Covid-19 Live Updates: N.Y.C. Positivity Rate Ticks Up and Elementary Schools Reopen Doors

SPORTS ROUNDUP

• After an auspicious beginning to the N.F.L. regular season played during a pandemic, the league got news of its first coronavirus outbreak after Week 3’s games. The Tennessee Titans suspended all in-person activities Tuesday after three players and five members of the team’s personnel tested positive, the first such outbreak to hit a team since training camps began in late July. The Minnesota Vikings, who hosted the Titans on Sunday, also shut down in-person activities. “Both clubs are working closely with the N.F.L. and the N.F.L.P.A., including our infectious disease experts, to evaluate close contacts, perform additional testing and monitor developments,” the league said in a joint statement with the players’ union. “All decisions will be made with health and safety as our primary consideration. We will continue to share updates as more information becomes available.”

• After weeks of indecision and discussion, FIFA is planning to order soccer clubs to release players who have been called up for World Cup qualification games next week, a move that is very likely to lead to a furious backlash from teams, leagues and player unions fearful of the risks of international travel during the pandemic. The FIFA demand will come after weeks of unsuccessful talks to find a compromise that addresses concerns about committing players to intercontinental travel amid a global rise in cases, and will apply most notably to South American national teams eager to recall their overseas-based players for the first round of qualifying matches for the 2022 World Cup.

Long before the coronavirus, the Indian Health Service, the U.S. government program that provides health care to the 2.2 million members of tribal communities, was plagued by shortages of funding and supplies.

Now the pandemic has exposed those weaknesses as never before, contributing to the disproportionally high infection and death rates among Native Americans and fueling new anger about what critics say has been decades of neglect from Congress and successive administrations in Washington.

Hospitals waited months for protective equipment, some of which ended up being expired, and had far too few beds and ventilators to handle the flood of Covid-19 patients. The agency failed to tailor health guidance to the reality of life on poverty-wracked reservations.

The virus has killed more than 500 people in the Navajo Nation in the southwestern United States, giving it a death rate higher than New York, Florida and Texas. It has infected more than 10 percent of the small Choctaw tribe of Mississippi.

A New York Times analysis found that the coronavirus positivity rate for Indian Health Service patients in Navajo Nation and the Phoenix area was nearly 20 percent from the start of the pandemic through July, compared with 7 percent nationally during the same period. It is now down to about 14 percent in both areas, nearly three times higher than the current nationwide rate.

Katina Brenn, the school superintendent in Colby, Kan., knows what is supposed to be done when students are exposed to the virus: Quarantine them at home for 14 days.

But what if it’s a quarter of the school?

Colby is a small town in western Kansas, with fewer than 300 students in its close-knit high school. When a girl on the volleyball team tested positive recently, the whole team was sent home to quarantine. Then a football player was exposed, raising concerns about the rest of the squad. Soon, the school was facing having to quarantine as many as 75 students.

The town pushed back. “The parents were upset,” Ms. Brenn said. “They want their kids to get an education.”

She said she heard from parents who were worried that the way things were going, their children would have to be quarantined again and again when someone they knew was potentially exposed — and in Colby, everybody knows everybody.

The pandemic, once mainly an urban problem, has surged across the Great Plains and Upper Midwest in recent weeks, reaching previously unscathed small towns and rural areas. North Dakota, South Dakota and Wisconsin now lead the nation in new cases per capita, and the figures for states like Kansas are as bad as they have ever been.

No one has yet died of Covid-19 in Thomas County, which includes Colby, but there have been 163 coronavirus cases so far among the population of 7,700, and one-third of those cases are new and considered currently active. And the hub of the community is Colby High.

Ms. Brenn said having the schools open for in-person learning was vital, so parents could go to work and keep the town running.

At a recent county meeting, officials agreed to roll back restrictions and allow students who were not directly exposed to a known case and who had no symptoms to return to school.

“Parents really want their children to be at school,” Ms. Brenn said, adding that the school system had taken precautions like hula hoops laid out on gym floors to enforce spacing between students during physical education classes. “We’re really trying to keep our kids safe,” she said. “We think that their schools are their safe place.”

An independent association of health workers in Venezuela reported this week that at least 200 doctors, nurses and health care technicians across the country have died after contracting the coronavirus.

The count by Médicos Unidos Venezuela involves a rare effort to provide greater visibility into how the virus is evolving in Venezuela. Officially, Venezuela’s government says the virus has killed only 12 health workers.

In what critics contend is also a gross undercount, Venezuela officially had 73,528 cases and only 614 deaths as of Monday, far lower than any other large country in Latin America either on a per capita or absolute basis. Neighboring Colombia has reported 818,203 cases and 25,641 deaths.

Public health experts say the Venezuelan government’s repressive measures in response to the pandemic are hampering efforts to accurately assess its impact. Security forces have detained at least 12 doctors and nurses in Venezuela for speaking publicly about the virus, according to medical unions.

Venezuela’s health ministry did not immediately respond to a request for comment.

Dr. Jaime Lorenzo, the director of Médicos Unidos, said the exodus of thousands of health workers from Venezuela in recent years had also constrained efforts to mitigate the spread of the virus in the country.

“The personnel we have left are getting sick as they deal with fatigue and a lack of protective equipment,” Dr. Lorenzo said.

Health care workers have been hit hard by the virus around the world. In a survey of countries in the Western Hemisphere, including the United States, the Pan American Health Organization found that the virus had killed more than 2,500 health workers, the group said this month.

The president of the University of Notre Dame, the Rev. John I. Jenkins, has issued a public apology after coming under criticism for not wearing a mask or adhering to social distancing guidelines during the Supreme Court nomination ceremony over the weekend at the White House for Judge Amy Coney Barrett.

“I failed to lead by example,” Father Jenkins, who is also a philosopher trained in theology and a member of Notre Dame’s philosophy department, said in a letter on Monday to the Notre Dame community. “I especially regret my mistake in light of the sacrifices made on a daily basis by many, particularly our students, in adjusting their lives to observe our health protocols.”

The move by Father Jenkins points to the challenges some public figures face as they promote virus-mitigation efforts. He has repeatedly urged students and staff to hew to social-distancing guidelines but was seen in videos and photographs shaking hands with others and not wearing a mask at the Rose Garden event on Saturday for Judge Barrett, who is a professor at Notre Dame.

In his written apology, Father Jenkins said he was given a rapid coronavirus test upon arriving at the White House. He said he and others were told after receiving negative results that it would be safe to remove their masks. Still, he said following that guidance was a mistake.

In August, Notre Dame became one of the first major universities to resume in-person classes, but had to shift to virtual learning for two weeks this month in response to a spike in coronavirus cases. While Notre Dame has switched again to in-person classes, Father Jenkins said he had decided to quarantine “in an abundance of caution” after returning to the campus from the White House.

Global roundup

• Israel’s second national lockdown is likely to last at least a month and perhaps much longer, Prime Minister Benjamin Netanyahu said on Tuesday, as the country’s soaring infection rate of around 8,000 confirmed new cases a day remained among the highest in the world. “In my opinion it won’t be less than a month and it could take much more time,” Mr. Netanyahu said in reply to a question from a member of the public during a Facebook Live video session. The lockdown came into effect in mid-September, on the eve of the Jewish New Year holiday, and was tightened with new restrictions that came into effect on Friday.

• The authorities in Germany announced a number of new rules to try to halt rising cases while keeping the economy, schools and day care centers open. Group gatherings will be capped at 50 in bars and rented spaces, with a recommendation that private parties be capped at 25. Bars, restaurants, hairdressers and others will be fined a minimum of about $58 if patrons don’t leave required contact data.

• Ontario, the most populous province in Canada, on Monday reported 700 new infections, its highest one-day total. Premier Doug Ford said the province was beginning a second wave that would be worse than the first, but he resisted calls by experts for more stringent health measures. In the neighboring province of Quebec, which has also experienced a surge in infections, Premier François Legault said on Monday that Montreal, Quebec City and the administrative region of Chaudière-Appalaches would be designated as “red zones” for four weeks starting on Thursday. It means home visits will be mostly banned and movie theaters, libraries, museums, bars and casinos will be closed. Restaurants will be limited to takeout service, but schools will remain open.

• The pandemic will keep this year’s economic growth rate in East Asia and the Pacific region to 0.9 percent, the lowest since 1967, the World Bank said in an economic update on Monday. The bank forecast that China — where the virus is contained and spending is recovering, especially among the wealthy — would lead regional growth with a 2 percent expansion, but output in the rest of the region would shrink about 3.5 percent.

• Kenya on Monday extended its nationwide curfew for two months, though it will start two hours later, at 11 p.m. In an address to the nation, President Uhuru Kenyatta also said bars and nightclubs could reopen starting Tuesday. There will be no change to schools, which have been closed since March.

• Twelve crew members on a cruise ship intercepted by the authorities in Greece tested negative for the virus on Tuesday, after initially testing positive. The ship, carrying more than 1,500 people and bound for the Greek island of Corfu, was docked in Piraeus, Greece’s main port.

Almost alone in the Western world, Sweden refused to impose a coronavirus lockdown last spring, as the country’s leading health officials argued that limited restrictions were sufficient and would better protect against economic collapse.

It was an approach that transformed the country into an unlikely ideological lightning rod. Many scientists blamed it for a spike in deaths, even as many libertarians critical of lockdowns portrayed Sweden as a model.

For their part, the Swedes admit to making some mistakes, particularly in nursing homes, where the death toll was staggering. Now, though, the question is whether the country’s current low caseload — compared with sharp increases elsewhere — shows that it has found a sustainable balance, or whether the recent numbers are just a temporary aberration.

With a population of 10.1 million, Sweden averaged just over 200 new cases a day for several weeks, though in recent days that number has jumped to about 380, and critics say the country should test more. The per capita rate is far lower than nearby Denmark or the Netherlands (if higher than the negligible rates in Norway and Finland). Sweden is also doing far better, for the moment, than Spain, with 10,000 cases a day, and France, with 12,000.

In response to the recent outbreaks, many European countries are imposing new restrictions, but avoiding total lockdowns. In essence, some experts say, they are quietly adopting the Swedish approach.

“Today, all of the European countries are more or less following the Swedish model, combined with the testing, tracing and quarantine procedures the Germans have introduced, but none will admit it,” said Antoine Flahault, director of the Institute of Global Health, in Geneva. “Instead, they made a caricature out of the Swedish strategy. Almost everyone has called it inhumane and a failure.”

Negotiators resumed talks on Monday over a coronavirus relief package in a final bid to revive stalled negotiations as House Democrats unveiled a $2.2 trillion coronavirus relief bill that would provide aid to American families, businesses, schools, restaurants and airline workers.

The release of the legislation came minutes before Speaker Nancy Pelosi of California and Steven Mnuchin, the Treasury secretary, spoke on the phone Monday evening, as the pair seeks to end the impasse over another round of aid. Ms. Pelosi and Mr. Mnuchin spoke for about 50 minutes Tuesday morning, said Drew Hammill, a spokesman for Ms. Pelosi, and discussed the new legislation House Democrats had introduced. The pair agreed to speak again on Wednesday.

The moves appeared to be the most concrete action toward another stimulus bill since negotiations stalled nearly two months ago. But the sides remain far apart on an overall price tag, and with just over a month before Election Day, lawmakers and aides in both chambers warned that the time frame for striking a deal was slim.

Absent an agreement with the administration, the House could vote this week to approve the legislation, responding to growing pressure for Congress to provide additional relief and quelling the concerns of moderate lawmakers unwilling to leave Washington for a final stretch of campaigning without voting on another round of aid. But at roughly $1 trillion more than what Mr. Mnuchin has signaled the White House is willing to consider, the package is likely just a starting point, all but guaranteed to be rejected by the Republican majority in the Senate should the House pass it in its current form.

Democrats maintained a provision that would revive a lapsed $600 enhanced federal unemployment benefit and another one that would send a second round of $1,200 stimulus checks to Americans. And some measures were either added or expanded: $225 billion for schools and $57 billion for child care, an extension of an expiring program intended to prevent the layoffs of airline workers through March 31 and the creation of a $120 billion program to bolster ailing restaurants.

In the past two weeks, leading epidemiologists from many respected institutions have, through different methods, reached the same conclusion: About 85 to 90 percent of the American population is still susceptible to SARS-CoV-2, the virus causing the current pandemic.

The number is important because it means that “herd immunity” — the point at which a disease stops spreading because nearly everyone in a population has contracted it — is still very far off.

The evidence — both from antibody testing and from epidemiological modeling — runs strongly counter to a theory being promoted in influential circles that the United States has either already achieved herd immunity or is close to doing so, and that the pandemic is all but over. That conclusion would imply that businesses, schools and restaurants could safely reopen, and that masks and other distancing measures could be abandoned.

“The idea that herd immunity will happen at 10 or 20 percent is just nonsense,” said Dr. Christopher J.L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, which produced the epidemic model frequently cited during White House news briefings as the epidemic hit hard in the spring.

That belief began circulating months ago on conservative news programs like those of Rush Limbaugh and Laura Ingraham. It has been cited several times by Dr. Scott W. Atlas, President Trump’s new pandemic adviser. It appears to be behind Mr. Trump’s recent remarks that the pandemic is “rounding the corner” and “would go away even without the vaccine.”

But it is also gaining credence on Wall Street and among some business executives, said prominent public health experts, who consider the idea scientifically unfounded as well as dangerous; its most vocal adherents are calling for mask-wearing and social distancing to end just as cold weather is shifting social activity indoors, where the risk of transmission is higher.

Even in places where the pandemic hit especially hard — a French aircraft carrier, the Brazilian city of Manaus, the slums of Mumbai and a neighborhood in Queens, N.Y. — infections did not noticeably slow down until almost 60 percent of the inhabitants were infected. And even those levels may not suffice, given that cases are increasing again in Brazil and in Brooklyn, areas that had seen cases spike and then drop off.

A leading humanitarian relief organization issued a sharply critical report Tuesday on what it described as fundamental shortcomings in the global response to the pandemic, punctuated by “absence of global leadership, insufficient funding, and lack of coordination between countries.”

The report by the International Rescue Committee, a group formed during World War II that responds to the most urgent humanitarian crises, said it had calculated that an unprecedented $8 trillion had been committed by governments to domestic economic stimulus packages to counter the pandemic’s effects — but only $48 billion for areas of the world least capable of combating the scourge. The group said the lack of a coordinated approach to the pandemic had led to “dire consequences for millions of the most vulnerable people around the world.”

Within the first few months of lockdown measures this year, the group said, 15 million more known cases of gender-based violence were reported. An additional 70 to 100 million people could be pushed into extreme poverty, it said, and 10 of the world’s most fragile countries could face famine this year or in the first quarter of 2021.

“The international community has both a moral obligation and strategic imperative to support the most vulnerable,” said David Miliband, the president and chief executive of the International Rescue Committee.

Its report, coming as global virus deaths surpassed 1 million, was issued on the final day of the United Nations General Assembly session, held virtually this year because of the pandemic. The 193-member organization’s inability to manage the crisis, which Secretary General António Guterres has called the biggest challenge in U.N. history, has been a recurring theme.

Mr. Guterres’s frustration was evident in his opening remarks on Tuesday to one of the last online sessions of the General Assembly.

“Unless we take action now, we face a global recession that could wipe out decades of development,” Mr. Guterres said.

As obesity continues to climb in the United States, its role in Covid-19 is a thorny scientific question. Recent studies have shown that people with extra weight are more susceptible than others to severe bouts of disease. And experiments in animals and human cells have demonstrated how excess fat can disrupt the immune system.

But the relationship between obesity and Covid-19 is complex, and many mysteries remain. Excess weight tends to go hand in hand with other medical conditions, like high blood pressure and diabetes, which may by themselves make it harder to fight Covid-19.

Obesity also disproportionately affects people who identify as Black or Latino — groups at much higher risk than others of contracting and dying from Covid-19, in large part because of exposure at their workplaces, limited access to medical care and other inequities tied to systemic racism. And people with extra weight must grapple with persistent stigma about their appearance and health, even from doctors, further imperiling their prognoses.

“A new pandemic is now laying itself on top of an ongoing epidemic,” said Dr. Christy Richardson, an endocrinologist at SSM Health in Missouri. Regarding obesity’s effects on infectious disease, she said, “We are still learning, but it’s not difficult to understand how the body can become overwhelmed.”

Like many other conditions that can exacerbate Covid-19, excess weight does not have a quick fix, especially in areas where access to healthy food and opportunities for exercise are vastly uneven among communities.

“If we don’t address these social underpinnings, I think we’ll continue to see a recurrence of what is happening now,” said Dr. Jennifer Woo Baidal, a pediatric weight management specialist at Columbia University.