• Mon. Mar 1st, 2021

Firm Helping Run U.S. Coronavirus Database Refuses Senators’ Questions

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ImageA Covid-19 testing site in Los Angeles.
Credit…Philip Cheung for The New York Times

The private health care technology vendor that is helping to manage the Trump administration’s new coronavirus database has refused to answer questions from top Senate Democrats about its $10.2 million contract, saying it signed a nondisclosure agreement with the federal Department of Health and Human Services.

In a letter obtained by The New York Times, dated Aug. 3, a lawyer for the Pittsburgh-based TeleTracking Technologies cited the nondisclosure agreement in refusing to provide information about its process for collecting and sharing data; its proposal to the government; communications with White House staff or other officials; and any other information related to the award.

A spokeswoman for Department of Health and Human Services said members of Congress should direct their inquiries to the government, not the company. But Senator Patty Murray of Washington, the top Democrat on the Senate Health Committee, sent a letter to the agency in June seeking similar information and has not received a reply, her office said.

The arrangement was unusual, Jessica Tillipman, an assistant dean at George Washington University Law School who teaches about government contracts and anti-corruption, said in an interview.

“One of the cornerstones of the federal procurement system is transparency, so it strikes me as odd,” she said.

TeleTracking was responding to a July 22 letter from two top Democrats: Senator Chuck Schumer of New York, the minority leader, and Ms. Murray. The two recently introduced legislation aimed at protecting data transparency — an issue Mr. Schumer addressed during recent talks with Mark Meadows, the White House chief of staff, and Treasury Secretary Steven Mnuchin, according to a person familiar with their discussion.

“The Trump administration’s decision to hire a private vendor and then cloak that vendor in a nondisclosure agreement raises numerous questions about their motivations and risks the ability of our public health experts to understand and effectively fight this virus,” Mr. Schumer said in a statement Friday.

The controversy over the contract stems from the administration’s abrupt order in July for hospitals to stop reporting coronavirus information to the C.D.C.’s National Healthcare Safety Network — a longstanding government data system — and instead send it to TeleTracking for inclusion in a coronavirus database overseen by H.H.S. officials in Washington. H.H.S. has said the switch was necessary because the C.D.C.’s system was slow and incomplete; the government uses the hospital data to make critical decisions about how to allocate scarce supplies, like ventilators and the drug Remdesivir.

The contract — and in particular the sudden switch in reporting from C.D.C. to TeleTracking — generated objections from public health experts and outside advisers to the health agency, who say that the new system is burdening hospitals and endangering scientific integrity by sidelining government experts.

TeleTracking is majority owned by its chairman and chief executive, Michael Zamagias, a Pittsburgh real estate developer.

The manner in which the contract was awarded has also generated confusion. A government website initially listed it as a “sole source” contract, but H.H.S. officials later said there were six bidders, though they refused to name the others, saying they were “prohibited from sharing that information by federal regulations and statutes.”

Ms. Tillipman said it is also unusual for the government to keep the names of bidders a secret.

Credit…Michelle Gustafson for The New York Times

The United States Postal Service on Friday warned several states that it may not be able to meet deadlines for delivering last-minute mail-in ballots.

It’s only the latest sign of upheaval at the Post Service prompted by the pandemic and the new postmaster general, Louis DeJoy, who is a Republican megadonor, an ally of President Trump and now under investigation by the Post Service’s inspector general.

As many states turn to vote-by-mail operations to carry out elections safely amid the coronavirus pandemic, Thomas J. Marshall, general counsel for the Postal Service, warned that “certain deadlines for requesting and casting mail-in ballots are incongruous with the Postal Service’s delivery standards.”

Mr. Marshall urged the states — including electoral battlegrounds like Pennsylvania, Florida and Michigan — to require residents request ballots at least 15 days before an election rather than just the four days allowed under some state laws.

President Trump, who has sought to deny the option to millions of Americans through litigation while attempting to block additional funding for the Postal Service, has requested his vote-by-mail ballot.

The Palm Beach County elections department in Florida has prepared mail ballots for this Tuesday’s primary election for the president and the first lady, according to local registration records.

How and where a president votes is typically a footnoted formality. But Mr. Trump has broadly questioned the legitimacy of voting by mail, without evidence of significant voter fraud, and made statements suggesting that he views expansion of mail voting as a threat to the Republican Party.

Credit…Lindsey Wasson/Reuters

The Centers for Disease Control and Prevention updated their guidance recently to suggest that people who have recovered from the virus can safely mingle with others for three months.

It was a remarkable addition to the body of guidance from the agency, and its first indication that immunity to the virus may persist for at least three months. Scientists have said that it could last even longer but no definitive evidence exists yet. Even so, the C.D.C. still recommends physical distancing, mask-wearing and other precautions.

“People who have tested positive for Covid-19 do not need to quarantine or get tested again for up to three months as long as they do not develop symptoms again,” the guidance, which was tucked into public recommendations about who needs to quarantine, said. “People who develop symptoms again within three months of their first bout of Covid-19 may need to be tested again if there is no other cause identified for their symptoms.”

Doctors have reported some cases of people who seemed to be infected a second time after recovery, but experts have said those are more likely to represent a re-emergence of symptoms from the initial bout.

“There is no evidence to date of any reinfection within 90 days of the initial diagnosis,” said a C.D.C. spokesman.

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Credit…Adriana Zehbrauskas for The New York Times

Clinical trials for some of the most promising experimental drugs are taking longer than expected, even as the pandemic continues to wreak havoc in the United States and treatments are needed more than ever.

Researchers at a dozen clinical trial sites said that testing delays, staffing shortages, space constraints and reluctant patients were complicating their efforts to test monoclonal antibodies — man-made drugs that mimic the molecular soldiers made by the immune system.

As a result, once-ambitious deadlines are slipping. The drug maker Regeneron, which previously said it could have emergency doses of its antibody cocktail ready by the end of summer, has shifted to talking about how “initial data” could be available by the end of September.

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Updated 2020-08-20T23:11:01.534Z

And Eli Lilly’s chief scientific officer, who had said in June that its antibody treatment might be ready in September, said this week that he now hopes for something before the end of the year.

“Of course, I wish we could go faster — there’s no question about that,” said the executive, Dr. Daniel Skovronsky. “I guess in my hopes and dreams, we enroll the patients in a week or two, but it’s taking longer than that.”

One major hurdle has been testing. According to the rules of the Regeneron trial, a patient must be treated with the antibodies within seven days of the onset of symptoms. Both the Regeneron and Eli Lilly trials require giving the drug within three days of taking a test that comes back positive, but with turnaround times in some areas lagging for five days or more, keeping within those time frames has proved difficult.

Credit…Jung Yeon-Je/Agence France-Presse — Getty Images

South Korea reported 166 new coronavirus cases on Saturday as health officials struggled to contain local transmissions, which have mainly centered around two church congregations. The daily caseload was the highest since March 11, indicating that the country’s outbreak was gaining momentum once again.

The Korea Centers for Disease Control and Prevention said that all but 11 of the 166 new patients reported on Saturday were infected through local transmissions.

Health officials this week shut down two churches in the Seoul metropolitan area where a total of 91 worshipers had tested positive for the virus as of midnight Friday, contributing to a sharp increase in the national tally.

South Korea reported 103 new cases on Friday, the first three-digit daily rise in three weeks. Officials were testing thousands of worshipers from the two churches, as well as their contacts, in an effort to isolate the infected and cut transmission chains.

Additionally, Seoul, the capital, which is home to 10 million people, and the equally populous Gyeonggi Province surrounding it have ordered all churches to refrain from large gatherings and to require masks and other disease-prevention measures during prayer services.

South Korea was among the countries hit early by the epidemic. But it has relaxed its social-distancing rules in recent months as the country managed to sharply reduce the number of new daily cases. The government has urged people to adopt a “new daily life with Covid-19,” a term for reclaiming old daily routines but with preventive measures, such as mask-wearing and social distancing in schools and sports stadiums.

Later on Saturday, Prime Minister Chyung Sye-kyun ordered social-distancing rules to be tightened to Level 2 in Seoul and Gyeonggi Province. Under the new rules, sports events must be held without spectators, and large indoor and outdoor gatherings are banned. District authorities are also empowered to shut down public facilities deemed vulnerable to spreading the disease.

Credit…Lee Jin-Wook/Yonhap, via Associated Press

A study by researchers in South Korea last month suggested that children ages 10 to 19 spread the coronavirus more frequently than adults — a widely reported finding that influenced the debate about reopening schools.

But additional data from the research team now calls that conclusion into question; it’s not clear who was infecting whom. Some of the household members who appeared in the initial report to have been infected by older children in fact were exposed to the virus at the same time as the children.

The incident — just the latest example of science about the virus unfolding in front of our eyes — underscores the need to consider the preponderance of evidence, rather than any single study, when making decisions about children’s health or education, scientists said.

The disclosure does not negate the overall message of that study: Children under 10 do not spread the virus as much as adults do, and the ability to transmit seems to increase with age.

“It’s indisputable that the highest risk of becoming infected and being detected as being infected is in older age groups,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “I think you have to be really careful before you decide to open high schools.”

The earlier study was not intended to demonstrate transmission from children to adults, only to describe contact-tracing efforts in South Korea, said Dr. Young June Choe, assistant professor of social and preventive medicine at Hallym University College of Medicine and an author of both studies.

The first study from South Korea grouped children in 10-year ranges. Tracing the contacts of 29 children ages 9 or younger, it found that the children were about half as likely as adults to spread the virus to others, consistent with other research.

But Dr. Choe and his colleagues reported an odd finding in the group of 124 children aged 10 to 19: They appeared significantly more likely than adults to spread the coronavirus. Experts told The Times at the time that the finding was likely to be a fluke.

In the latest study, the researchers found only one undebatable case of transmission among older children, from a 16-year-old girl, who had returned from Britain, to her 14-year-old sister. The remaining infected contacts of the older children could all be explained by a shared exposure.


Credit…Associated Press

France on Friday declared Paris and the Marseille region in its southeast to be high-risk zones, granting the local authorities powers to restrict the movements of people and vehicles, limit access to public transportation and public buildings and close restaurants and bars.

France’s seven-day average is now above 2,000 cases, according to a Times database, a level the country reached in late March during a sharp rise in its outbreak.

Britain added France to its list of countries that visitors arriving from must quarantine for two weeks. Britain also added the Netherlands, where cases have doubled every two weeks since early July, along with Aruba, Malta, Monaco and Turks and Caicos.

Authorities in Britain unveiled the expanded list with little more than a day’s notice, prompting an instant scramble from vacationers to return there before the quarantine is imposed at 4 a.m. on Saturday.

France’s rising caseload reflected not only an increase in the number of tests, which stand at more than 600,000 per week, but also a higher infection rate, especially among young people, the health authorities said. The country’s total caseload has risen to 209,365, with 30,388 deaths, according to the Times database.

In other news from around the world:

  • North Korea lifted a lockdown it had imposed last month on the city of Kaesong, near its border with South Korea, on government suspicions that a runaway from South Korea had brought the virus with him. The North said the reversal was “based on the scientific verification and guarantee by a professional anti-epidemic organization” but without saying whether the nation has a coronavirus outbreak. Its leader, Kim Jong-un, has said it is facing “twin perils” — the virus and flooding from an unusually long monsoon season.

  • Spain ordered bars and clubs to close by 1 a.m. and banned drinking on the street on Friday, according to Reuters. Virus cases have risen steadily since July when the country emerged from a strict lockdown that only allowed residents to leave their home to walk their dog or grocery shop. Spain reported more than 5,400 new cases on Friday, according to a New York Times database.

  • President Rodrigo Duterte of the Philippines has delayed opening schools until Oct. 5, his chief aide said. The Philippines has the highest number of infections in Southeast Asia, with 153,660 confirmed cases and 2,442 deaths, according to the Times database.

  • Health officials in Toronto said that about 550 people may have been exposed to the coronavirus at a strip club bar after an employee tested positive for the virus. The occupation of the infected employee was not disclosed.

  • Vietnam’s health ministry announced that it had registered to buy Russia’s coronavirus vaccine, despite experts’ concerns that the Kremlin is distributing it before the last phase of human trials have even begun. The ministry said it had also registered to buy a vaccine from the United Kingdom. It cautioned that using the vaccines would depend on the progress of clinical trials and compliance with Vietnam’s “strict regulations.

U.S. Roundup

Various factors are known to increase the risk of severe Covid-19, including older age and chronic health conditions like high blood pressure and heart disease. The Centers for Disease Control and Prevention also lists extreme obesity as a high risk.

But is the excess weight to blame? Or is it the health problems that accompany obesity, like metabolic disorders and breathing problems?

A new study points to obesity itself as a culprit. An analysis of thousands of patients treated in Southern California identified extreme obesity as an independent risk factor for dying among Covid-19 patients — most strikingly among adults 60 and younger, and particularly among men.

Among female Covid-19 patients, body mass index — a measure of body fat based on height and weight — does not appear to be independently associated with an increased risk of dying at any age, the authors said, possibly because women carry weight differently than do men, who tend to have more visceral and abdominal fat. The study was published in Annals of Internal Medicine.

“Body mass index is a really important, strong independent risk factor for death among those who are diagnosed with Covid-19,” said Sara Tartof, the study’s first author, a research scientist at Kaiser Permanente of Southern California.

In other news from around the United States:

  • Georgia Gov. Brian Kemp is expected to sign an executive order on Saturday allowing local governments to issue mask ordinances, according to The Associated Press, which cited the Atlanta Journal-Constitution. The governor has staunchly opposed issuing a statewide mask ordinance — even suing Mayor Keisha Lance Bottoms for signing a mask order in Atlanta. Mr. Kemp’s executive order is expected to give businesses the option of enforcing local mandates and comes after a “strong recommendation” from the White House coronavirus task force. Officials announced 3,319 new cases in Georgia today, according to a New York Times database.

  • An Arizona school district that had planned to restart in-person classes next week in defiance of the state’s health benchmarks abruptly reversed course on Friday after staff members staged a “sick out” in protest. The state’s Republican governor, Doug Ducey, has recommended that in-person classes not resume until counties have met a number of targets, including going two weeks with Covid-19 positivity tests below 7 percent. The J.O. Combs Unified School District in greater Phoenix had planned to ignore the advice, but said on Friday evening that all instruction on Monday would be canceled because of “insufficient staffing.”

  • The five metropolitan areas that have the highest rate of new coronavirus cases relative to their population are all in South Texas, according to data compiled by The Times.

  • The Department of Homeland Security announced an extension of the U.S. agreement with Canada and Mexico to limit nonessential travel through Sept. 21. It was the fifth extension since the measure was put in place in March.

  • A federal judge dismissed a lawsuit by an Arizona woman who claimed New York’s 14-day quarantine requirement for travelers from hot spot coronavirus states infringed on her “fundamental right to travel.” This was the second challenge to Gov. Andrew Cuomo’s quarantine order to be thrown out by a federal judge, The Associated Press reported.

  • Gov. Gretchen Whitmer of Michigan said that the state would give four million free face masks to homeless shelters, tribal organizations, community health centers, schools and grocery stores. The effort, which targets people particularly vulnerable to the virus, includes one million masks provided by the Federal Emergency Management Agency and 1.5 million masks donated by Ford Motor.

  • At least 22 workers at a remote mining camp in Alaska have been infected with the virus, forcing a temporary stoppage to underground work. The Kensington Mine, about 45 miles north of Juneau, has about 200 to 250 workers on site at a time, said a spokeswoman for its owner, Coeur Alaska. The state has embraced a broad reopening but implemented protocols to keep infections in check, and though Alaska has had a spike in reported infections this summer, its numbers remain low compared with other states’.

Credit…Doug Mills/The New York Times

A group of Democratic senators said Friday that they were worried about the military’s ability to handle a coronavirus outbreak at the wartime prison at Guantánamo Bay, Cuba, after the Pentagon told Congress that it could maintain just four of the 40 detainees on ventilators and offered no details of how it might care for the 1,500 troops there.

“The Pentagon’s response leaves doubts about the Guantánamo prison’s capacity to protect military personnel and detainees from Covid-19,” the 11 senators, led by Elizabeth Warren of Massachusetts and Jack Reed of Rhode Island, the ranking member of the Senate Armed Services Committee, said in a statement.

One key concern is that, by law, prisoners at Guantánamo must receive all their medical care there, while any of the other 6,000 residents could be medically evacuated to mainland hospitals if needed.

In detailing the base’s health capabilities, Matthew P. Donovan, an under secretary of defense, said the detention operation had acquired the ability do rapid on-site testing in addition to airlifting samples to U.S. military labs.

The military acknowledged two cases of the virus on the base, in March and April, before the Pentagon ordered installations to stop disclosing any new cases for “operational security” reasons.

The prison has the capacity to isolate each of the 40 prisoners, including with space for four in regular inpatient rooms, two in intensive care and two more in rooms that have negative pressure and can control the flow of infectious particles.

Doctors who looked at the capabilities noted that the prison’s Covid-19 Care Team lists only four I.C.U. nurses, far below a standard of care that requires one such nurse per ventilated patient around the clock.

This article was produced in partnership with the Pulitzer Center on Crisis Reporting.

Culture RoundUp

Credit…Robyn Beck/Agence France-Presse — Getty Images

More than 8,500 people have signed a petition asking the health plan of SAG-AFTRA, the American union for professional film and television actors, to reverse changes that will result in at least several hundred members no longer qualifying for health insurance.

The health plan said in an email sent to members on Wednesday that it would raise the floor for eligibility from those earning $18,040 a year to $25,950, effective Jan. 1. Premiums will also increase.

“The Trustees of the SAG-AFTRA Health Plan have taken a difficult but necessary action to address financial deficits facing the plan,” the Screen Actors Guild-American Federation of Television and Radio Artists (SAG-AFTRA) Health Plan said in a statement.

At a time when film jobs are scarce and live theater is almost completely shut down because of the pandemic, many actors have seen their income slow to a trickle or disappear entirely.

SAG-AFTRA represents approximately 160,000 actors, singers, journalists and other media professionals in film and television. Membership is considered a rite of passage that can lead to more prestigious work.

According to the email, the changes are in response to projected deficits of $141 million this year and $83 million in 2021. The health plan estimated that, without the changes, it would run out of reserves by 2024.

In other U.S. cultural news:

  • As New York maintains its hard-won progress against the coronavirus, New York City’s museums and other cultural institutions will be allowed to open their doors again on Aug. 24, Gov. Andrew M. Cuomo said.

  • The National September 11 Memorial & Museum canceled its annual light display on the anniversary of the 2001 terrorist attacks because of the coronavirus. The decision was made “after concluding the health risks during the pandemic were far too great for the large crew,” a spokesman said.

Credit…Haiyun Jiang for The New York Times

A growing number of people, stuck at home and tired of staring at their own haggard faces on Zoom, are finding a fix: face and eye lifts, chin and tummy tucks and more.

At a time when many medical fields are reeling from lockdowns because lucrative elective work was postponed, cosmetic surgery procedures are surging, practitioners say, driven by unexpected demand from patients who have found the coronavirus pandemic a perfect moment for corporeal upgrades.

“I have never done so many face-lifts in a summer as I’ve done this year,” said Dr. Diane Alexander, a plastic surgeon in Atlanta. She said she had performed 251 procedures through the end of July from May 18, when her clinic reopened for elective surgery. “Pretty much every face-lift patient that comes in says, ‘I’ve been doing these Zoom calls and I don’t know what happened but I look terrible.’”

“This is the weirdest world I live in,” Dr. Alexander added. “The world is shut down, we’re all worried about global crisis, the economy is completely crashing, and people come in and still want to feel good about themselves.”

One of her patients, a 55-year-old woman named Joanne who asked that her last name not be used because she feared seeming vain, said she considered getting work done on her face for years. But the pandemic finally made it possible because she could conceal the bruising and swelling during her recovery period.

“Not one friend knows I’ve done it,” she said. “Family members don’t know, and my sister and mom don’t even know.”

Education Roundup

Credit…Hannah Yoon for The New York Times

Whatever one calls them — learning pods, pandemic pods or microschools — small groups that hire teachers to supplement or even replace the virtual instruction offered by public schools have become an obsession among many parents of means.

A virtual cottage industry of companies and consultants has emerged to help families organize these small-group, in-home instruction pods and pair them with instructors, many of whom are marketing themselves on Facebook pages and neighborhood email lists.

But the cost — often from $30 an hour per child to $100 or more — has put them out of reach for most families, generating concerns that the trend could make public education even more segregated and unequal.

In Washington, D.C., one parent started a GoFundMe page to raise money to subsidize learning pods for low-income students in the district.

Education experts say fund-raising efforts and “pod scholarships,” however well meaning, are no solution for millions of low-income parents juggling the educational, child care and economic challenges of the pandemic.

More useful, they say, would be if school districts or city governments created their own version of learning pods, especially for at-risk students or children of essential workers.

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In other education news:

  • Barnard College and Columbia University said that all undergraduate classes would be held remotely for the fall semester and that student housing would be mostly closed. The announcement came days before students were to move into dormitories.

  • The president of Villanova University in Pennsylvania has warned students that they will be sent home if they are caught disregarding the school’s coronavirus protocols, which include wearing a mask “at all times” and social distancing. Videos that appear to show a gathering of dozens of new Villanova students recently drew backlash on social media.

Credit…Amr Alfiky/The New York Times

Even as coronavirus infections spread, school reopenings were scrapped and near-historic unemployment levels persisted Americans kept shopping in July, reflecting a rare bright spot in the battered economy.

Retail sales rose 1.2 percent from June, the Commerce Department reported. Though smaller than increases in the previous two months, the jump in sales showed that the bounceback in spending to pre-pandemic levels was not a fluke. Sales have returned to their February level, a sign that consumerism, buoyed by government support, remains resilient even as many other facets of American life are increasingly bleak.

“It shows there is a willingness and a desire to spend,” said Michelle Meyer, chief U.S. economist at Bank of America. “There is no doubt the recovery in consumer spending has been robust.”

Retail sales in June rose 8.4 percent. That followed a May jump, 18.2 percent, which was the largest monthly surge on record. But that had followed two months of record declines.

But some of the recovery was helped by the $600 a week in unemployment assistance that expired at the end of July, and Congress’ failure so far to extend the emergency benefit could derail the retail rebound in coming months. And certain sectors of the industry may not truly bounce back until a vaccine is approved and widely distributed, allowing people to shop and dine indoors again without fear.

If you feel as if you can barely cope, while others are doing just fine, remember that the very earliest days of our lives, and our closest relationships, can offer clues about how we deal with adversity.

Credit…Fiona Goodall/Getty Images

The border, the border, the border: That’s been the mantra for Australia and New Zealand since the coronavirus emerged. But both countries are now learning that their definition of the border, and border security, needs to expand to control the pandemic.

In New Zealand, where a cluster that emerged on Tuesday had grown to 30 cases by Friday, officials struggled to explain a lack of regular testing for border officials and workers who manage hotel quarantine for the roughly 400 residents returning every day from overseas.

One respected epidemiologist, Sir David Skegg, a professor at Otago University, called the lack of testing an “extraordinary” breach of known best practices.

Investigators still haven’t determined how the virus re-entered the isolated Pacific country after 102 days without a case of community transmission. Prime Minister Jacinda Ardern, who on Friday extended a lockdown in Auckland for another 12 days, told reporters that officials had not yet linked the first identified case to either the border or quarantine facilities.

But New Zealand’s process for handling returning citizens and residents has become a focal point, in part because new details have emerged about what caused the outbreak that is still raging in Australia.

Leaked emails from government officials, published Friday by The Age, a newspaper in Melbourne, Australia, identified a hotel night manager as patient zero. He tested positive for the virus on May 26, and worked at one of the largest quarantine hotels in the city. Five security guards at the hotel later tested positive, after spreading the virus to relatives and their communities.

A public inquiry into how passengers infected with the coronavirus were allowed to disembark from a cruise ship in Sydney in March, setting off a major outbreak, also handed down its findings on Friday.

The detailed report from a panel of experts found a litany of “serious mistakes” and failures (a word the authors used 34 times) that ultimately led to 20 deaths in Australia and eight more in the United States. Chief among the errors was a lack of testing and the assumption that the ship’s 2,700 passengers were low-risk because they had come from New Zealand even though it was known that many of the arriving tourists had flown to their departure point from the United States and other high-risk locations.

Credit…Korean Central News Agency, via Agence France-Presse — Getty Images

North Korea on Friday lifted a lockdown that it had imposed on a border city last month, but without providing any details or saying whether the nation has a coronavirus outbreak.

North Korea imposed the lockdown in Kaesong, near the border with South Korea, based on the government’s suspicion that a runaway from South Korea had brought the virus with him. On Friday, it said only that the reversal had been “based on the scientific verification and guarantee by a professional anti-epidemic organization.”

North Korea sealed its borders in late January and has insisted for months that it had no coronavirus cases, although outside experts questioned the claim. It has not revealed whether the defector who crossed back from South Korea tested positive.

This summer, an unusually long monsoon season, as well as torrential rains, have set off floods and landslides in parts of North Korea that suffer chronic food shortages even during normal years.

The twin calamities of the pandemic and the floods have battered an economy that was already hamstrung by the sanctions imposed by the United Nations for North Korea’s nuclear weapons development — and which went into a tailspin this year as the border restrictions cut deeply into exports and imports with China, the North’s primary trading partner.

North Korea’s leader, Kim-Jong-un, has said the nation faces “two crises at the same time.” But on Friday, the North’s state-run media reported that he had ordered his country not to accept any international aid for fear that outside help might bring in the coronavirus.

By precluding outside aid, he appeared to be denying Seoul and Washington a chance to thaw relations with the North through humanitarian shipments.

“North Korea’s rejection of flood relief is ostensibly to prevent transmission of Covid-19 into the country,” said Leif-Eric Easley, a professor of international studies at Ewha Womans University in Seoul. “But humanitarian assistance is heavily politicized by the Kim regime, as it does not want to show weakness to the domestic population or international rivals.”

Credit…Julien De Rosa/EPA, via Shutterstock

France on Friday declared Paris and the Marseille region in the southeastern part of the country to be high-risk zones, granting local authorities powers to impose new restrictions aimed at containing the spread of the coronavirus.

The declaration allows the authorities to restrict the movements of people and vehicles, limit access to public transportation and public buildings and to close down restaurants, bars and similar establishments.

The move come as France faces a resurgence of the virus. The country’s seven-day average is now above 2,000 cases, a level the country reached in late March during a sharp rise in its outbreak that peaked in early April with a seven-day average of over 4,400 cases.

The increase prompted Britain on Thursday to add France to its list of countries from which visitors have to quarantine.

The number of coronavirus patients in intensive care, which had been steadily falling since early April, has also risen slightly in recent days.

The increase in cases reflects not only an increase in the number of tests, which now stand at more than 600,000 per week, but also a higher contamination rate, especially among young people, the health authorities said.

On Tuesday, Prime Minister Jean Castex said that he wanted “to extend as far as possible the obligation to wear masks in public spaces” to prevent “a high risk of epidemic resumption.”

Many French cities, including Paris and Marseille, have already imposed mandatory mask-wearing in busy outdoor spaces like open-air markets or crowded streets, in addition to the national requirement to wear masks in indoor spaces.

Credit…Peter Nicholls/Reuters

Britain followed through on its promise that it would “not hesitate” to add more countries to its quarantine list by imposing new restrictions on travelers coming into the U.K.

The government announced on Thursday that anyone coming into Britain from France and five other countries must isolate for 14 days, pointing to a “significant change” in the risk of contracting the coronavirus.

The two-week quarantine will also to travelers from Aruba, Malta, Monaco, the Netherlands and Turks and Caicos. Britain has already imposed restrictions on Spain and Belgium, among other countries.

The new measures were unveiled with little more than a day’s notice, prompting an instant scramble from vacationers to get back to Britain before the quarantine is imposed at 4 a.m. on Saturday.

But as Britain ramps up its measures on other countries, it is steaming ahead with its efforts to revive its own economy, which has spiraled into the deepest recession of its modern history.

Bowling alleys, theaters, and casinos will be allowed to reopen in England starting Saturday with social distancing in place, and beauty salons will be allowed to provide “close contact” services such as facials and eyebrow threading for the first time since lockdown began.

Wedding receptions will be also allowed for up to 30 guests, providing they are socially distanced.

Penalties for refusing to wear a face covering, as is required in enclosed public spaces and public transport, will also increase. And organizers of illegal gatherings could be fined up to 10,000 pounds ($13,000).

Official statistics released on Friday showed the number of infections in England were leveling off after a small increase in July. But for residents in parts of northwest England, stricter lockdown measures implemented by the government two weeks ago over fears of local outbreaks will remain in place. The health department said there was no evidence that there had been a fall in the infection rate or number of cases.

Credit…Remko De Waal/Agence France-Presse — Getty Images

The number of coronavirus infections in the Netherlands has doubled every two weeks since early July, causing experts to warn that the country could experience a full-blown second wave by mid-September.

The surge in cases has prompted Finland and the three Baltic countries — Estonia, Latvia and Lithuania — to tell their citizens not to travel to the Netherlands because of the increasing rate of infections. Britain is now requiring those coming from the Netherlands to quarantine for 14 days.

The country currently has 62,406 confirmed cases and 6,187 deaths, according to a New York Times database. But, a leading Dutch expert has said the rise continues at the rate its going, by the fall the Netherlands could have 250,000 infections and about 4,000 hospitalized patients. That would be roughly similar to the first virus peak in April.

“We are seeing the number of infected persons first rising gradually, but picking up speed as time passes,” Ernst Kuipers, who leads the Dutch National Network for Intensive Care, told the current affairs show “Nieuwsuur” on Thursday. “Numbers are now doubling every two weeks from July 10th,” he said. In the seven days from Aug. 5-11, 4,036 new case were counted, a 56 percent increase compared to the week before, the Dutch National Institute for Public Health and the Environment announced.

The Netherlands has no countrywide mask mandate, though some places in Amsterdam and Rotterdam have recently implemented rules for specific locations, and masks are required on public transportation. There is no requirement for quarantine upon arrival in the Netherlands, but those traveling from places with higher virus numbers are “urged” to quarantine.

A walk-through testing center has been set up at Amsterdam’s Schiphol Airport for passengers from high-risk countries, but many are not taking the optional tests, according to the newspaper De Volkskrant.

Over 60 percent of all new infections are in people under 40. While they usually aren’t hospitalized, Mr. Kuipers warned that the young often flaunt the Dutch rules on social distancing and are potentially infecting older people.

Schools in the northern part of the Netherlands are getting ready to open on Monday. Students in elementary and high schools will not have to socially distance from each other, even if they’re 18 or older, according to the government. Where possible, teachers are required to socially distance from students.

Credit…Nataliia Rumiantseva/Alamy

Amid a flurry of concern over reports that frozen chicken wings imported to China from Brazil had tested positive for the coronavirus, experts said on Thursday that the likelihood of catching the virus from food — especially frozen, packaged food — is exceedingly low.

“This means somebody probably handled those chicken wings who might have had the virus,” said Angela Rasmussen, a virologist at Columbia University. “But it doesn’t mean, ‘Oh my god, nobody buy any chicken wings because they’re contaminated.’”

Guidelines from the Centers for Disease Control and Prevention maintain that “there is no evidence to suggest that handling food or consuming food is associated with Covid-19.” The main route the virus is known to take from person to person is through spray from sneezing, coughing, speaking or even breathing.

“I make no connection between this and any fear that this is the cause of any long-distance transmission events,” said C. Brandon Ogbunu, a disease ecologist at Yale University. When the virus crosses international boundaries, it’s almost certainly chauffeured by people, rather than the commercial products they ship.

The chicken wings were screened on Wednesday in Shenzhen’s Longgang district, where officials have been testing imports for the presence of coronavirus genetic material, or RNA. Several samples taken from the outer packaging of frozen seafood, some of which had been shipped in from Ecuador, recently tested positive for virus RNA in China’s Anhui, Shaanxi and Shandong provinces as well.

Both Dr. Ogbunu and Dr. Rasmussen said that an extraordinarily unusual series of events would need to occur for the virus to be transmitted via a frozen meat product. Depending on where the virus originated, it would need to endure a potentially cross-continental journey in a frozen state — likely melting and refreezing at least once along the way — then find its way onto someone’s bare hands, en route to the nose or mouth.

Reporting was contributed by Sarah Bahr, Mike Baker, Luke Broadwater, Damien Cave, Choe Sang-Hun, Emily Cochrane, Michael Corkery, James Dobbins, Thomas Erdbrink, Manny Fernandez, Hailey Fuchs, Abby Goodnough, Jason Gutierrez, Rebecca Halleck, Sapna Maheshwari, Apoorva Mandavilli, Constant Méheut, Claire Moses, Colin Moynihan, Richard C. Paddock, Alan Rappeport, Matt Richtel, Rick Rojas, Carol Rosenberg, Anna Schaverien, Jeanna Smialek, Mitch Smith, Paula Span, Eileen Sullivan, Sheryl Gay Stolberg, Katie Thomas, Glenn Thrush, Billy Witz and Katherine J. Wu.