible for his 84 million followers. Trump yesterday raged that his approval rating did not match Fauci’s. That ‘new tone’? It might be short-lived.

This is not a president who likes to be controlled or shaped by dictatorial advisers. Sean Spicer learned that the hard way when he was despatched to lie to the press about the size of the Presidential inauguration crowd. Push back against the President and you will be fired. If the polling picture does not improve for the President – and fast – then Stepien might be the next former Trump 2020 campaign manager.

What appears evident is that, unless the White House can be seen to get a tighter grip of case numbers in the United States, the President’s chances of re-election will falter.

Why the Democratic VP pick matters more than normal

What motivates the choice of a running mate? Age. Diversity. Experience. Geographical balance. Popularity. It differs in each election. Although the lack of journalistic rigour at the time makes it hard to verify, VP John Nance Garner is reported to have once famously said that the office of the vice president “is not worth a bucket of warm spit.” This time around it matters more.

The presumptive Democratic nominee, Joe Biden, has confirmed that he will announce his running mate in the first week in August before the Democratic convention (August 17-20). Biden has pledged to name a woman as his running mate and his team has been vetting four African American women understood to be Senator Kamala Harris, former national security adviser Susan Rice, and Reps. Val Demings and Karen Bass.

At 77 years old and – 78 by the time he might assume office – Joe Biden is, respectfully, no spring chicken. For the Biden campaign, his choice of running mate matters more because voters could well be choosing an imminent successor to the President at any given moment. When Barack Obama became president at age 47, voters were not concerned that his age could become a hindrance to his tenure. On that basis, he selected Joe Biden, a political veteran with decades of experience.

Further, mental acuity has become a wedge issue this election. The President has bragged in an interview of his stellar performance in a cognitive test, recalling ‘person, woman, man, camera, TV’ in the correct order. Similarly, the Trump campaign has spent advertising money portraying Joe Biden as forgetful and in poor control of the facts. For these reasons, Biden’s choice of running mate is a hugely significant moment in the election campaign.

Keep one eye on the polls and the other on the map

The polling industry has taken a battering ever since it got – for the majority – Brexit and the 2016 presidential election wrong. But just as night follows day, we all return to the polls as the most reliable reference point for how elections might pan out. There is no proven better alternative.

As such, with fewer than 100 days to go, one eye should be kept on the polls. The Real Clear Politics average (Biden +9) paints a useful national picture, but swing state polling is more important in the electoral college system that operates on a state-by-state basis. What becomes crucial is swing states moving from ‘toss up’ to likely Trump/Biden, as was the case with Florida this week when the Cook Political Report moved it to ‘lean Democrat’.

With one eye on the polls, the other should be focussed on planes, trains and automobiles. Look closely where the Trump and Biden campaigns are going to rally and fundraise (within the current limitations of COVID-19). A defensive strategy by the President suggests he will seek to only defend his 2016 map and not expand on it by focussing on the 2016 swing states that went to Hillary Clinton by five points or fewer. An offensive strategy by the Biden campaign will be visible if he focusses on the traditionally red states that are now in play – like Texas (Trump +0.2) and Georgia (Trump +2.7).

Both men will be desperate to avoid the mistake made by the Clinton campaign in 2016. Wisconsin has been such a reliably Democratic state that Hillary Clinton failed to visit it entirely, the fist major-party nominee since 1972 to do so. Polls put Clinton ahead by over 6 points as election day neared. Then Trump won the state and its 10 electoral college votes. The running joke was that instead of calling her post-election book ‘What Happened’, Hillary Clinton might have called it “Should have Gone to Wisconsin”.

The lesson? Don’t take anything, anywhere for granted. Even the most solidly red or blue states will require attention and the promise of a new injection of political and financial capital. It means both candidates will have to balance shoring up their reliable support with the temptation to campaign in purple states that could possibly tip either way.

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A Viral Epidemic Splintering Into Deadly Pieces

Once again, the coronavirus is ascendant. As infections mount across the country, it is dawning on Americans that the epidemic is now unstoppable, and that no corner of the nation will be left untouched.

As of Tuesday, the pathogen had infected at least 4.3 million Americans, killing almost 150,000. Many experts fear the virus could kill 200,000 or even 300,000 by year’s end. Even President Trump has donned a mask, after resisting for months, and has canceled the Republican National Convention celebrations in Florida.

Each state, each city has its own crisis driven by its own risk factors: vacation crowds in one, bars reopened too soon in another, a revolt against masks in a third.

“We are in a worse place than we were in March,” when the virus coursed through New York, said Dr. Leana S. Wen, a former Baltimore health commissioner. “Back then we had one epicenter. Now we have lots.”

To assess where the country is heading now, The New York Times interviewed 20 public health experts — not just clinicians and epidemiologists, but also historians and sociologists, because the spread of the virus is now influenced as much by human behavior as it is by the pathogen itself.

Not only are American cities in the South and West facing deadly outbreaks like those that struck Northeastern cities in the spring, but rural areas are being hurt, too. In every region, people of color will continue to suffer disproportionately, experts said.

While there may be no appetite for a national lockdown, local restrictions must be tightened when required, the researchers said, and governors and mayors must have identical goals. Testing must become more targeted.

In most states, contact tracing is now moot — there are simply too many cases to track. And while progress has been made on vaccines, none is expected to arrive this winter in time to stave off what many fear will be a new wave of deaths.

Overall, the scientists conveyed a pervasive sense of sadness and exhaustion. Where once there was defiance, and then a growing sense of dread, now there seems to be sorrow and frustration, a feeling that so many funerals never had to happen and that nothing is going well. The United States is a wounded giant, while much of Europe, which was hit first, is recovering and reopeningalthough not to us.

“We’re all incredibly depressed and in shock at how out of control the virus is in the U.S.,” said Dr. Michele Barry, the director of the Center for Innovation in Global Health at Stanford University.

With so much wealth and medical talent, they asked, how could we have done so poorly? How did we fare not just worse than autocratic China and isolated New Zealand, but also worse than tiny, much poorer nations like Vietnam and Rwanda?

“National hubris and belief in American exceptionalism have served us badly,” said Martha L. Lincoln, a medical anthropologist and historian at San Francisco State University. “We were not prepared to see the risk of failure.”

ImageWestlake Legal Group merlin_174267405_2f8e4d59-b785-4231-aea5-476014cc6306-articleLarge A Viral Epidemic Splintering Into Deadly Pieces Ventilators (Medical) Vaccination and Immunization United States Trump, Donald J States (US) Shutdowns (Institutional) Polls and Public Opinion Minorities Medicine and Health Masks Influenza hospitals Health Insurance and Managed Care Gerberding, Julie L Epidemics Deaths (Fatalities) Coronavirus Reopenings Coronavirus (2019-nCoV) Centers for Disease Control and Prevention Allen, Danielle S
Credit…Ryan Christopher Jones for The New York Times

The infection may start in the lungs, but it is very different from influenza, a respiratory virus. In severely ill patients, the coronavirus may attach to receptors inside the veins and arteries, and move on to attack the kidneys, the heart, the gut and even the brain, choking off these organs with hundreds of tiny blood clots.

Most of the virus’s victims are elderly, but it has not spared young adults, especially those with obesity, high blood pressure or diabetes. Adults aged 18 to 49 now account for more hospitalized cases than people aged 50 to 64 or those 65 and older.

Children are usually not harmed by the virus, although clinicians were dismayed to discover a few who were struck by a rare but dangerous inflammatory version. Young children appear to transmit the virus less often than teenagers, which may affect how schools can be opened.

Among adults, a very different picture has emerged. Growing evidence suggests that perhaps 10 percent of the infected account for 80 percent of new transmissions. Unpredictable superspreading events in nursing homes, meatpacking plants, churches, prisons and bars are major drivers of the epidemic.

Thus far, none of the medicines for which hopes were once high — repurposed malaria drugs, AIDS drugs and antivirals — have proved to be rapid cures. One antiviral, remdesivir, has been shown to shorten hospital stays, while a common steroid, dexamethasone, has helped save some severely ill patients.

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Updated 2020-07-29T10:06:27.761Z

One or even several vaccines may be available by year’s end, which would be a spectacular achievement. But by then the virus may have in its grip virtually every village and city on the globe.

Credit…Scott McIntyre for The New York Times

Some experts, like Michael T. Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy, argue that only a nationwide lockdown can completely contain the virus now. Other researchers think that is politically impossible, but emphasize that localities must be free to act quickly and enforce strong measures with support from their state capitols.

Danielle Allen, the director of Harvard University’s Edmond J. Safra Center for Ethics, which has issued pandemic response plans, said that finding less than one case per 100,000 people means a community should continue testing, contact tracing and isolating cases — with financial support for those who need it.

Up to 25 cases per 100,000 requires greater restrictions, like closing bars and limiting gatherings. Above that number, authorities should issue stay-at-home orders, she said.

Testing must be focused, not just offered at convenient parking lots, experts said, and it should be most intense in institutions like nursing homes, prisons, factories or other places at risk of superspreading events.

Testing must be free in places where people are poor or uninsured, such as public housing projects, Native American reservations and churches and grocery stores in impoverished neighborhoods.

None of this will be possible unless the nation’s capacity for testing, a continuing disaster, is greatly expanded. By the end of summer, the administration hopes to start using “pooling,” in which tests are combined in batches to speed up the process.

But the method only works in communities with lower infection rates, where large numbers of pooled tests turn up relatively few positive results. It fails where the virus has spread everywhere, because too many batches turn up positive results that require retesting.

At the moment, the United States tests roughly 800,000 people per day, about 38 percent of the number some experts think is needed.

Above all, researchers said, mask use should be universal indoors — including airplanes, subway cars and every other enclosed space — and outdoors anywhere people are less than six feet apart.

Dr. Emily Landon, an infection control specialist at the University of Chicago Pritzker School of Medicine, said it was “sad that something as simple as a mask got politicized.”

“It’s not a statement, it’s a piece of clothing,” she added. “You get used to it the way you got used to wearing pants.”

Arguments that masks infringe on personal rights must be countered both by legal orders and by persuasion. “We need more credible messengers endorsing masks,” Dr. Wen said — just before the president himself became a messenger.

“They could include C.E.O.s or celebrities or religious leaders. Different people are influencers to different demographics.”

Although this feels like a new debate, it is actually an old one. Masks were common in some Western cities during the 1918 flu pandemic and mandatory in San Francisco. There was even a jingle: “Obey the laws, wear the gauze. Protect your jaws from septic paws.”

“A libertarian movement, the Anti-Mask League, emerged,” Dr. Lincoln of San Francisco State said. “There were fistfights with police officers over it.” Ultimately, city officials “waffled” and compliance faded.

“I wonder what this issue would be like today,” she mused, “if that hadn’t happened.”

Images of Americans disregarding social distancing requirements have become a daily news staple. But the pictures are deceptive: Americans are more accepting of social distancing than the media sometimes portrays, said Beth Redbird, a Northwestern University sociologist who since March has conducted regular surveys of 8,000 adults about the impact of the virus.

“About 70 percent of Americans report using all forms of it,” she said. “And when we give them adjective choices, they describe people who won’t distance as mean, selfish or unintelligent, not as generous, open-minded or patriotic.”

The key predictor, she said in early July, was whether or not the poll respondent trusted Mr. Trump. Those who trusted him were less likely to practice social distancing. That was true of Republicans and independents, “and there’s no such thing as a Democrat who trusts Donald Trump,” she added.

Whether or not people support coercive measures like stay-at-home orders or bar closures depended on how scared the respondent was.

“When rising case numbers make people more afraid, they have more taste for liberty-constraining actions,” Dr. Redbird said. And no economic recovery will occur, she added, “until people aren’t afraid. If they are, they won’t go out and spend money even if they’re allowed to.”

Credit…Erin Trieb for The New York Times

As of Tuesday, new infections were still rising in 28 states, according to a database maintained by The Times.

Weeks ago, experts like Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases, were advising states where the virus was surging to pull back from reopening by closing down bars, forbidding large gatherings and requiring mask usage.

Many of those states are finally taking that advice, but it is not yet clear whether this national change of heart has happened in time to stop the newest wave of deaths from ultimately exceeding the 2,750-a-day peak of mid-April. Through Tuesday, the seven-day average was 1,078 virus deaths nationwide.

Deaths may surge even higher, experts warned, when cold weather, rain and snow force Americans to meet indoors, eat indoors and crowd into public transit.

Oddly, states that are now hard-hit might become safer, some experts suggested. In the South and Southwest, summers are so hot that diners seek air-conditioning indoors, but eating outdoors in December can be pleasant.

Several studies have confirmed transmission in air-conditioned rooms. In one well-known case cluster in a restaurant in Guangzhou, China, researchers concluded that air-conditioners blew around a viral cloud, infecting patrons as far as 10 feet from a sick diner.

Rural areas face another risk. Almost 80 percent of the country’s counties lack even one infectious disease specialist, according to a study led by Dr. Rochelle Walensky, the chief of infectious diseases at Massachusetts General Hospital in Boston.

At the moment, the crisis is most acute in Southern and Southwestern states. But websites that track transmission rates show that hot spots can turn up anywhere. For three weeks, for example, Alaska’s small outbreak has been one of the country’s fastest-spreading, while transmission in Texas and Arizona has dramatically slowed.

Deaths now may rise more slowly than they did in spring, because hospitalized patients are, on average, younger this time. But overwhelmed hospitals can lead to excess deaths from many causes all over a community, as ambulances are delayed and people having health crises avoid hospitals out of fear.

The experts were divided as to what role influenza will play in the fall. A harsh flu season could flood hospitals with pneumonia patients needing ventilators. But some said the flu season could be mild or almost nonexistent this year.

Normally, the flu virus migrates from the Northern Hemisphere to the Southern Hemisphere in the spring — presumably in air travelers — and then returns in the fall, with new mutations that may make it a poor match for the annual vaccine.

But this year, the national lockdown abruptly ended flu transmission in late April, according to weekly Fluview reports from the Centers for Disease Control and Prevention. International air travel has been sharply curtailed, and there has been almost no flu activity in the whole southern hemisphere this year.

Assuming there is still little air travel to the United States this fall, there may be little “reseeding” of the flu virus here. But in case that prediction turns out be wrong, all the researchers advised getting flu shots anyway.

“There’s no reason to be caught unprepared for two respiratory viruses,” said Tara C. Smith, an epidemiologist at Kent State University’s School of Public Health.

Credit…Misha Friedman for The New York Times

Experts familiar with vaccine and drug manufacturing were disappointed that, thus far, only dexamethasone and remdesivir have proved to be effective treatments, and then only partially.

Most felt that monoclonal antibodies — cloned human proteins that can be grown in cell culture — represented the best hope until vaccines arrive. Regeneron, Eli Lilly and other drugmakers are working on candidates.

“They’re promising both for treatment and for prophylaxis, and there are companies with track records and manufacturing platforms,” said Dr. Luciana Borio, a former director of medical and biodefense preparedness at the National Security Council. “But manufacturing capacity is limited.”

According to a database compiled by The Times, researchers worldwide are developing more than 165 vaccine candidates, and 27 are in human trials.

New announcements are pouring in, and the pressure to hurry is intense: The Trump administration just awarded nearly $2 billion to a Pfizer-led consortium that promised 100 million doses by December, assuming trials succeed.

Because the virus is still spreading rapidly, most experts said “challenge trials,” in which a small number of volunteers are vaccinated and then deliberately infected, would probably not be needed.

Absent a known cure, “challenges” can be ethically fraught, and some doctors oppose doing them for this virus. “They don’t tell you anything about safety,” Dr. Borio said.

And when a virus is circulating unchecked, a typical placebo-controlled trial with up to 30,000 participants can be done efficiently, she added. Moderna and Pfizer have already begun such trials.

The Food and Drug Administration has said a vaccine will pass muster even if it is only 50 percent effective. Experts said they could accept that, at least initially, because the first vaccine approved could save lives while testing continued on better alternatives.

“A vaccine doesn’t have to work perfectly to be useful,” Dr. Walensky said. “Even with measles vaccine, you can sometimes still get measles — but it’s mild, and you aren’t infectious.”

“We don’t know if a vaccine will work in older folks. We don’t know exactly what level of herd immunity we’ll need to stop the epidemic. But anything safe and fairly effective should help.”

Still, haste is risky, experts warned, especially when opponents of vaccines are spreading fear. If a vaccine is rushed to market without thorough safety testing and recipients are hurt by it, all vaccines could be set back for years.

Credit…Callaghan O’Hare for The New York Times

No matter what state the virus reaches, one risk remains constant. Even in states with few Black and Hispanic residents, they are usually hit hardest, experts said.

People of color are more likely to have jobs that require physical presence and sometimes close contact, such as construction work, store clerking and nursing. They are more likely to rely on public transit and to live in neighborhoods where grocery stores are scarce and crowded.

They are more likely to live in crowded housing and multigenerational homes, some with only one bathroom, making safe home isolation impossible when sickness strikes. They have higher rates of obesity, high blood pressure, diabetes and asthma.

Federal data gathered through May 28 shows that Black and Hispanic Americans were three times as likely to get infected as their white neighbors, and twice as likely to die, even if they lived in remote rural counties with few Black or Hispanic residents.

“By the time that minority patient sets foot in a hospital, he is already on an unequal footing,” said Elaine Hernandez, a sociologist at Indiana University.

The differences persist even though Black and Hispanic adults drastically altered their behavior. One study found that through the beginning of May, the average Black American practiced more social distancing than the average white American.

Officials in Chicago, Baltimore and other communities faced another threat: rumors flying about social media that Black people were somehow immune.

The top factor making people adopt self-protective behavior is personally knowing someone who fell ill, said Dr. Redbird. By the end of spring, Black and Hispanic Americans were 50 percent more likely than white Americans to know someone who had been ill, her surveys found.

Dr. Hernandez, whose parents live in Arizona, said their neighbors who had not been scared in June had since changed their attitudes.

Her father, a physician, had set an example. Early on, he wore a mask with a silly mustache when he and his wife took walks, and they would decline friends’ invitations, saying, “No, we’re staying in our bubble.”

Now, she said, their neighbors are wearing masks, “and people are telling my father, ‘You were right,’” Dr. Hernandez said.

Credit…Dustin Chambers for The New York Times

There was no widespread agreement among experts about what is likely to happen in the years after the pandemic. Some scientists expected a quick economic recovery; others thought the damage could persist for years.

Working at home will become more common, some predicted, while crowded, open-plan offices may be changed. The just-in-time supply chains on which many businesses depend will need fixing because the processes failed to deliver adequate protective gear, ventilators and test materials.

A disease-modeling system like that used by the National Weather Service to predict storms is needed, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. Right now, the country has surveillance for seasonal flu but no national map tracking all disease outbreaks. As Dr. Thomas R. Frieden, a former C.D.C. director, recently pointed out, states are not even required to track the same data.

Several experts said they assumed that millions of Americans who have been left without health insurance or forced to line up at food banks would vote for politicians favoring universal health care, paid sick leave, greater income equality and other changes.

But given the country’s deep political divisions, no researcher was certain what the outcome of the coming election would be.

Dr. Redbird said her polling of Americans showed “little faith in institutions across the board — we’re not seeing an increase in trust in science or an appetite for universal health care or workers equity.”

The Trump administration did little to earn trust. More than six months into the worst health crisis in a century, Mr. Trump only last week urged Americans to wear masks and canceled the Republican convention in Florida, the kind of high-risk indoor event that states have been banning since mid-March.

“It will probably, unfortunately, get worse before it gets better,” Mr. Trump said at the first of the resurrected coronavirus task force briefings earlier this month, which included no scientists or health officials. The briefings were discontinued in April amid his rosy predications that the epidemic would soon be over.

Mr. Trump has ignored, contradicted or disparaged his scientific advisers, repeatedly saying that the virus simply would go away, touting unproven drugs like hydroxychloroquine even after they were shown to be ineffective and sometimes dangerous, and suggesting that disinfectants or lethal ultraviolet light might be used inside the body.

Millions of Americans have lost their jobs and their health insurance, and are in danger of losing their homes, even as they find themselves in the path of a lethal disease. The Trump presidency “is the symptom of the denigration of science and the gutting of the public contract about what we owe each other as citizens,” said Dr. Joia S. Mukherjee, the chief medical officer of Partners in Health in Boston.

One lesson that will surely be learned is that the country needs to be better prepared for microbial assaults, said Dr. Julie Gerberding, a former director of the C.D.C.

“This is not a once-in-a-century event. It’s a harbinger of things to come.”

Credit…Brittainy Newman/The New York Times

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