Coronavirus Live Updates: 34 Health Experts Warn New Data Rules Left Hospitals ‘Scrambling’ and Could Mar Data Integrity

Experts warn that new U.S. rules on virus data collection are creating problems for hospitals and data integrity.

Nearly three dozen current and former members of a federal health advisory committee — including some appointed or reappointed by Health Secretary Alex M. Azar — are warning that the Trump administration’s new coronavirus database is placing an undue burden on hospitals and will have “serious consequences on data integrity.”

The advisers, all current or former members of the Healthcare Infection Control Practices Advisory Committee, issued their warning in a previously unpublished letter obtained by Sheryl Gay Stolberg, a Washington correspondent for The New York Times.

The administration last month ordered hospitals to send daily reports about virus cases to a central database in Washington — controlled by Mr. Azar’s department — instead of to the Centers for Disease Control and Prevention. Such reports include information about current patients, the number of available beds and ventilators, and other information vital to tracking the pandemic. The order raised alarm that the data could be politicized or withheld from the public.

The transition left hospitals “scrambling to determine how to meet daily reporting requirements,” the authors of the letter wrote. They urged that the C.D.C.’s data experts “be allowed to continue their important and trusted work” of gathering, analyzing and disseminating the daily reports, which help the government track the pandemic and guide crucial health care decisions, including how to allocate scarce supplies and medication like remdesivir, the only drug that has federal approval to treat Covid-19.

“The U.S. cannot lose their decades of expertise in interpreting and analyzing crucial data,” wrote the authors, who include the current co-chairs of the panel reappointed by Mr. Azar — Dr. Lisa Maragakis of Johns Hopkins Hospital and Dr. Hilary Babcock, a professor in the Infectious Disease Division at the Washington University School of Medicine in St. Louis.

The 34 signatories are “the elite of the infection control personnel from hospitals all over the country,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University (not Emory University, as an earlier version of this item said) who is not affiliated with the group.

The letter amounts to a sharp rebuke to Mr. Azar. It should be taken “very seriously,” said another expert, Michael T. Osterholm of the University of Minnesota.

Hospital officials around the country questioned the wisdom of switching systems in the middle of a pandemic, and said that the shift in reporting requirements has been time-consuming and difficult. And because the metrics are different, it is hard to compare current data with information collected earlier in the pandemic.

The C.D.C. referred questions to its parent agency, the Department of Health and Human Services, run by Mr. Azar.

A spokesman for Mr. Azar, Michael Caputo, said the C.D.C.’s health care network “was unable to keep up with the fast-paced data collection demands of the Covid-19 pandemic.” And while the C.D.C. no longer collects the data, Mr. Caputo said, the agency has “access to all the data it once had and more.”

The principals’ and teachers’ unions in N.Y.C. call on the mayor to delay in-person instruction by several weeks.

New York City’s bid to become the only major U.S. school district to physically reopen its schools hit a snag on Wednesday, when the city’s influential principals’ and teachers’ unions called on Mayor Bill de Blasio to delay the start of in-person instruction by several weeks, and then begin phasing students back into buildings throughout the fall. Students are scheduled to return to classrooms one to three days a week starting Sept. 10.

The united front presented by the city’s educators, less than a month before the nation’s largest school district is scheduled to physically reopen, will make it much more difficult for Mr. de Blasio’s administration to pull off a high-stakes plan that is being closely watched by school leaders across the country.

“The city has failed to address many of our crucial concerns and ignored repeated appeals from school leaders to allow enough time to implement highly complicated protocols,” said Mark Cannizzaro, president of the principals’ union.

Michael Mulgrew, president of the union representing teachers, has been raising alarms about reopening for weeks, as his members have grown increasingly skittish. The principals typically avoid wading into big political fights, so their expression of concern gives Mr. Mulgrew much-needed political cover to continue his opposition to reopening.

“Will any parents be willing to put their children in a school whose principal believes the building is not ready to open because it is not safe?” he said Wednesday.

Mr. de Blasio pushed back in a hastily arranged news conference Wednesday afternoon, insisting that the city would be ready to reopen as scheduled.

“We owe it to our kids to get this right,” he said. “We are moving forward with that spirit, of devotion to our children.”

And he said the city’s unions “will sometimes say something in a very dramatic fashion, this is nothing new in New York City.”

As U.S. schools reopen, New Jersey and Florida are a study in contrasts.

The push-and-pull over policies on in-person learning between the governors’ offices and local authorities in Florida and New Jersey is emblematic of the confusing messages that parents across the nation are receiving as the new school year begins.

In Florida, Gov. Ron DeSantis, a Republican, and the education commissioner are demanding that one of the nation’s largest school districts reverse its plans for exclusive online learning and offer in-person classes.

In New Jersey, Gov. Philip D. Murphy, a Democrat, is giving districts the option to offer all-virtual classes when school resumes next month, relaxing his original requirement that teachers provide some form of in-person classroom instruction.

The tensions over who should call the shots also have echoes of debates in Florida and Texas between local and state officials over mandates to wear masks.

But for schools, teachers around the country have raised concerns about their own risks of contracting the virus if schools reopen, and teachers’ unions have threatened strikes and have pressured officials to steer away from mandating in-school classes.

School officials in Tampa, Fla., are bracing for a showdown with the state later this week after defying executive orders by voting to hold classes exclusively online for the first four weeks of school.

The Hillsborough County school board last week made the decision to start the school year on Aug. 24 with remote instruction, after hearing from a panel of health professionals. The board said that it would review the situation on Sept. 8 to decide what to do after that initial period.

Soon after the vote, the state’s education commissioner, Richard Corcoran, notified the district that the decision to remain closed contradicted a state mandate requiring schools to offer students the option of in-person classes. He said the district had until Friday to submit modifications or its state funding could be affected.

At a discussion on Monday when he appeared with Mr. DeSantis, Mr. Corcoran said that any district that fails to provide the option of in-person classroom instruction could suffer consequences. “If you go to a strictly virtual model, under the existing law, without the emergency order, then the funding is less.”

The district risks losing $ 23 million a month if it does not follow the state mandate, a number of Hillsborough District board members told the Tampa Bay Times.

In New Jersey, Mr. Murphy released a 104-page plan in June that required schools to offer some form of in-person instruction. To go virtual, he said Wednesday that a district would need to document why it is using all-remote instruction and set a date for a return to in-person classes.

Penn State to students: Come to campus at your own risk.

Pennsylvania State University is requiring its students to sign a waiver that absolves the university of liability for exposure to the coronavirus on campus. If they do not accept the terms in the document, which the school calls a compact, the students are denied access to the university’s portal where they sign up for classes.

“I assume any and all risk of exposure to Covid-19 that may result from attending Penn State, or participating in Penn State activities, and I acknowledge that exposure or infection may result in personal injury, illness, permanent disability, or death,” the waiver says.

Students are protesting the requirement, which appeared on the student portal about a week ago, said Maggie Hernandez, an anthropology graduate student at the university.

“This compact is basically placing all of the blame on students returning here for contracting Covid-19,” Ms. Hernandez said. “That is completely unacceptable.”

Wyatt DuBois, a spokesperson for Penn State, told local media outlets in a statement that “Penn State has committed to meeting and exceeding the guidance of health experts,” but that “it is important that students and families understand there is Covid-19 risk everywhere in our daily lives.”

In the waiver, students are required to acknowledge that the university’s safety measures “may, or may not, be effective in mitigating the spread” of the virus. Ms. Hernandez said that seemed to her to be a tacit admission that the school should be taking more precautions before welcoming students back to campus.

Other schools, like Bates College in Maine and the University of New Hampshire, are also requiring students to sign documents accepting the risk of infection on campus and agreeing to follow pandemic safety rules, and are getting some pushback from students.

But Heidi Li Feldman, a law professor at Georgetown University, said the wording of Penn State’s document was especially sweeping. “That language functions to very much minimize the university’s self-assigned responsibility,” she said. “It’s a very extreme version of saying, ‘We can’t make you any promises.’”

Ms. Feldman said she thought students should not sign it. “You’re agreeing to release someone from responsibility from taking care with your life,” she said.

U.S. ROUNDUP

The battle lines are hardening in the U.S. mask war.

It took a while, but public health officials now agree that wearing a face covering in public is crucial to slowing the spread of the coronavirus. In the United States, many localities that initially resisted imposing mask mandates changed course after virus cases started to soar over the summer, and now require them.

Even so, there remain deep divisions over mask-wearing, often rooted in partisan politics. Some people resent being told to wear them, and others resent their refusal; the arguments at times have turned violent.

So officials in some parts of the country are putting their foot down.

In Miami Beach, Fla., officials have issued more than $ 14,000 in fines to people who refuse to wear masks, though most of that has not been collected, The Miami Herald reported on Tuesday. Fines under the mask rule, which took effect last month, start at $ 50 per infraction but can reach $ 500 if left unpaid. (An earlier version of this item mistakenly said those figures were for the city of Miami.)

And the state of Illinois, where coronavirus cases have been rising, enacted a measure on Friday making it a felony to assault a retail worker who is enforcing a mask-wearing policy.

But the sheriff of Marion County, Fla., which includes Ocala, has come down hard on the opposite side. Sheriff Billy Woods has ordered his deputies not to wear masks on duty, except in limited situations, and has banned visitors to sheriff’s offices from wearing them.

Sheriff Woods said the purpose of his order, which was first reported by The Ocala Star-Banner, was to improve communication, because officers’ voices can be muffled behind a mask. He made exceptions for officers at the county courthouse, in jails and in public schools — but he made clear that he wasn’t convinced they were necessary.

“We can debate and argue all day of why and why not,” the sheriff said about mask-wearing in an email announcing the policy. “The fact is, the amount of professionals that give the reason why we should, I can find the exact same amount of professionals that say why we shouldn’t.”

The sight of thousands of unmasked faces at a motorcycle rally last week in Sturgis, S.D., prompted Gov. Chris Sununu of New Hampshire to change his mind, and issue an order requiring masks at gatherings of more than 100 people in his state. The order would apply to the Laconia Motorcycle Rally in Laconia, N.H., now scheduled for Aug. 22 after being postponed by the pandemic.

Governor Sununu, a Republican, had resisted issuing a statewide order. But “Sturgis was a clear warning sign to us,” he said at a news conference Tuesday. “I don’t think anyone saw the photos out of Sturgis and thought, ‘That looks safe.’”

In other U.S. news:

• The U.S. budget deficit grew to a record $ 2.8 trillion for the fiscal year to date as the federal government continued to pump money into the economy, the Treasury Department said on Wednesday. The monthly shortfall of $ 63 billion for July was an improvement from the prior month, however, as tax payments that were delayed from April came in and as government loans that were being supported through the $ 660 billion Paycheck Protection Program slowed.

• Tribune Publishing said on Wednesday that The Daily News, once the largest-circulation newspaper in the country, was permanently closing its Manhattan newsroom. The company said it made the decision “in light of the health and economic conditions brought about by the pandemic.” While the paper will still be published, the company made no promises about a future physical location.

• Data from states and cities show that many community outbreaks this summer have centered on restaurants and bars, often the largest settings to infect Americans. Since late June, scores of popular restaurants nationwide, including in Nashville, Las Vegas, Atlanta and Milwaukee, had to close temporarily because of cases among employees. Texas and Florida also had to close bars this summer after a surge of new cases hobbled those states. In a recent week in San Diego, 15 of the 39 new cases in community settings stemmed from restaurants.

• New Jersey’s governor, who was asked on Wednesday about why concerns about the spread of the virus at indoor restaurants didn’t seem apply to schools, said there’s a large difference between the two spaces. Indoor dining remains closed in the state. “Putting aside that going to a restaurant is a volitional step, getting our kids educated is our responsibility,” he said. “You do not have your mask on by definition if you’re eating or drinking.”

• In California, the governor said that while the state had recorded an unusually high number of cases over the past day, more than half were from a backlog stemming from a data reporting problem that has clouded California’s ability to gauge its progress in controlling the spread of Covid-19 over the past couple of weeks. He said the two-week average of hospitalizations in the state was down around 19 percent, “yet another indication that we are turning the corner on this pandemic.”

• Kentucky on Wednesday reported more than 1,000 new cases, a single-day record for the state.

Fauci: ‘I seriously doubt’ Russia has proven its new vaccine is safe and effective.

In a panel discussion, Dr. Anthony S. Fauci, the nation’s top infections disease expert, criticized Russia’s rushed clearance of a coronavirus vaccine. The vaccine, called Sputnik V, was approved without evidence that Phase 3 clinical trials had been completed, an essential part of the development pipeline to prove a product is safe and effective in people.

“Having a vaccine, Deborah, and proving that a vaccine is safe and effective are two different things,” Dr. Fauci said to Deborah Roberts, an ABC News journalist who moderated the panel on Tuesday that is set to air in full on Thursday.

Dr. Fauci called attention to the many other coronavirus vaccines vying for eventual clearance, including several that are in Phase 3 trials in the United States. The process for testing vaccines can last months and usually involves thousands of people.

“So if we wanted to take the chance of hurting a lot of people or giving them something that doesn’t work, we could start doing this, you know, next week if we wanted to,” Dr. Fauci said. “But that’s not the way this works.”

The timing of Russia’s announcement makes it “very unlikely that they have sufficient data about the efficacy of the product,” said Natalie Dean, an infectious disease expert at the University of Florida who has warned against rushing the vaccine-approval process. Dr. Dean noted that even vaccines that have produced promising data from early trials in humans have flopped at later stages.

On Tuesday, President Vladimir V. Putin had announced that the vaccine “works effectively enough.”

Experts — including Dr. Fauci — were quick to temper the excitement with criticism and warnings about taking Mr. Putin at his word.

“I hope that the Russians have actually definitively proven that the vaccine is safe and effective,” Dr. Fauci said. “I seriously doubt they’ve done that.”

As the U.S. economy sputters, Congress and the White House remain deadlocked on more aid.

Treasury Secretary Steven Mnuchin spoke on Wednesday with Speaker Nancy Pelosi of California about a coronavirus relief package, but the conversation appeared to do little to break the stalemate between the White House and top congressional Democrats.

According to a statement Ms. Pelosi released jointly with Senator Chuck Schumer of New York, the minority leader, Mr. Mnuchin said once again on the call that the administration would not agree to an aid package larger than $ 1 trillion. House Democrats approved a $ 3.4 trillion measure in May that the Senate has yet to act on.

Ms. Pelosi and Mr. Schumer have repeatedly said they would be willing to come down by $ 1 trillion if the White House would come up by the same amount. But the White House was “refusing to budge,” they said.

For his part, Mr. Mnuchin said on Wednesday that there had been no progress this week in negotiations, and accused Democrats of being intransigent for political reasons.

“Her statement is not an accurate reflection of our conversation,” Mr. Mnuchin said, adding that the administration was willing to move forward on a package that provided funding for schools, child care, vaccines, hospitals, broadband and liability protection for universities, schools, and businesses, among other provisions. “She made clear that she was unwilling to meet to continue negotiations unless we agreed in advance to her proposal, costing at least $ 2 trillion.”

The call between Mr. Mnuchin and Ms. Pelosi was the first overture between the two sides since talks all but collapsed on Friday. Over the weekend, President Trump signed a series of executive actions in an effort to circumvent Congress and impose certain measures, including an extension of unemployment benefits at a lower level. But the move prompted confusion, criticism from some governors and questions about whether the president had exceeded his authority.

Mr. Mnuchin said federal funding for state and local governments was the most significant area of disagreement. He said the White House was willing to provide an additional $ 150 billion to states to deal with virus-related costs, while Democrats want to give states approximately $ 1 trillion.

Mr. Mnuchin urged Democrats on Wednesday to consider narrowing the deal to items that the two sides agree on. “We don’t have to do everything at once,” he said.

White House officials have also explored whether Mr. Trump has the power to sidestep Congress and unilaterally cut a wide array of taxes, according to a senior administration official. The legality of such a move is dubious, but Mr. Trump has not been shy about pushing the boundaries of his authority.

Nursing homes seek federal aid to combat increases in cases and to ease shortages of protective equipment.

Citing severe shortages of protective equipment for staff members and inadequate testing, officials for U.S. nursing homes and assisted-living facilities called on federal government officials this week to provide tens of billions of dollars in more funding.

Industry officials are seeking $ 100 billion in additional congressional aid for the Provider Relief Fund, which is overseen by the Department of Health and Human Services, with a significant portion dedicated to nursing and assisted-living homes.

“Without adequate funding and resources, the U.S. will end up repeating the same mistakes from several months ago,” said Mark Parkinson, chief executive of the American Health Care Association and National Center for Assisted Living.

The organization noted that in several states, the rise in cases at nursing home in recent weeks was occurring in places with Covid-19 outbreaks in the general community.

By the end of July, about 41 percent of the nation’s deaths from the pandemic had been linked to nursing homes, according to an independent analysis by The New York Times.

Three weeks ago, the trade groups sent a letter to the National Governors Association, noting that 20 percent of nursing homes had inadequate protective equipment or had less than a week’s supply. Also, nearly a quarter of nursing homes and assisted-living facilities reported in surveys that tests were taking five days or longer to be processed.

From the third week in June to the third week in July, confirmed cases in nursing homes rose 57 percent, from 5,468 to 8,628, the industry said, citing data compiled by the Centers for Medicare and Medicaid Services.

SPORTS ROUNDUP

The Big 12 says it will hold games starting next month; the Masters Tournament will be held without spectators.

The Big 12 on Wednesday may have salvaged the remnants of the college football season. It also may have simply delayed its collapse.

One day after the Big Ten and Pac-12 conferences postponed football until at least the spring semester, the Big 12, which includes titans like Oklahoma and Texas, said it intended to hold league games beginning Sept. 26. Each team is expected to also play one additional game before that date.

The decision left three of the sport’s most influential leagues planning to pursue a football season, shriveled as it might be, and offered a measure of cover for two of them, the Atlantic Coast and Southeastern conferences, which have said previously that they were moving ahead with plans to start the season.

Before the Big 12’s announcement, some college sports executives said they believed any ambitions for a season would erode if the Big 12 declined to play.

The Big Ten and the Pac-12 cited the virus’s risks and uncertainties when they separately announced on Tuesday that they would not play sports this fall. Those decisions placed new pressure on the A.C.C., the Big 12 and the SEC, whose teams play in some of the nation’s most virus-ridden states but are also cultural touchstones and economic juggernauts for their universities and surrounding communities.

In other sports news:

• The Augusta National Golf Club announced Wednesday that the 2020 Masters Tournament, postponed from its traditional April date to Nov. 12-15, will be held without patrons or guests in attendance. The decision came after many other fixtures of the men’s professional golf schedule, including last week’s P.G.A. Championship, the first major championship of the year, previously were conducted without spectators. The Masters decision could signal that the remaining tournaments left this season will follow suit.

• The Paris marathon has been canceled, its organizers said on Wednesday, as France faces an uptick in virus cases and the authorities have announced that restrictions on public gatherings would be maintained through most of the fall.

GLOBAL ROUNDUP

New Zealand returns to a partial lockdown after a resurgence of locally transmitted cases.

Parts of New Zealand were back under a partial lockdown on Wednesday, a day after officials confirmed the country’s first locally transmitted cases of the coronavirus in months.

Four people from the same family were found to be infected from an unknown source, Dr. Ashley Bloomfield, the country’s top health official, said on Tuesday. The first case in the new cluster was a person living in South Auckland who had no history of traveling abroad, he said. New Zealand officials identified another confirmed case and four probable ones on Wednesday. Dr. Bloomfield said the country’s total number of active cases was now 22.

Officials were looking into the possibility that the virus had been imported by freight. Dr. Bloomfield told reporters that surfaces were being testing at a storage facility in Auckland where a man from the infected family worked.

“We know the virus can survive within refrigerated environments for quite some time,” Dr. Bloomfield said.

The new cases immediately triggered Level 3 restrictions in Auckland for three days, which means residents were instructed to stay home other than for essential personal movements, while the rest of the country would follow social-distancing measures. The authorities set up checkpoints on the main highway out of Auckland to prevent people from leaving the city.

All of the country’s nursing homes have also been placed under a Level 4 lockdown, meaning that no visitors are allowed, the broadcaster Radio New Zealand reported on Wednesday.

“I realize how incredibly difficult this will be for those who have loved ones in these facilities, but it’s the strongest way we can protect and look after them,” Prime Minister Jacinda Ardern said. She added that the authorities were releasing five million masks from a central supply, even though masks are not mandatory in Auckland.

The nation of five million declared itself free from the coronavirus in June after strict lockdown measures, and had been hailed as a model of successfully fighting the virus. But imported cases were later confirmed.

In other news from around the world:

• The state of Victoria, which is experiencing Australia’s worst outbreak, reported a daily record of 21 deaths on Wednesday, with 16 of them linked to outbreaks in nursing homes. Victoria also reported 410 new cases, and its capital, Melbourne, remained under a strict lockdown. Victoria’s premier, Daniel Andrews, said he worried that the outbreak might spread to other parts of the state. “This is really an endurance test,” he said. “We need to stay the course.”

• Pranab Mukherjee, 84, a former president of India who tested positive for the coronavirus this week during a hospital visit for brain surgery, was put on a ventilator on Tuesday after his health deteriorated, The Hindustan Times reported. As of Wednesday morning, India had 45,257 deaths and more than 2.2 million cases, according to a New York Times database.

• Singapore said on Tuesday that most migrant workers in the city-state could return to work — but also that there had been new infections in cleared migrant dorms. Migrant workers have accounted for the vast majority of Singapore’s 55,353 cases, and a recent spate of suicides and attempted suicides in their dorms has heightened concerns about their mental health during the pandemic.

• Mr. Azar, the top U.S. health official, used a high-profile trip to Taiwan this week to contrast the island’s response to the pandemic with that of China.

Reporting was contributed by Sarah Almukhtar, Alan Blinder, Damien Cave, Emily Cochrane, Jill Cowan, Troy Closson, Thomas Fuller, Kimiko de Freytas-Tamura, Isabella Kwai, Giulia McDonnell Nieto del Rio, Eshe Nelson, Elian Peltier, Bryan Pietsch, Brendan Porath, Amy Qin, Alan Rappeport, Matt Richtel, Eliza Shapiro, Karan Deep Singh, Jennifer Steinhauer, Sheryl Gay Stolberg, Eileen Sullivan, Tracey Tully, Elaine Yu and Carl Zimmer.