#childsafety | Trump Covid-19 Live Updates: President Leaves Walter Reed But Isn’t ‘Out of the Woods’


President Trump’s doctors provided the latest developments on the state of his condition as he recovers from coronavirus after misleading accounts of his health over the weekend.CreditCredit…Anna Moneymaker for The New York Times

President Trump’s physician, Dr. Sean P. Conley, said on Monday that the president would return to the White House after having spent three nights at the Walter Reed medical center, although he was not “out of the woods yet” in his fight against Covid-19.

“Over the past 24 hours, the president has continued to improve,” Dr. Conley said. “He’s met or exceeded all standard hospital discharge criteria.”

The president’s doctors evaded some key questions about the president’s condition, including his lung function and the date of his last negative coronavirus test. They said that he had received a third dose of the antiviral drug remdesivir, and that he has continued to take dexamethasone, a steroid drug that has been shown to be beneficial to patients who are very sick with Covid-19.

“We’re looking to this weekend,” Dr. Conley said. “If we can get through to Monday, with him remaining the same or improving better yet, then we will all take that final deep sigh of relief.”

Dr. Conley did not give a firm answer about whether Mr. Trump would be confined to his residence. The West Wing is experiencing a growing outbreak, with Mr. Trump’s press secretary, Kayleigh McEnany, joining the list on Monday of his close aides who tested positive.

The doctors’ remarks came after Mr. Trump tweeted that he would be returning at 6:30 p.m. to the White House, which has a medical suite of its own. In doing so, as he has throughout the pandemic, he downplayed the seriousness of a virus that has killed more than 209,000 people in the United States, writing in his post, “Don’t be afraid of Covid. Don’t let it dominate your life.”

Dr. Conley would not discuss the findings of a scan of Mr. Trump’s lungs, which can be affected by the respiratory virus. His doctors had earlier said that his blood oxygen levels had dropped at least twice, and that he had received supplemental oxygen, which would indicate that his lungs were not functioning properly.

“There are HIPAA rules and regulations that restrict me in sharing certain things for his safety and his own health and reasons,” Dr. Conley said, referring to a federal law that restricts what type of patient information health professionals can share. On Sunday, Dr. Conley was also evasive, avoiding questions about whether any lung damage or pneumonia was revealed by the president’s X-rays.

The announcement was a dramatic turn of events given that just a day earlier, his medical team had presented mixed messages about his condition, saying that the president was feeling well but also revealing that he had been prescribed the steroid dexamethasone, which is typically not used unless someone needs mechanical ventilation or supplemental oxygen.

Some medical experts said on Monday that given Mr. Trump’s risk factors — he is 74, male and overweight — he should be closely watched for at least the first week of his infection because some patients quickly deteriorate several days into their illness.

“I think it would be disastrous to be in a situation where he gets really sick at the White House, and you’re having to emergency transfer him,” said Dr. Céline Gounder, of N.Y.U. Grossman School of Medicine, who has been caring for Covid-19 patients. “To me, it’s not safe.”

Dr. Mangala Narasimhan, director of critical care services for Northwell Health, said that if the president does not need oxygen, it may be reasonable for him to go home, given that he can receive medical treatment at the White House.

But she said the information about his condition was too limited to allow outside experts to assess his condition. “We’re all guessing,” she said.

She, too, warned that Mr. Trump is heading into a critical period. “There could be a very rapid decline in these patients,” she said, adding that some develop blood clots in their lungs and other pulmonary problems, and need to be quickly put on ventilators.

Credit…Doug Mills/The New York Times

President Trump tweeted Monday afternoon that he intended to leave Walter Reed medical center, where he has been receiving treatment since Friday for Covid-19, an illness he downplayed in his post.

Mr. Trump was eager to leave the hospital as soon as possible, as the drama around his treatment and the virus’s toll on the White House continued to mount.

In the morning, the White House shuttled reporters to Walter Reed, where a briefing lectern had been placed, raising speculation about another update from Mr. Trump’s medical team. But the lectern remained covered with a garbage bag through lunchtime.

Amid questions about whether Mr. Trump could relocate to the White House without endangering himself and others came a reminder that the virus may still be spreading through the West Wing and beyond: Mr. Trump’s press secretary, Kayleigh McEnany, announced that she, too, had tested positive for the virus and would be isolating. Ms. McEnany, who said she had previously tested negative several times, spoke briefly to reporters outside the White House on Sunday. She did not wear a mask.

Two more members of the press team, Karoline Leavitt and Chad Gilmartin, who is Ms. McEnany’s relative, also tested positive but learned about their diagnosis prior to Ms. McEnany, according to two people familiar with the diagnosis.

Vice President Mike Pence was not quarantining, and was scheduled to travel to Utah ahead of Wednesday night’s vice-presidential debate. Afterward, Mr. Pence plans to attend campaign events in Arizona and Florida later this week before stopping in his home state of Indiana to vote early.

Mr. Trump had pushed to be discharged earlier on Sunday, according to people familiar with the events, motivated to leave out of a desire to show the country and the world that he is functional and not bedridden by a virus.

But Mr. Trump’s doctors on Sunday did not favor him leaving the hospital to return to the White House. Instead, a decision was made to allow Mr. Trump to be driven slowly by crowds of supporters across the street from the hospital so he could be seen.

Health experts have said the decision was highly unusual for a patient with an infectious illness who is being treated with a therapeutic drug that is administered intravenously.

Based on his doctors’ accounts on Sunday, Mr. Trump’s symptoms appear to have rapidly progressed since he announced early Friday that he had tested positive for the coronavirus.

Mr. Trump had a “high fever” on Friday, and his blood oxygen levels dropped on two occasions, his doctors said, including to a level that can indicate that a patient’s lungs are compromised, a symptom seen in many patients with severe Covid-19.

His doctors said he is also undergoing a five-day antiviral treatment regimen for Covid-19 and that he had been prescribed dexamethasone, a steroid used to head off an immune system overreaction that kills many Covid-19 patients. This is also generally reserved for those with severe illness.

Credit…Doug Mills/The New York Times

Two weeks after the Centers for Disease Control and Prevention removed online guidance about airborne transmission of the coronavirus, the agency has replaced it with language citing new evidence that the virus can spread beyond six feet indoors, adrift in the air.

“These transmissions occurred within enclosed spaces that had inadequate ventilation,” the new guidance said. “Sometimes the infected person was breathing heavily, for example while singing or exercising.”

Notably, the new version is missing a previous statement that said the virus can be “airborne,” a term that would require hospitals to treat infected patients in specialized rooms and health care workers to wear N95 masks anywhere in a hospital.

The new version says the virus can be spread by both larger droplets and smaller aerosols released when people “cough, sneeze, sing, talk, or breathe.” But while the virus can be airborne under some circumstances, this is not the primary way the virus spreads.

The C.D.C.’s revisions arrive as President Trump receives treatment at Walter Reed National Military Medical Center in Bethesda, Md., for what appears to be severe case of Covid-19, the illness caused by the coronavirus.

The administration is contending with a rising number of such infections among Mr. Trump’s inner circle. Kayleigh McEnany, the president’s chief spokeswoman, announced on Monday morning that she was positive for the coronavirus, the latest in a string of political figures heading into isolation following what may have been a so-called superspreader event at the White House earlier this month.

Despite the time former Vice President Joseph R. Biden spent with President Trump during the presidential debate, Mr. Biden is continuing to campaign because he did not meet the C.D.C. requirement for close contact — less than six feet of distance from an infected person.

But in a statement to the press accompanying the new guidance, the C.D.C. said, “People are more likely to become infected the longer and closer they are to a person with Covid-19.”

Mr. Trump talked loudly and at length during the debate, which experts said could have released ten times as much virus as breathing alone.

Credit…Doug Mills/The New York Times

President Trump’s declaration that he will leave Walter Reed National Military Medical Center — and his impromptu ride in a motorcade around Bethesda, Md. — has stunned health professionals. But even if he were not the president, his doctors would have to take extraordinary measures to keep him in the hospital against his will.

Under ordinary circumstances, a patient who wanted to leave the hospital against the recommendation of his or her doctor might be asked to sign a discharge form acknowledging that he or she was declining further treatment. At times, psychiatrists are called in to determine if the patient is capable of making such a decision.

In the medical lexicon, this is called leaving “A.M.A.” — against medical advice. Roughly 2 percent of all patients do so, for varying reasons, often because they need to juggle work and home obligations. If the patient leaving against medical advice had a contagious disease, he or she would be asked to pledge to follow public health guidelines to keep those around him or her safe.

“Having an infectious illness itself is not a reason to keep someone in the hospital,” said Dr. Leana Wen, a former commissioner of health for the city of Baltimore. “But if there is a suspicion that a patient will knowingly and purposefully endanger others, there would need to be a discussion had about keeping that patient in the hospital against his will.”

That discussion would be a complicated legal one, governed by state and local public health laws — and the Constitution. Both Dr. Wen and Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, raised tuberculosis — a highly infectious disease — as an applicable analogy.

In Baltimore, Dr. Wen said, the public health department routinely stepped in to ensure that patients in the hospital for tuberculosis treatment were kept there if “they gave us reason to believe that if they were to leave that they would not take the medications that were prescribed and then they would be at high risk for infecting others.” She said law enforcement often became involved.

In Tennessee, Dr. Schaffner said, doctors would be required to seek permission from a judge. The burden of proof is on the health care system, he said, “to document that the person is a substantial hazard to others and then they can be confined until they complete their therapy.”

The federal Centers for Disease Control and Prevention has published a handbook on tuberculosis control laws as a guide for medical professionals. “Courts have struggled to determine when government authority to promote the population’s health justifies encroaching upon established individual rights,” the handbook says.

The White House physician, Dr. Sean P. Conley, told reporters on Monday that Mr. Trump had not pushed them to “do anything that was beyond safe and reasonable practice.” And he noted that at the White House, Mr. Trump would have “24-7 world class medical care surrounding him.”

Even so, Dr. Conley acknowledged that Mr. Trump is not yet in the clear. Other experts have raised blunt questions about why Mr. Trump would go home — even to the White House— so soon after diagnosis, especially given the unpredictable course of Covid-19.

“I’m worried about in two days he might suddenly crash and then on an emergency basis he would have to be rushed back,” Dr. Schaffner said.

He also raised questions about the president’s ride through Bethesda Sunday afternoon. Ordinarily doctors want patients to self-isolate until they are 10 days from the onset of symptoms, and three days without symptoms.

“I’d be surprised if it were with medical concurrence,” Dr. Schaffner said.




‘Better Safe Than Sorry,’ Cuomo Says After School Closings

Gov. Andrew M. Cuomo of New York announced that he would close schools on Tuesday in areas where there has been a spike in coronavirus cases.

On the schools in these areas not all of them have been tested. So we don’t have data on all of the schools in these hotspot clusters — that troubles me. They have sampled some schools in the clusters, but not all the schools. And these are the hotspot clusters, right? So you have to prioritize testing. You want to go to these schools first because you know they are in hotspot clusters. So some schools in those clusters we have not yet done testing on. Better safe than sorry. I would not send my child to a school in a hotspot cluster that has not been tested, where I did not have proof that the infection rate was low in that school. I would not send my child. I am not going to recommend or allow any New York City family to send their child to a school that I wouldn’t send my child. We’re going to close the schools in those areas tomorrow.

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Gov. Andrew M. Cuomo of New York announced that he would close schools on Tuesday in areas where there has been a spike in coronavirus cases.CreditCredit…Spencer Platt/Getty Images

Gov. Andrew M. Cuomo of New York refused on Monday to allow New York City to close nonessential businesses in nine hot spots in Brooklyn and Queens where the coronavirus has spiked, pre-empting a plan announced the day before by Mayor Bill de Blasio.

The governor’s stance created more confusion over how the authorities intend to tackle early signs of a second wave of the virus in a one-time center of the pandemic.

Mr. Cuomo, a third-term Democrat, also accelerated the plan to close schools in the affected areas, moving the closure date up a day to Tuesday. “I’m not going to recommend or allow any New York City family to send their child to a school that I wouldn’t send my child,” he said.

The governor’s announcement seemed to be yet another manifestation of his long feud with Mr. de Blasio. Mr. Cuomo has frequently second-guessed or overruled the mayor, also a Democrat, during their tenures. Mr. Cuomo said he spoke with Mr. de Blasio and Michael Mulgrew, the president of the city’s teachers’ union, among other local officials, on Monday morning and added that all were in agreement on the need for additional data on cases at specific schools.

On Monday afternoon, not long after the governor’s news conference, Mr. de Blasio said at a news conference of his own that he still planned to close nonessential businesses in the nine ZIP codes.

“Until we hear otherwise, our plan is to move ahead Wednesday morning with enforcement in those nine ZIP codes of all nonessential businesses,” Mr. de Blasio said. “We will continue to work with the state in the meantime to get to a final resolution.”

Asked whether he had the authority to move ahead with his plan, Mr. de Blasio added that “we obviously will follow state law, and if the state does not authorize restrictions we’re not going to act. But I find that very unlikely at this point.”

Mr. Cuomo had also announced that the state would take over supervision of enforcement of mask and social-distancing rules in the hot spot clusters, presumably putting the State Police in charge of New York City Police Department officers. He added that local governments would need to provide personnel.

“Warnings are not enforcement. Put a mask on or I will ticket you is not enforcement,” Mr. Cuomo said. “We are past that. Everybody knows the rules.”

ZIP codes with major restrictions

ZIP codes with lesser restrictions

ZIP codes with major restrictions

ZIP codes with lesser restrictions

ZIP codes with major restrictions

ZIP codes with lesser restrictions

The mayor said that he did not believe that the state could seize control of enforcement from local governments but that he agreed with Mr. Cuomo on the need for aggressive enforcement and that “stronger restrictions that will allow us to turn the tide.”

Outside of New York City, the governor said that schools in Rockland and Orange Counties, other hot spots the state has highlighted, could close in the future, but he said that he would first speak with local officials in those areas to decide whether doing so was necessary.

Mr. Cuomo noted that one challenge of shutting down schools by ZIP code was that students who live in hot spot areas may be enrolled in institutions elsewhere, but said “right now, that’s the best we have with the New York City data.”

On Sunday, with fears growing in New York City of a second wave of the coronavirus, Mr. de Blasio announced an emergency crackdown, saying that he intended to impose new restrictions on schools and businesses in 20 hot spots in Brooklyn and Queens that have been experiencing rising positivity rates.

The announcements represented a major setback for New York City, amounting to the first significant reversal in the reopening and offering further evidence of the challenges in curbing the pandemic. The city over the last month had taken several strides forward, allowing indoor dining for the first time and becoming the first major school district in the country to bring children back into its public schools.

On Monday, however, Mr. Cuomo refused to allow the city to close nonessential businesses in nine ZIP codes as the mayor had proposed. He said that “there could be” a rollback of indoor and outdoor dining in hot spot areas in the future, but that whether and how to do so was still be reviewed.

“I believe we can draw better lines than a ZIP code,” he said, adding that closing nonessential businesses in the same manner as schools would be “arbitrary and capricious.”

The governor also addressed mounting concerns in the city about infections among Orthodox Jewish populations after gatherings like religious services, weddings and funerals, saying that if leaders of religious communities did not agree to follow and enforce rules at places of worship, they would be shut down.

Mr. de Blasio said that he planned to focus on the hot spots, but that basic precautions, like wearing masks and social distancing, were the best way to keep the virus in check.

“If we don’t all deal with this together we could be running the risk of that second wave,” Mr. de Blasio said. “None of us wants to see that happen, so I’d ask everyone to start altering their behavior in light of that reality.”

Credit…Alex Wroblewski/Reuters

As President Trump and some of his associates test positive for the coronavirus, the number of new cases reported each day across the United States has been slowly rising.

The country is at a key moment in the pandemic, and spread of the virus could worsen significantly through the autumn, experts fear, as colder weather forces people indoors. Every day, some 43,000 new cases are being reported — far fewer than during the surge in the summer, but still an uncomfortably large number.

Some of the country’s least populous states are now seeing their highest infection rates.

When coastal cities suffered in the spring, cases remained relatively scarce across most of the nation’s midsection. But since late summer, North Dakota and South Dakota have added more cases per capita than any other state.

Utah recorded 1,387 new cases on Sunday, a single-day record. Four states — Wisconsin, Indiana, Montana and Wyoming — have added more cases in the last week than in any other seven-day stretch of the pandemic.

One significant change from the spring and early summer has been the return of college students to campuses.

The New York Times has identified more than 130,000 cases at more than 1,300 American colleges since the pandemic began.

Some of the worst trouble spots have calmed. Florida is now averaging about 2,300 new cases a day, roughly one-fifth of what it was seeing at its worst. In Arizona, daily case reports have dropped to about 500 on average, down from more than 3,600.

New infections have also plunged in Georgia, Louisiana and South Carolina. Mississippi and Alabama have made significant progress since midsummer as well, though case numbers there remain high.

California and Texas have also seen drops in case numbers. Both states, however, have recorded more than 800,000 cases.

“I’m actually disturbed and concerned about the fact that our baseline of infections is still stuck at around 40,000 per day,” Dr. Anthony S. Fauci, the country’s leading expert on infectious disease, said Monday on CNN. “That’s no place to be when you’re trying to get your arms around an epidemic and get it to a very low baseline as you get into a situation where you’re going to be indoors more than outdoors.”

United States › On Oct. 4 14-day
New cases 34,491 +6%
New deaths 332 –8%

Where cases are
per capita

Credit…Anna Moneymaker for The New York Times

Speaker Nancy Pelosi said Friday that President Trump’s positive test for coronavirus “changes the dynamic of stimulus talks.” But developments since suggest that the sides are still far apart on negotiating a new pandemic aid package, according to today’s DealBook newsletter.

Those pushing hard for a bill include the White House. Mr. Trump tweeted from the hospital on Saturday that the country “wants and needs” more stimulus. For Mr. Trump, a deal would serve as a sign of his authority, taking attention away from his health and unfavorable polls.

Congressional leaders, though, are still haggling. When asked Sunday whether Mr. Trump’s comments meant the two parties were closer to a deal, Ms. Pelosi demurred: “No, it means that we want to see that they will agree on what we need to do to crush the virus so that we can open the economy and open our schools safely.” She said that the parties were “making progress” toward a deal, but with Mr. Biden ahead in the polls, Democrats may feel they have the upper hand in negotiations.

On the Senate side, the majority leader, Mitch McConnell, is balancing competing interests among his Republican colleagues — some want a deal to bring home to constituents and others are worried about approving another large spending deal. Adding to the difficulties, the Senate has delayed its next sitting until Oct. 19, to account for positive coronavirus tests among Republican members.

Hanging in the balance are jobs and the economy. The longer people are out of the work, the harder it is for them to come back, suggesting that we may be entering the slow, grinding phase of a recovery that could tip into recession. There are still about twice as many people out of work now than before the pandemic, and without aid akin to what was in the first stimulus bill, weaker consumer spending, missed rent payments and other factors could ripple through the economy and the financial system.

Credit…Jon Super/Associated Press

England’s perpetually troubled coronavirus testing system was recently felled by a technical problem involving an overly large spreadsheet, lawmakers said on Monday. The glitch caused nearly 16,000 positive test results to go unrecorded in the country’s official tallies.

Those unrecorded positive test results dramatically changed the picture of England’s widening coronavirus outbreak, pushing it closer to the brink of fresh restrictions on travel and socializing.

While the people who tested positive received their own results, their names were not fed into the country’s contact tracing system, leaving tens of thousands of people in the dark about their exposure.




‘Incredible What They’re Doing,’ Johnson Says of Vaccine Team

On Monday, Prime Minister Boris Johnson of Britain spoke of the incredible work the vaccine team is doing, and noted that the increase in coronavirus cases across England is not surprising.

The incidents that were seeing in the cases really sort of corresponds to pretty much where we thought we were. And to be frank, I think the slightly lower numbers that we’d seen, you know, didn’t really reflect where we thought the disease was likely to go. So I think it’s — these numbers are realistic. The crucial thing is that in the next few days, week, we will see more clearly whether some of the restrictions that we’ve put in, the extra enforcement of the Rule of 6, the extra enforcement of self-isolation, the rules en masse and so on — all the stuff that has come in, we’ll see whether that starts to work in in driving down the virus. But you know, this is all very much in our hands. I went to see the scientists at Oxford at the Edward Jenner Institute, the AstraZeneca team. Incredible what they’re doing. You really feel that they must be on the verge of it. But, you know, it’s got to be properly tested. It’s got to be properly validated, and we’re not there yet. Obviously, if and when we get a vaccine then the crucial thing will be to ensure that we have sufficient supplies in this country that we’re able to make it in this country, distribute it fast in this country. And clearly, the priority for a vaccine will be as I think Kate Bingham among others have said, will be those who are the most vulnerable groups.

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On Monday, Prime Minister Boris Johnson of Britain spoke of the incredible work the vaccine team is doing, and noted that the increase in coronavirus cases across England is not surprising.CreditCredit…Tolga Akmen/Agence France-Presse — Getty Images

Because of the glitch, English health officials reported daily new infections in the middle of last week that were several thousand cases lower than they should have been. On Wednesday and Thursday, the country was reporting roughly 7,000 new daily cases, when the actual count was above 10,000.

“This isn’t just a shambles,” Jonathan Ashworth, the opposition Labour Party’s lead lawmaker on health issues, said in the House of Commons on Monday. “It’s much worse.”

Matt Hancock, the health secretary for the Conservative government, attributed the problem to a “legacy” data collection system used by England’s health officials.

Health authorities said that some files with positive test results exceeded the maximum size that its systems could handle. They said they were now splitting large files to ensure that they do not get stuck again.

Credit…Pool photo by Johanna Geron

The European Commission said Monday that 179 staff members had tested positive for Covid-19 since the start of the pandemic, while its leader continued to isolate after being exposed to the virus during an official visit to Portugal last week.

Ursula von der Leyen, the president of the European Commission, was exposed to someone who later tested positive during her trip. While she had tested negative twice, Ms. von der Leyen was expected to continue quarantining until Tuesday, in accordance with local rules in Brussels.

Charles Michel, the president of the European Council, which is the other major E.U. institution, also based in Brussels, had to isolate in late September after a member of his security staff tested positive, leading to the postponement of an important E.U. leaders’ summit on foreign policy. He eventually tested negative for the virus.

The infections at the heart of the bloc’s bureaucracy, in offices primarily in Brussels, but also in Luxembourg and Italy, have driven home that the bloc, which runs on constant meetings, would need to change the way it does business.

Ms. von der Leyen, for example, came under criticism for traveling to Portugal last week, as her visit did not seem necessary. She announced Monday that she would cancel a planned visit to Greece to collect an award this week.

Credit…Anna Moneymaker for The New York Times

Dr. Anthony S. Fauci, the nation’s leading infectious disease expert and to many a trusted voice throughout the pandemic, said he has confidence in the doctor overseeing President Trump’s care, Dr. Sean P. Conley, a Navy commander and doctor of osteopathy who has been the White House physician since 2018.

“Personally, I have not been involved in the direct care of the president,” Dr. Fauci said Monday on CNN, a fact that has come as a surprise to many in medicine. “But I might comment that my colleagues that I know, including Sean Conley, are very good physicians and they’re very qualified, so I am really confident that the president of the United States is getting the optimal care that you can get with the team over at Walter Reed.”

Americans have been looking to Dr. Conley who, over a busy weekend of medical briefings, has at times delivered confusion and obfuscation about the president’s condition. Dr. Conley even confessed that he had misled the public on Saturday about Mr. Trump’s treatment to reflect the “upbeat attitude” of the White House.

On Saturday, he ducked questions about whether Mr. Trump had been on oxygen, then revealed on Sunday that indeed, the president had been on oxygen — an indicator that Mr. Trump’s illness may be classified as “severe.” On Sunday, Dr. Conley was similarly evasive, sidestepping questions about whether the president’s X-rays revealed any lung damage or pneumonia. “I’m not going to get into specifics of his care,” he said.

Caring for any president presents unique challenges. Like all doctors, Dr. Conley is bound by oath to respect his patient’s wishes for privacy and to keep secret that which “ought not to be spoken of outside.” He is also a Navy officer caring for the commander in chief, whose orders he is obliged to follow.

But all of that must be balanced against the public’s right to have information about the health of one of the world’s most powerful leaders. And this particular leader, Mr. Trump, is well known for not wanting to look weak.

Dr. Conley is supervising a team of medical experts at Walter Reed National Military Medical Center, including Dr. Sean Dooley, a pulmonologist, as well as an outside expert, Dr. Brian Garibaldi, the director of the biocontainment unit at Johns Hopkins Hospital in Baltimore.

No matter what Dr. Conley says or does not say, his colleagues in medicine agree on one thing: If he is going to put himself in the position of answering questions about the president’s care, he has to answer truthfully and to the fullest extent possible.

“You can’t both wear the white coat and lie, evade, obfuscate the situation,” said Dr. Ezekiel Emanuel, a bioethicist at the University of Pennsylvania, “because you are using the white coat to give yourself credibility.”

Credit…Charlotte Kesl for The New York Times

The plight of the entertainment industry deepened on Monday as the British company Cineworld, which owns Regal Cinemas in the United States, said it would temporarily close all 663 of its movie theaters in the United States and Britain. The move was expected to affect 40,000 employees in the United States and 5,000 in Britain.

The chain had reopened in parts of the United States and Europe over the summer, but about 200 theaters, mostly in California and New York, have been shut since the pandemic began in the spring.

The news sent Cineworld’s stock spiraling. It fell as much as 60 percent when the stock market opened in London on Monday. It was later trading about 38 percent lower on the day.

The company said it could not entice viewers back without a pipeline of new films. The news came after Metro-Goldwyn-Mayer announced on Friday it would push back the release date of the latest James Bond film, “No Time to Die,” to April from this fall — the second time its release date has been delayed because of the pandemic.

Mooky Greidinger, the chief executive of Cineworld, said on Sky News that delays in the opening of many films — including “Mulan,” “Black Widow,” “Wonder Woman 1984,” as well as the Bond movie — meant the company “didn’t have the goods” for customers.

“It’s the wrong decision from the studios to move the movies in such a way,” Mr. Greidinger said.

He added that he felt the company had been able to reopen with enough health and safety precautions to welcome back customers, and cited “Tenet,” the Christopher Nolan film that opened in August and September, as the most significant release this year. It has made more than $300 million in the box office globally but just $45 million of that was in the United States.

The delays by studios in releasing what would have been before the pandemic blockbuster movies, is hurting theaters all over the world. Tim Richards, the chief executive of Vue International, said that the studios were being too U.S.-centric by not acknowledging reopenings in Europe and China. “We are struggling. We are absolutely struggling,” he said on Sky News.

Mr. Greidinger did not specify when Cineworld and Regal theaters might reopen. That “might be in two months, it might even a little bit longer,” he said.

In September, Cineworld reported a pretax loss of $1.6 billion for the first half of 2020. In total, the company operates 780 cinemas and is leaving about 100 locations in Poland, the Czech Republic, Slovakia, Hungary, Bulgaria and Romania open. Last year, 90 percent of the company’s revenue was generated in the United States and Britain.

In a memo to staff in Britain, Mr. Greidinger said: “Unfortunately, we cannot operate without a proper flow of products and sadly, you, like I, have seen audience numbers dwindle to tiny and unsustainable levels and the delay of Bond has been a huge blow.”

He did not say what would happen to workers’ jobs. The British government has announced a new job support program, in which employers and the government would share the cost of topping up the wages of employees whose hours were reduced. It will replace a more generous furlough program that ends later this month. Echoing critics of the government’s new plan, Mr Greidinger told staff that because it places a greater financial burden on employers it “cannot work for us when we have almost no income.”

Anna Schaverien contributed reporting.

Global Roundup

Credit…Cesar Manso/Agence France-Presse — Getty Images

Two mid-size Spanish cities, León and Palencia, were ordered on Monday by regional authorities to apply lockdown restrictions similar to those that came into force in Madrid last weekend, underlining the extent to which a second wave of Covid-19 is spreading beyond Spain’s capital region.

The new restrictions mean that residents of León and Palencia, which are in the northwestern region of Castile and León, will not be able to leave their cities as of Tuesday. Both have reached an infection rate of more than 500 cases per 100,000 residents.

Over the last seven days, Spain has reported 73,451 new cases, which works out to 157 cases per 100,000 residents, according to a Times database. As of Monday, almost 11,000 people were being treated in hospitals across the country for Covid-19, including 1,580 people in intensive care units.

In other world news:

  • Bars in Paris will close for two weeks starting on Tuesday, the authorities there announced on Monday, as France tries to stem a surge of coronavirus cases in its capital. The measure will also affect most cafes, which in many cases serve alcohol, but little or no food. Restaurants will be able to remain open if they follow a strict health protocol. Local health authorities said the capital had been above the thresholds for the top alert level — more than 250 coronavirus cases per 100,000 people generally, more than 100 per 100,000 in the elderly, and more than one-third of intensive care beds used for Covid-19 patients — since last Thursday.

  • With President Trump hospitalized with Covid-19, Secretary of State Mike Pompeo will cut short a trip to Asia this week, canceling stops in South Korea and Mongolia but continuing with a visit to Japan. Mr. Pompeo alluded earlier to the possibility of curtailing his Asia visit because of the infections in the president’s circle, but a State Department spokeswoman, Morgan Ortagus, did not specify why the schedule had been changed in a statement on Saturday.

  • New Zealand will lift restrictions on Auckland, its most populous city, from midnight on Wednesday, joining the rest of the nation. Restrictions had been reinstated after a cluster of infections emerged, but after the city reported no new infections for 10 consecutive days, Prime Minister Jacinda Ardern said on Monday that a second wave there had almost certainly been “eliminated.”

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