The Virus Can Be Stopped, but Only With Harsh Steps, Experts Say.

Scientists who have fought pandemics describe difficult measures needed to defend the United States against a fast-moving pathogen.

Donald G. McNeil Jr. | The New York Times

Terrifying though the coronavirus may be, it can be turned back. China, South Korea, Singapore and Taiwan have demonstrated that, with furious efforts, the contagion can be brought to heel.

Whether they can keep it suppressed remains to be seen. But for the United States to repeat their successes will take extraordinary levels of coordination and money from the country’s leaders, and extraordinary levels of trust and cooperation from citizens. It will also require international partnerships in an interconnected world.

There is a chance to stop the coronavirus. This contagion has a weakness.

Although there are incidents of rampant spread, as happened on the cruise ship Diamond Princess, the coronavirus more often infects clusters of family members, friends and work colleagues, said Dr. David L. Heymann, who chairs an expert panel advising the World Health Organization on emergencies.

No one is certain why the virus travels in this way, but experts see an opening nonetheless. “You can contain clusters,” Dr. Heymann said. “You need to identify and stop discrete outbreaks, and then do rigorous contact tracing.”

But doing so takes intelligent, rapidly adaptive work by health officials, and near-total cooperation from the populace. Containment becomes realistic only when Americans realize that working together is the only way to protect themselves and their loved ones.

In interviews with a dozen of the world’s leading experts on fighting epidemics, there was wide agreement on the steps that must be taken immediately.

Those experts included international public health officials who have fought AIDS, malaria, tuberculosis, flu and Ebola; scientists and epidemiologists; and former health officials who led major American global health programs in both Republican and Democratic administrations.

Americans must be persuaded to stay home, they said, and a system put in place to isolate the infected and care for them outside the home. Travel restrictions should be extended, they said; productions of masks and ventilators must be accelerated, and testing problems must be resolved.

But tactics like forced isolation, school closings and pervasive GPS tracking of patients brought more divided reactions.

It was not at all clear that a nation so fundamentally committed to individual liberty and distrustful of government could learn to adapt to many of these measures, especially those that smack of state compulsion.

“The American way is to look for better outcomes through a voluntary system,” said Dr. Luciana Borio, who was director of medical and biodefense preparedness for the National Security Council before it was disbanded in 2018.

“I think you can appeal to people to do the right thing.”

In the week since the interviews began, remarkable changes have come over American life. State governments are telling residents they must stay home. Nonessential businesses are being shuttered.

The streets are quieter than they have been in generations, and even friends keep a wary distance. What seemed unthinkable just a week ago is rapidly becoming the new normal.

What follows are the recommendations offered by the experts interviewed by The Times.

Scientists must be heard

The White House holds frequent media briefings to describe the administration’s progress against the pandemic, often led by President Trump or Vice President Mike Pence, flanked by a rotating cast of officials.

Many experts, some of whom are international civil servants, declined to speak on the record for fear of offending the president. But they were united in the opinion that politicians must step aside and let scientists both lead the effort to contain the virus and explain to Americans what must be done.

Just as generals take the lead in giving daily briefings in wartime — as Gen. Norman Schwarzkopf did during the Persian Gulf war — medical experts should be at the microphone now to explain complex ideas like epidemic curves, social distancing and off-label use of drugs.

The microphone should not even be at the White House, scientists said, so that briefings of historic importance do not dissolve into angry, politically charged exchanges with the press corps, as happened again on Friday.

Instead, leaders must describe the looming crisis and the possible solutions in ways that will win the trust of Americans.

Above all, the experts said, briefings should focus on saving lives and making sure that average wage earners survive the coming hard times — not on the stock market, the tourism industry or the president’s health. There is no time left to point fingers and assign blame.

“At this point in the emergency, there’s little merit in spending time on what we should have done or who’s at fault,” said Adm. Tim Ziemer, who was the coordinator of the President’s Malaria Initiative from 2006 until early 2017 and led the pandemic response unit on the National Security Council before its disbanding.

“We need to focus on the enemy, and that’s the virus.”

Stop transmission between cities

The next priority, experts said, is extreme social distancing.

If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt.

The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.

The crisis would be over.

Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.

To attempt that, experts said, travel and human interaction must be reduced to a minimum.

Italy moved incrementally: Officials slowly and reluctantly closed restaurants, churches and museums, and banned weddings and funerals. Nonetheless, the country’s death count continues to rise.

The United States is slowly following suit. International flights are all but banned, but not domestic ones. California has ordered all residents to stay at home; New York was to shutter all nonessential businesses on Sunday evening.

But other states have fewer restrictions, and in Florida, for days spring break revelers ignored government requests to clear the beaches.

On Friday, Dr. Anthony S. Fauci, chief medical adviser to the White House Coronavirus Task Force, said he advocated restrictive measures all across the country.

In contrast to the halting steps taken here, China shut down Wuhan — the epicenter of the nation’s outbreak — and restricted movement in much of the country on Jan. 23, when the country had a mere 500 cases and 17 deaths.

Its rapid action had an important effect: With the virus mostly isolated in one province, the rest of China was able to save Wuhan.

Even as many cities fought their own smaller outbreaks, they sent 40,000 medical workers into Wuhan, roughly doubling its medical force.

In a vast, largely closed society, it can be difficult to know what is happening on the ground, and there is no guarantee that the virus won’t roar back as the Chinese economy restarts.

But the lesson is that relatively unaffected regions of the United States will be needed to help rescue overwhelmed cities like New York and Seattle. Keeping these areas at least somewhat free of the coronavirus means enacting strict measures, and quickly.

Stop transmission within cities

Within cities, there are dangerous hot spots: One restaurant, one gym, one hospital, even one taxi may be more contaminated than many identical others nearby because someone had a coughing fit inside.

Each day’s delay in stopping human contact, experts said, creates more hot spots, none of which can be identified until about a week later, when the people infected there start falling ill.

To stop the explosion, municipal activity must be curtailed. Still, some Americans must stay on the job: doctors, nurses, ambulance drivers; police officers and firefighters; the technicians who maintain the electrical grid and gas and phone lines.

The delivery of food and medicine must continue, so that people pinned in their homes suffer nothing worse than boredom. Those essential workers may eventually need permits, and a process for issuing them, if the police are needed to enforce stay-at-home orders, as they have been in China and Italy.

People in lockdown adapt. In Wuhan, apartment complexes submit group orders for food, medicine, diapers and other essentials. Shipments are assembled at grocery warehouses or government pantries and dropped off. In Italy, trapped neighbors serenade one another.

It’s an intimidating picture. But the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.

South Korea avoided locking down any city, but only by moving early and with extraordinary speed. In January, the country had four companies making tests, and as of March 9 had tested 210,000 citizens — the equivalent of testing 2.3 million Americans.

As of the same date, fewer than 9,000 Americans had been tested.

Everyone who is infected in South Korea goes into isolation in government shelters, and phones and credit card data are used to trace their prior movements and find their contacts. Where they walked before they fell ill is broadcast to the cellphones of everyone who was nearby.

Anyone even potentially exposed is quarantined at home; a GPS app tells the police if that person goes outside. The fine for doing so is $8,000.

British researchers are trying to develop a similar tracking app, albeit one more palatable to citizens in Western democracies.

Fix the testing mess

Testing must be done in a coordinated and safe way, experts said. The seriously ill must go first, and the testers must be protected.

In China, those seeking a test must describe their symptoms on a telemedicine website. If a nurse decides a test is warranted, they are directed to one of dozens of “fever clinics” set up far from all other patients.

Personnel in head-to-toe gear check their fevers and question them. Then, ideally, patients are given a rapid flu test and a white blood cell count is taken to rule out influenza and bacterial pneumonia.

Then their lungs are visualized in a CT scanner to look for “ground-glass opacities” that indicate pneumonia and rule out cancer and tuberculosis. Only then are they given a diagnostic test for the coronavirus — and they are told to wait at the testing center.

The results take a minimum of four hours; in the past, if results took overnight, patients were moved to a hotel to wait — sometimes for two to three days, if doctors believed retesting was warranted. It can take several days after an exposure for a test to turn positive.

In the United States, people seeking tests are calling their doctors, who may not have them, or sometimes waiting in traffic jams leading to store parking lots. On Friday, New York City limited testing only to those patients requiring hospitalization, saying the system was being overwhelmed.

Isolate the infected

As soon as possible, experts said, the United States must develop an alternative to the practice of isolating infected people at home, as it endangers families. In China, 75 to 80 percent of all transmission occurred in family clusters.

That pattern has already repeated itself here. Seven members of a large family in New Jersey were infected; four have already died. After a lawyer in New Rochelle, N.Y., fell ill, his wife, son and daughter all tested positive.

Instead of a policy that advises the infected to remain at home, as the Centers for Disease and Prevention now does, experts said cities should establish facilities where the mildly and moderately ill can recuperate under the care and observation of nurses.

Wuhan created many such centers, called “temporary hospitals,” each a cross between a dormitory and a first-aid clinic. They had cots and oxygen tanks, but not the advanced machines used in intensive care units.

American cities now have many spaces that could serve as isolation wards. Already New York is considering turning the Jacob K. Javits Convention Center into a temporary hospital, along with the Westchester Convention Center and two university campuses.

Gov. Ron DeSantis of Florida said on Saturday that state officials were also considering opening isolation wards.

In China, said Dr. Bruce Aylward, leader of the World Health Organization’s observer team there, people originally resisted leaving home or seeing their children go into isolation centers with no visiting rights — just as Americans no doubt would.

In China, they came to accept it.

“They realized they were keeping their families safe,” he said. “Also, isolation is really lonely. It’s psychologically difficult. Here, they were all together with other people in the same boat. They supported each other.”

Find the fevers

Because China, Taiwan and Vietnam were hit by SARS in 2003, and South Korea has grappled with MERS, fever checks during disease outbreaks became routine.

In most cities in affected Asian countries, it is commonplace before entering any bus, train or subway station, office building, theater or even a restaurant to get a temperature check. Washing your hands in chlorinated water is often also required.

“They give you a sticker afterward,” said Dr. Heymann, who recently spent a week teaching in Singapore. “I built up quite a collection.”

In China, having a fever means a mandatory trip to a fever clinic to check for coronavirus. In the Wuhan area, different cities took different approaches.

Cellphone videos from China show police officers knocking on doors and taking temperatures. In some, people who resist are dragged away by force. The city of Ningbo offered bounties of $1,400 to anyone who turned in a coronavirus sufferer.

The city of Qianjiang, by contrast, offered the same amount of money to any resident who came in voluntarily and tested positive.

Some measures made Western experts queasy. It is difficult to imagine Americans permitting a family member with a fever to be dragged to an isolation ward where visitors are not permitted.

“A lot of people’s rights were violated,” Dr. Borio said.

Voluntary approaches, like explaining to patients that they will be keeping family and friends safe, are more likely to work in the West, she added.

Trace the contacts

Finding and testing all the contacts of every positive case is essential, experts said. At the peak of its epidemic, Wuhan had 18,000 people tracking down individuals who had come in contact with the infected.

At the moment, the health departments of some American counties lack the manpower to trace even syphilis or tuberculosis, let alone scores of casual contacts of someone infected with the coronavirus.

Dr. Borio suggested that young Americans could use their social networks to “do their own contact tracing.” Social media also is used in Asia, but in different ways.

China’s strategy is quite intrusive: To use the subway in some cities, citizens must download an app that rates how great a health risk they are. South Korean apps tell users exactly where infected people have traveled.

When he lectured at a Singapore university, Dr. Heymann said, dozens of students were in the room. But just before he began class, they were photographed to record where everyone sat.

“That way, if someone turns up infected later, you can find out who sat near them,” Dr. Heymann said. “That’s really clever.”

Contacts generally must remain home for 14 days and report their temperatures twice a day.

Make masks ubiquitous

American experts have divided opinions about masks, but those who have worked in Asia see their value.

There is very little data showing that flat surgical masks protect healthy individuals from disease. Nonetheless, Asian countries generally encourage people wear them. In some cities in China where masks are compulsory, the police even used drones to chase individuals down streets, ordering them to go home and mask up.

The Asian approach is less about data than it is about crowd psychology, experts explained.

All experts agree that the sick must wear masks to keep in their coughs. But if a mask indicates that the wearer is sick, many people will be reluctant to wear one. If everyone is required to wear masks, the sick automatically have one on and there is no stigma attached.

Also, experts emphasized, Americans should be taught to take seriously admonitions to stop shaking hands and hugging. The “W.H.O. elbow bump” may look funny, but it’s a legitimate technique for preventing infection.

“In Asia, where they went through SARS, people understand the danger,” Dr. Heymann said. “It’s instilled in the population that you’ve got to do the right thing.”

Preserve vital services

Federal intervention is necessary for some vital aspects of life during a pandemic.

Only the federal government can enforce interstate commerce laws to ensure that food, water, electricity, gas, phone lines and other basic needs keep flowing across state lines to cities and suburbs.

Mr. Trump has said he could compel companies to prioritize making ventilators, masks and other needed goods. Some have volunteered; the Hanes underwear company, for example, will use its cotton to make masks for hospital workers.

He also has the military; the Navy is committing two hospital ships to the fight. And Mr. Trump can call up the National Guard. As of Saturday evening, more than 6,500 National Guard members already are assisting in the coronavirus response in 38 states, Puerto Rico and the District of Columbia.

High-level decisions like these must be made quickly, experts said.

“Many Western political leaders are behaving as though they are on a tightrope,” said Dr. David Nabarro, a W.H.O. special envoy on Covid-19 and a veteran of fights against SARS, Ebola and cholera.

“But there is no choice. We must do all in our power to fight this,” he added. “I sense that most people — and certainly those in business — get it. They would prefer to take the bitter medicine at once and contain outbreaks as they start rather than gamble with uncertainty.”

Produce ventilators and oxygen

The roughly 175,000 ventilators in all American hospitals and the national stockpile are expected to be far fewer than are needed to handle a surge of patients desperate for breath.

The machines pump air and oxygen into the lungs, but they normally cost $25,000 or more each, and neither individual hospitals nor the federal emergency stockpile has ever had enough on hand to handle the number of pneumonia patients that this pandemic is expected to produce.

New York, for example, has found about 6,000 ventilators for purchase around the world, Governor Cuomo said. He estimated the state would need about 30,000.

The manufacturers, including a dozen in the United States, say there is no easy way to ramp up production quickly. But it is possible other manufacturers, including aerospace and automobile companies, could be enlisted to do so.

Ventilators are basically air pumps with motors controlled by circuits that make them act like lungs: the pump pushes air into the patient, then stops so the weight of the chest can push the air back out.

Automobiles and airplanes contain many small pumps, like those for oil, water and air-conditioning fluid, that might be modified to act as basic, stripped-down ventilators. On Sunday, Mr. Trump tweeted that Ford and General Motors had been “given the go-ahead” to produce ventilators.

Providers, meanwhile, are scrambling for alternatives.

Canadian nurses are disseminating a 2006 paper describing how one ventilator can be modified to treat four patients simultaneously. Inventors have proposed combining C-PAP machines, which many apnea sufferers own, and oxygen tanks to improvise a ventilator.

The United States must also work to increase its supply of piped and tanked oxygen, Dr. Aylward said.

One of the lessons of China, he noted, was that many Covid-19 patients who would normally have been intubated and on ventilators managed to survive with oxygen alone.

Retrofit hospitals

Hospitals in the United States have taken some measures to handle surges of patients, such as stopping elective surgery and setting up isolation rooms.

To protect bedridden long-term patients, nursing homes and hospitals also should immediately stop admitting visitors and do constant health checks on their staffs, said Dr. James LeDuc, director of the Galveston National Laboratory at the University of Texas Medical Branch.

The national stockpile does contain some prepackaged military field hospitals, but they are not expected to be nearly enough for a big surge.

In Wuhan, the Chinese government famously built two new hospitals in two weeks. All other hospitals were divided: 48 were designated to handle 10,000 serious or critical coronavirus patients, while others were restricted to handling emergencies like heart attacks and births.

Wherever that was impractical, hospitals were divided into “clean” and “dirty” zones, and the medical teams did not cross over. Walls to isolate whole wards were built, and — as in Ebola wards — doctors went in one end of the room wearing protective gear and left by the other end, where they de-gowned under the eyes of a nurse to prevent infection.

Decide when to close schools

As of Saturday, schools in 45 states were closed entirely, but that is a decision that divided experts.

“Closing all schools may not make sense unless there is documented widespread community transmission, which we’re not seeing in most of the country,” said Dr. Thomas R. Frieden, a former C.D.C. director under President Barack Obama.

It is unclear how much children spread coronavirus. They very seldom get sick enough to be hospitalized, which is not true of flu. Current testing cannot tell whether most do not even become infected.

In China, Dr. Aylward said, he asked all of the doctors he spoke to whether they had seen any family clusters in which a child was the first to be infected. No one had, he said, which astonished him.

That leaves a quandary. Closing schools is a normal part of social distancing; after all, schools are the workplaces for many adults, too. And when the disease is clearly spreading within an individual school, it must close.

But closing whole school districts can seriously disrupt a city’s ability to fight an outbreak. With their children stuck at home, nurses, doctors, police officers and other emergency medical workers cannot come to work.

Also, many children in low-income families depend on the meals they eat at schools.

Cities that close all schools are creating special “hub schools” for the children of essential workers. In Ohio, the governor has told school bus drivers to deliver hot meals to children who normally got them at school.

Recruit volunteers

China’s effort succeeded, experts said, in part because of hundreds of thousands of volunteers. The government declared a “people’s war” and rolled out a “Fight On, Wuhan! Fight On, China!” campaign.

It made inspirational films that combined airline ads with 1940s-style wartime propaganda. The ads were somewhat corny, but they rallied the public.

Many people idled by the lockdowns stepped up to act as fever checkers, contact tracers, hospital construction workers, food deliverers, even babysitters for the children of first responders, or as crematory workers.

With training, volunteers were able to do some ground-level but crucial medical tasks, such as basic nursing, lab technician work or making sure that hospital rooms were correctly decontaminated.

Americans often step forward to help neighbors affected by hurricanes and floods; many will no doubt do so in this outbreak, but they will need training in how not to fall ill and add to the problem.

“In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.”

Prioritize the treatments

Clinicians in China, Italy and France have thrown virtually everything they had in hospital pharmacies into the fight, and at least two possibilities have emerged that might save patients: the anti-malaria drugs chloroquine and hydroxychloroquine, and the antiviral remdesivir, which has no licensed use.

There is not proof yet that any of these are effective against the virus. China registered more than 200 clinical trials, including several involving those treatments, but investigators ran out of patients in critical condition to enroll. Italy and France have trials underway, and hospitals in New York are writing trial protocols now.

One worry for trial leaders is that chloroquine has been given so much publicity that patients may refuse to be “randomized” and accept a 50 percent chance of being given a placebo.

If any drug works on critical cases, it might be possible to use small doses as a prophylactic to prevent infection.

An alternative is to harvest protective antibodies from the blood of people who have survived the illness, said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.

The purified blood serum — called immunoglobulin — could possibly be used in small amounts to protect emergency medical workers, too.

“Unfortunately, the first wave won’t benefit from this,” Dr. Hotez said. “We need to wait until we have enough survivors.”

Find a vaccine

The ultimate hope is to have a vaccine that will protect everyone, and many companies and governments have already rushed the design of candidate vaccines. But as Dr. Fauci has explained multiple times, testing those candidate vaccines for safety and effectiveness takes time.

The process will take at least a year, even if nothing goes wrong. The roadblock, vaccine experts explained, is not bureaucratic. It is that the human immune system takes weeks to produce antibodies, and some dangerous side effects can take weeks to appear.

After extensive animal testing, vaccines are normally given to about 50 healthy human volunteers to see if they cause any unexpected side effects and to measure what dose produces enough antibodies to be considered protective.

If that goes well, the trial enrolls hundreds or thousands of volunteers in an area where the virus is circulating. Half get the vaccine, the rest do not — and the investigators wait. If the vaccinated half do not get the disease, the green light for production is finally given.

In the past, some experimental vaccines have produced serious side effects, like Guillain-Barre syndrome, which can paralyze and kill. A greater danger, experts said, is that some experimental vaccines, paradoxically, cause “immune enhancement,” meaning they make it more likely, not less, that recipients will get a disease. That would be a disaster.

One candidate coronavirus vaccine Dr. Hotez invented 10 years ago in the wake of SARS, he said, had to be abandoned when it appeared to make mice more likely to die from pneumonia when they were experimentally infected with the virus.

In theory, the testing process could be sped up with “challenge trials,” in which healthy volunteers get the vaccine and then are deliberately infected. But that is ethically fraught when there is no cure for Covid-19. Even some healthy young people have died from this virus.

Reach out to other nations

Wealthy nations need to remember that, as much as they are struggling with the virus, poorer countries will have a far harder time and need help.

Also, the Asian nations that have contained the virus could offer expertise — and desperately needed equipment. Jack Ma, the billionaire founder of Alibaba, recently offered large shipments of masks and testing kits to the United States.

Wealthy nations ignored the daily warnings from Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, that far more aggressive efforts at isolation and contact tracing were urgently needed to stop the virus.

“Middle income and poorer nations are following the advice of international organizations while the most advanced nations find it so hard to implement it,” Dr. Nabarro said. “That must change.”

In declaring the coronavirus a pandemic, Dr. Tedros called for countries to learn from one another’s successes, act with unity and help protect one another against a threat to people of every nationality.

“Let’s all look out for each other,” he said.

Coronavirus: WHO Head Says Nations Must Attack As 'Pandemic Is Accelerating'.

BILL CHAPPELL | NPR

With the coronavirus outbreak blowing past the 300,000-case mark, WHO Director-General Tedros Adhanom Ghebreyesus says world leaders and health officials won't be able to defeat COVID-19 if they rely only on defensive measures such as social distancing and requiring people to stay at home.

The coronavirus has now spread to nearly every country on the planet, the head of the World Health Organization said.

"The pandemic is accelerating," Tedros said. "It took 67 days from the first reported case to reach the first 100,000 cases, 11 days for the second 100,000 cases and just four days for the third 100,000 cases."

After describing the dire rate at which new cases are being reported, Tedros added, "But we're not prisoners to statistics. We're not helpless bystanders. We can change the trajectory of this pandemic."

The WHO leader's comments come as governments around the world face the daunting tasks of containment and mitigation: stopping the highly contagious viral disease in its tracks where possible, while also mitigating its effect on vulnerable populations and slowing its spread in communities where the virus has already gained a foothold.

"You can't win a football game only by defending. You have to attack as well," Tedros said at a briefing in Geneva.

He added:

"Asking people to stay at home and other physical-distancing measures are an important way of slowing down the spread of the virus and buying time — but they are defensive measures.

"To win, we need to attack the virus with aggressive and targeted tactics — testing every suspected case, isolating and caring for every confirmed case and tracing and quarantining every close contact."

Coronavirus: WHO Head Says Nations Must Attack As 'Pandemic Is Accelerating'

With the coronavirus outbreak blowing past the 300,000-case mark, WHO Director-General Tedros Adhanom Ghebreyesus says world leaders and health officials won't be able to defeat COVID-19 if they rely only on defensive measures such as social distancing and requiring people to stay at home.

The coronavirus has now spread to nearly every country on the planet, the head of the World Health Organization said.

"The pandemic is accelerating," Tedros said. "It took 67 days from the first reported case to reach the first 100,000 cases, 11 days for the second 100,000 cases and just four days for the third 100,000 cases."

After describing the dire rate at which new cases are being reported, Tedros added, "But we're not prisoners to statistics. We're not helpless bystanders. We can change the trajectory of this pandemic."

The WHO leader's comments come as governments around the world face the daunting tasks of containment and mitigation: stopping the highly contagious viral disease in its tracks where possible, while also mitigating its effect on vulnerable populations and slowing its spread in communities where the virus has already gained a foothold.

"You can't win a football game only by defending. You have to attack as well," Tedros said at a briefing in Geneva.

He added:

There are more than 370,000 confirmed coronavirus cases worldwide, according to a dashboard created by Johns Hopkins University's Whiting School of Engineering, which tracks COVID-19 data in near real time. That figure includes more than 100,000 people who have recovered from the disease, along with more than 16,000 who have died.

"Numbers matter, because they're not just numbers. They're people, whose lives and families have been turned upside down," Tedros said. "But what matters most is what we do."

For weeks, some of the most alarming COVID-19 numbers in the world have been emanating from Italy, which surpassed China's death toll from the respiratory disease last week. On Thursday afternoon, Italy's death toll of 3,405 eclipsed China's 3,249 deaths. On Monday afternoon, Italy said 6,077 people in the country have now died from COVID-19, and the country confirmed nearly 64,000 cases in total.

But Italian health officials are also seeing a potential bright spot, as Italy is reporting smaller daily increases in both deaths and new coronavirus cases.

"Deaths and new cases have grown every day for more than a month," NPR's Sylvia Poggioli reports. But over the weekend, the day-to-day numbers finally started to shrink.

"Today, the country marks the 14th day under quarantine, in which people are subjected to draconian restrictions and authorized to go out only for very few purposes," Poggioli adds.

If the pattern continues for several days, Italian officials say, it will be a sign that Italy may have finally turned a corner in its battle with COVID-19.

Global health experts are also keeping a close eye on India and its response to the coronavirus.

"The future of this pandemic, to a greater extent, will be determined by what happens in very large, highly populated, densely populated countries," said Mike Ryan, the World Health Organization's head of emergencies.

"So it's really, really important that India continues to take aggressive action at the public health level and at the level of society to contain, control, suppress this disease — and to save lives."

As Tedros took stock of the state of the global fight against COVID-19, he echoed many leaders in calling for solutions to ease a dangerous shortage of personal protective equipment such as N95 face masks and gloves.

"Health workers can only do their jobs effectively when they can do their jobs safely," Tedros said. "We continue to hear alarming reports from around the world of large numbers of infections among health workers."

Urging governments to make it a priority to protect hospital staff and other vital workers, the WHO head said that without action, "many people will die because the health worker who could have saved their life is sick."

Copyright 2020 NPR. To see more, visit NPR.

U.S. Olympic Committee says poll shows postponing Olympics is best path.

The U.S. Olympic and Paralympic Committee on Monday night urged the International Olympic Committee to postpone this summer's Olympic Games in Tokyo.

Associated Press / ESPN

DENVER -- NEARLY seven in 10 U.S. Olympic hopefuls say they don't think the Tokyo Games will be fair if they are held in July, prompting leaders of the U.S. Olympic and Paralympic Committee to conclude that "it's more clear than ever that the path toward postponement is the most promising."

The USOPC has come under criticism for not advocating for postponement, which is the position taken by its own sports organizations in swimming, track and gymnastics, along with national committees in Canada, Australia, Brazil and Germany.

Part of the hesitance, CEO Sarah Hirshland said Sunday, was to get a clearer picture from athletes about their training conditions and their feelings. Armed with the data, Hirshland and board chair Susanne Lyons put out their strongest statement to date.

"Our most important conclusion from this broad athlete response is that even if the current significant health concerns could be alleviated by late summer, the enormous disruptions to the training environment, doping controls and qualification process can't be overcome in a satisfactory manner," they said in a joint statement. "To that end, it's more clear than ever that the path toward postponement is the most promising, and we encourage the IOC to take all needed steps to ensure the Games can be conducted under safe and fair conditions for all competitors."

Over the weekend, the USOPC sent a survey to more than 4,000 athletes for details on how the coronavirus pandemic has influenced their training and their feelings about the upcoming games. The committee received responses from 1,780.

Of the respondents, 69% said they would feel comfortable competing in July if the World Health Organization -- one of the groups consulting with the IOC -- deemed it safe. But virtually that same number -- 68% -- said they didn't think the Olympics would be fair under those circumstances.

The main reason for that has been the massive disruption in training schedules as athletes prepare for qualifying events this spring and summer.

With city and state governments closing gyms and asking people to stay in their homes, fewer than one in 10 of the athletes said they can continue to train without any impact. Further, 65% said that continuing to train and prepare would put their health at risk.

The calls for postponement are growing seemingly by the hour, and by Monday evening, it seemed certain that postponement will happen.

Craig Reedie, an IOC member, told The Associated Press that conditions in Japan and worldwide "clearly indicates the likelihood of postponement." A decision will be made within four weeks, with IOC President Thomas Bach guiding the outcome.

Bach has taken the idea of a full cancellation off the board, and the American athletes agreed with that view: 93% said they preferred postponing to canceling.

Amazon fights coronavirus price-gouging, suspends 3,900 accounts.

Thomas Barrabi | Fox Business

Amazon said Monday that it has already suspended more than 3,900 seller accounts for price-gouging during the coronavirus outbreak, a disclosure that came on the same day President Trump issued an executive order aimed at curtailing the practice.

The e-commerce giant said the banned accounts were all active on its U.S. marketplace and were suspended for "violating our fair pricing policies." More than 500,000 product listings have been removed over price-related violations related to the outbreak.

"We are constantly monitoring our stores for unfair prices and listings that make false claims in regards to COVID-19," Amazon said in a blog post. "We have dynamic, automated systems in place that locate and remove unfairly priced items."

Amazon said that sellers found to have violated its policies are referred to law enforcement agencies for potential action. The company added that it is actively sharing information with federal and state officials to crack down on price-gouging and misleading product listings.

The update came as Americans around the country stock up on critical supplies to contend with the outbreak. Online and traditional retailers have experienced shortages of many key items, including hand sanitizer, face masks and toilet paper.

"We strongly support legislative efforts to ensure unreasonably excessive price increases are illegal during this and other national crises," the blog post added.

Trump's executive order was aimed to protect key medical supplies from price-gouging or hoarding that would limit their accessibility to those in need. Individuals who accumulate more items than is reasonably necessary for personal or commercial use could face prosecution.

Earlier this month, Amazon said it would hire 100,000 workers to build out its warehouse and delivery staff amid a surge in demand.

Stunning NASA image shows center of Milky Way.

Christopher Carbone | Fox News

NASA on Monday released a gorgeous image of the center of our galaxy.

The central region of our galaxy, the Milky Way, contains an exotic collection of objects, according to the space agency.

Those objects include a supermassive black hole weighing about 4 million times the mass of the sun (called Sagittarius A/*) and clouds of gas at temperatures of millions of degrees, NASA said in a statement published with the colorful photograph.

"The region around Sagittarius A/* is shown in this new composite image with Chandra data (green and blue) combined with radio data (red) from the MeerKAT telescope in South Africa, which will eventually become part of the Square Kilometer Array (SKA)," according to NASA.

Neutron stars and white dwarf stars can also be seen tearing material from companion stars in the image.