Coronavirus in Wisconsin: State reaches nearly 8,000 cases, 339 deaths from COVID-19 – Green Bay Press Gazette

When a relative of mine recently became seriously ill with what seemed to be a coronavirus infection, my first question was about timing. How many days ago did your symptoms start?

Marking your calendar at the first sign of illness, and tracking your fever and oxygen levels, are important steps in monitoring a coronavirus infection. Covid-19, the disease caused by the coronavirus, has been unpredictable in the range of symptoms it can cause. But when it turns serious, it often follows a consistent pattern.

While most patients recover in about a week, a significant minority of patients enter a very nasty second wave of illness, said Dr. Ilan Schwartz, assistant professor of infectious disease at the University of Alberta. After the initial symptoms, things plateau and maybe even improve a little bit, and then there is a secondary worsening.

While every patient is different, doctors say that days five through 10 of the illness are often the most worrisome time for respiratory complications of Covid-19, particularly for older patients and those with underlying conditions like high blood pressure, obesity or diabetes. Younger patients who develop complications may begin struggling a little later, as late as days 10 to 12. Most people who reach day 14 without any worrying symptoms (other than feeling miserable and fatigued) are likely to be on the road to recovery.

With any other disease, most people, after a week of symptoms, theyre like OK, things will get better, said Dr. Leora Horwitz, associate professor of population health and medicine at N.Y.U. Langone Health. With Covid, I tell people that around a week is when I want you to really pay attention to how youre feeling. Dont get complacent and feel like its all over.

Its important to call a doctor if you have shortness of breath or any concerning symptom no matter what day of illness you are on. And dont panic if you still feel lousy after a week of illness. Its common for Covid symptoms to linger, and feeling unwell for more than a week doesnt always mean you need medical treatment.

But tracking symptoms and paying special attention as the illness nears its second week has taken on new urgency as more doctors are seeing patients arriving at the hospital with an insidious form of pneumonia. On scans, patients with Covid pneumonia have a finding called ground-glass opacities, a hazy appearance in the lower part of both lungs. Oxygen levels may drop so slowly that the patient doesnt even notice, a condition called silent hypoxia. Often it is not until oxygen saturation reaches dangerously low levels, causing severe shortness of breath, that they finally seek care.

The best way to monitor your health during this time is to use a pulse oximeter, a small device that clips on your finger and measures your blood oxygen levels. (There are phone-based apps meant to do this, but they have tested poorly) The normal oxygen saturation range is about 96 to 99 percent. If your blood oxygen reading drops to 92 percent, its time to call a doctor.

While at home, you can also increase the flow of oxygen to your lungs by not resting on your back. Resting on your stomach, in the prone position, can open parts of the lungs that are compressed when lying on your back. You can also change to resting on your left side or right side, or sit upright in a chair.

Dr. Anna Marie Chang, an associate professor of emergency medicine and director of clinical research at Thomas Jefferson University, was sick for about a week before her oxygen levels dropped to 88 on the ninth day of her illness. She went to the hospital and was treated with oxygen and rested mostly in the prone position for four days to recover.

Its not clear why relatively young, healthy patients like Dr. Chang, who is 38, sometimes take a turn for the worse.

The first part is viral illness and everything else, said Dr. Chang. Your body is developing your immune inflammatory response and trying to fight off infection. That system can get over stimulated, and that seems to be what causes the acute worsening. Were seeing that around days seven to 10.

Dr. Chang cautioned that patients should listen to their bodies and not be too strict about following a timeline of symptoms. The human body does not follow the perfect manual, she said.

The problem, say doctors, is that the public health guidance so far has been to tell patients to ride out the illness at home and seek medical care or return only if they experience severe shortness of breath. As a result, too many patients are waiting too long to contact a doctor.

From a public health perspective, weve been wrong to tell people to come back only if they have severe shortness of breath, said Dr. Richard Levitan, a well-known emergency room doctor from New Hampshire who has called for widespread use of home pulse oximeters during the first two weeks of Covid-19 illness. Toughing it out is not a great strategy.

Dr. Levitan notes that while many patients may take a turn for the worse five to 10 days into the illness, he hesitates to be too specific about the timeline because not every patient is clear about exactly what day their illness began.

Patients will sometimes define a time course of illness differently than what you would expect, Dr. Levitan said. When you ask someone how long have you been sick, I find a patient says a few days and his wife will say, no, hes been sick for a week.

But what if you dont have a home pulse oximeter to monitor your health? The devices are now in short supply or can take weeks to be delivered.

Some medical practices are sending their patients home kits that include pulse oximeters, so check with your doctor about how you might be monitored. Ask friends now if they have a pulse oximeter so you have a plan in place to borrow one for two weeks should you get sick (the device is easily sanitized).

If you are still feeling lousy a week into your illness and dont have a pulse oximeter, you can also check in with an urgent care clinic and ask them to check your oxygen level. If you are concerned, talk to your doctor about whether a visit to an urgent care center or the emergency room is warranted.

In the absence of a pulse oximeter, one rough measure of respiratory function is a self-test called the Roth score. It requires the patient to take a breath and try counting to 30. If a patient cant make it to the number 10 (or seven seconds) without another breath, its likely their oxygen level has dropped below 95. If they cant count to the number 7 (or five seconds), their oxygen score may be below 90 percent. The test is not perfect, nor has it been studied in Covid-19. A University of Oxford team said the Roth score should not be used because it hasnt been validated and could give false reassurance.

Another physical but subtle sign of falling oxygen: Patients may start taking short, fast breaths to compensate, although they may not notice they are doing it. Patients with low oxygen levels might also have a blue tinge to their lips or skin. Thats why a video conference with your doctor can be helpful if youre not sure about whether you need to go to the hospital.

Heres a look at the timeline of Covid symptoms. While this can serve as a general guide, symptoms can appear at any time. Always listen to your body and consult with a doctor for guidance about your specific case.

Early symptoms of Covid-19 vary widely. It can start with a tickle in your throat, a cough, fever, headache and feeling winded or just a little pressure in your chest. Sometimes it begins with a bout of diarrhea. Some people just feel tired and lose their sense of taste and smell. Many people have several symptoms but no fever. Some patients with gastrointestinal symptoms go on to develop respiratory symptoms, while others dont.

Some patients never develop more than mild symptoms, or none at all. Others begin to feel terrible, with an ever-present fever, aches, chills, cough and an inability to get comfortable.

Some children and younger adults with mild disease may develop rashes, including itchy red patches, swelling or blistering on the toes or fingers, similar to frostbite. The exact timing isnt clear, and the symptom may appear early in the infection or after it has passed. Thats what happened to Dr. Schwartz, who developed respiratory symptoms and then blisters on his feet. It seems that a lot of these individuals, including myself, test negative on coronavirus swab tests, he said. I presume its a false negative. It could be that what were seeing is an immunological phenomenon that occurs after the initial infection is on the mend.

For some lucky patients with mild illness, the worst is over after a week. Guidelines from the Centers for Disease Control and Prevention say patients whose symptoms have improved and who havent had a fever for three days can leave isolation.

But some patients who have felt terrible continue to feel terrible or get worse. And some patients might start to feel better briefly then take a turn for the worse.

Patients should monitor their oxygen levels and check in with a doctor if they start to feel unwell. We should instruct patients to have a lower threshold for contacting their doctor, Dr. Levitan said. I believe they should contact their physicians to have monitoring if theyre feeling worse.

Monitoring should continue for the second week of illness. Patients may feel better sleeping on their stomachs or sides.

Days eight to 12 are when we have a really good idea if someone is going to get better or get worse, said Dr. Charles A. Powell, director of the Mount Sinai-National Jewish Health Respiratory Institute. The major thing we worry about is a worsening at eight to 12 days an increasing shortness of breath, worsening cough.

Dr. Powell said a home oxygen monitor can signal if someone needs to come in. Otherwise, patients should talk to their doctors.

If its difficult for the person at home to feel comfortable, and its difficult for the family to feel things are manageable, that would lead a physician to suggest the patient come in for evaluation, said Dr. Powell. We dont want to wait too long for blood oxygen levels to get worse.

Patients who had mild illness should be well recovered. Patients who had worse symptoms but maintained normal oxygen levels should feel mostly recovered after two weeks. However, patients with severe symptoms and those who needed additional treatment because of low oxygen may still feel unwell and fatigued and take longer to recover.

It is a sobering thought that, according to the many well-researched accounts to have appeared in recent weeks, this Johnson/Cummings government seems to have been prepared to risk 250,000 deaths from the policy of herd immunity. This approach was, mercifully, laid to rest after the intervention of Professor Neil Ferguson, of Imperial College London, on 16 March. There followed the introduction of lockdown and what some of us prefer to call physical distancing.

Commentators have been putting the 27,000 or more deaths in this country attributed to the virus so far in the context of the 60,000 civilian deaths recorded during the second world war. This is bad enough. But I wonder how many people are aware that during the Spanish flu epidemic of 1918-21, which followed the first world war, the estimated loss of life in this country was, well, 250,000?

In passing, I think it is worth mentioning that, until the onset of the coronavirus plague, the impact of Spanish flu in this country had hardly seemed to dawn on the consciousness of subsequent generations. The first world war itself? Yes. The Great Depression? Of course. Spanish flu? Wasnt that something that occurred in Latin America Love in the Time of Cholera?

In drawing attention to the parallels between the economic consequences of Spanish flu and coronavirus, the National Institute of Economic and Social Research has performed a great service. In its May Economic Review, it calculates that output (gross domestic product) will fall by anything between 15% and 25% in this April-June quarter, as a result of the painfully obvious impact of the lockdown on economic activity we see all around us. This compares with a 12-15% fall in the second quarter of 1921.

But in 1921, output recovered by a similar magnitude 12-15% in the third quarter, and the NIESR is assuming that, as things ease up, a recovery in the second half of this year might mean that the actual reduction of GDP this year could be some 8% still unnerving. However, the drop could have been 10% without the alleviation afforded by the furlough and other measures wisely unveiled by the chancellor, Rishi Sunak, and the Bank of England. Even so, unemployment is expected to soar to 10% by the end of this year, and there is already much hardship being suffered by innocent victims of the lockdown, or clampdown, on the economy.

Sunak is doing his best to do the right, Keynesian thing with the economy, and has realised the importance of the state

Whichever way you look at it, this is a calamity. Which makes it all the more reprehensible that one of the first announcements the prime minister made after his return was that there was no way he would extend the timetable for our complete withdrawal from the EU, come what may.

Well, a lot of it has come already. The International Monetary Fund calculates a no-deal Brexit which is what Johnson and Cummings are heading for would add a further, permanent loss of 5% to the UKs GDP, on top of the permanent damage from the virus, which the NIESR puts at 800bn, or some 10% of GDP. Citizens and businesses all over Europe are riven with uncertainty about the impact of Brexit.

I am well aware that these macroeconomic references to GDP mean little to average members of the public. But they should. One of the reasons why the NHS was so ill-prepared for the catastrophe which is not to underestimate the heroic efforts doctors and nurses have been making since it struck is that the NHS required a 4% increase in spending per annum after 2010 merely to cope with the cost of new technology and the ageing population; but it was granted a miserable 1% a year by Austerity Osborne.

People now hope that Johnson, having recovered from his near-death experience, means what he says about the value of the NHS. My good friend the historian Lord Hennessy, ever generous of spirit, spoke on the BBC of a new Boris.

I wonder. His former boss at the Telegraph, Sir Max Hastings, says: He is a far more ruthless, and frankly nastier, figure than the public appreciates. I would not take Boriss word about whether it is Monday or Tuesday. He has sacked decent people in his cabinet and packed it with rightwing Brexiters.

In which context, I shall watch the progress of the relatively new chancellor with interest. He is doing his best to do the right, Keynesian thing with the economy, and has realised the importance of the state, having clearly listened to his Treasury advisers. The latter are not natural spenders, but know a calamity when they see one. They also know, or ought to, that concerns about heavy borrowing are overdone when there is a counterpart of increased savings from a public whose spending opportunities are limited by the clampdown.

Sunak should now also ask his Treasury officials whether he should reconsider his support for Johnson and Cummings over Brexit.

Robert O'Brien, Trump's fourth national security adviser, has been conspicuously out of sight in the administration's efforts to fight the coronavirus. Rather than helping to lead the response, he has delegated responsibilities to top aides and even bypassed coronavirus task force meetings.

In a rare, in-depth interview, O'Brien acknowledged to CNN that he's been out of sight from many public events at the White House, but he pushed back on any notion that he's absent, saying he meets with Trump almost daily to discuss the virus and is in constant contact with foreign allies to coordinate the response.

He did say the administration, as well as much of the world and scientific experts, took time to grasp the severity of the threat.

"Initially, no one understood the magnitude of this crisis," O'Brien said.

As the head of the National Security Council inside the White House, it's up to the national security adviser to sift through reams of intelligence from across the government in order to flag potential threats to the President early on, and in times of crisis to coordinate a government-wide response.

In his interview with CNN, O'Brien insisted that senior national security officials have been on top of the coronavirus from early on, meeting daily to discuss the virus beginning in mid-January. O'Brien said he first briefed the President on the potential domestic threat it posed on January 23 and that he remains in daily contact with Trump on the fast-moving situation.

"We don't believe we should be out front in the news," O'Brien told CNN, adding that it is not his personal style to make a lot of news. "We want to give quiet advice."

Yet many around Washington believe that when it comes to the coronavirus, O'Brien's advice has been too quiet, and too reactive. One person familiar with how O'Brien is perceived by officials inside the White House called him, "The least influential national security adviser ever."

A senior Republican official familiar with the White House task force added that O'Brien was not involved with any of the calls or meetings one would expect the national security adviser to be on and that his absence was "inconceivable" during a pandemic.

"The [national security adviser] should be running a national security task force, and instead what we have are uncoordinated, shooting-from-the-hip decisions on tactical issues," said Samantha Vinograd, who was a senior adviser to Tom Donilon when he was President Barack Obama's national security adviser.

"Historically you would see the national security adviser being in on this action, really, since day one," said John Gans Jr., a former chief Pentagon speechwriter and author of the book "White House Warriors: How the National Security Council Transformed the American Way of War."

"I think there's a lot of people in Washington who are just like: Where's the national security adviser been in all this?"

Executing over influencing

O'Brien arrives at the White House each morning at 9 a.m., far later than his predecessors, having spent the early morning at home reading newspapers and speaking to the President and NSC staffers. As of Monday, O'Brien will have a SCIF, a secure room for reviewing classified or other highly sensitive information, installed in his home.

In the interim, he uses a secure phone line at home, and an armored SUV with a secure phone when out of the office, at times taking some of his more sensitive calls outside his house in the SUV.

Having no SCIF at home has meant that O'Brien often accesses the top secret Presidential Daily Briefings later than most of his predecessors. But since Trump himself doesn't come down from the White House residence until after 10 a.m., O'Brien said a later schedule jibes better with the boss.

O'Brien attends the intelligence briefing with Trump, but details of how he interacts with the President in that setting remain unclear, and he did not elaborate during his interview with CNN.

Previous national security advisers viewed getting the intelligence in the Presidential Daily Briefings to the President -- in any way they could -- as essential to their job, said Larry Pfeiffer, a 32-year veteran of the intelligence community. President Richard Nixon may not have even gotten the coveted intelligence at all were it not for his influential national security adviser, Henry Kissinger, said Pfeiffer.

"That's the job. You need to be able to see the whole field because the President doesn't have time to do it," said Gans.

The anti-Bolton

"Robert's shtick is 'I am a staffer. ... My purpose is not to tell the President what his agenda is,' " an administration official said. "He'll start by deferring to the President's stated opinions."

Earlier this year, O'Brien told CNN that Trump gets advice from his advisers but ultimately "makes his own decisions."

That's a stark contrast to how Bolton operated. A seasoned Washington infighter, the pugnacious Bolton was known to arrive at the office around 6 a.m. and for being an effective and eager debater, which sometimes led to heated discussions with Trump and the rest of the national security team.

"Bolton is a hard guy to follow," said a source familiar with internal White House dynamics. "With John Bolton there was incredible depth on just about every issue because he read so much and absorbed so much intelligence."

O'Brien is also seen by some as lacking Bolton's political savvy, which was bolstered by his longtime connections to Republican lawmakers on Capitol Hill. Still, O'Brien is viewed as having a closer relationship with the President's family, particularly Trump's son-in-law and senior adviser, Jared Kushner.

O'Brien "came into an impossible situation," another administration official said, noting the President's displeasure with the NSC, which he viewed as the source of his impeachment problems.

Deferring to his deputy

Early on, O'Brien tasked his deputy, Pottinger, to lead the National Security Council's effort to combat the virus. O'Brien told CNN that Pottinger was an obvious choice to lead the charge for the council. A former Marine and an Asia expert, Pottinger covered the SARS outbreak in China as a reporter for the Wall Street Journal in the early 2000s. O'Brien says that by delegating to Pottinger, he's been freed up to oversee other non-virus threats, such as Iran's recent aggression.

O'Brien says he and Pottinger are in constant communication over the coronavirus. "I am lucky to have a deputy to engage on this issue," O'Brien said. "He knows the issues extraordinarily well." O'Brien says he still personally briefs Trump on coronavirus news.

From the outset, Pottinger proposed taking a tough response against China for its failures to warn the world earlier about the virus and the risk of contagion. He pushed for travel restrictions on China and for labeling the virus the "Wuhan virus."

In the eyes of his national security colleagues, Pottinger's efforts were effective and smart. But West Wing colleagues viewed them as politically misguided and problematic. "He's losing allies," one administration official said of Pottinger.

Carving out a role

Vacancies have also hurt the White House's response to the virus. One former senior administration official said that as the coronavirus outbreak spread into the US, the absence of an empowered homeland security adviser likely contributed to the administration's failure to grasp the magnitude of the outbreak.

After Tom Bossert was pushed out of the job in 2018, the role was never really filled in its original form, according to several former administration officials. There were people who still had similar titles but with far less influence.

The role of homeland security adviser proved crucial to the Obama administration's response to the swine flu pandemic in 2009 and during the outbreak of Ebola in late 2014.

John Brennan, who was then Obama's homeland security adviser and eventually became CIA director, led the government's interagency response to the swine flu. Lisa Monaco, Obama's homeland security and counterterrorism adviser, reported directly to Obama and his then-national security adviser, Susan Rice, during the Ebola outbreak, according to a former Obama administration official who was involved in the response.

Both Monaco and Rice regularly attended task force meetings on Ebola, including those that involved protecting the homeland, the official said.

At the time, the National Security Council "understood there was a very close relationship between what was happening outside the United States and what was happening inside the United States, and we always had a very integrated strategy that had to involve our domestic tools and international response," this person said.

Countless Trump advisers, past and present, have said that the President doesn't give his Presidential Daily Briefings a close read and it is generally up to his top advisers to flag important issues to him. The onus, therefore, according to several former national security officials who spoke with CNN, was on O'Brien to fill the gaps.

"He's got to help connect the dots within government and help connect the dots between the information," said Gans, the former Pentagon speechwriter and author. "This is the first major crisis of the post-World War II era where the NSC really hasn't been operating and engaging at full capacity."

CNN's Dana Bash, Alex Marquardt, Zachary Cohen, Jamie Gangel and Jim Acosta contributed to this report.

His wife, Rajni Attavar, made soup for him. Mooliya struggled out of bed. With the help of eldest son, Amith, the 56-year-old subway station agent made his way to a kitchen chair in their Corona, Queens, home. Sweat beaded on his face. His mouth was open.

"I wiped his face," Attavar recalled through tears. "Then I called out his name. He didn't respond."

She sprinkled water on his head. Amith checked his father's weakening pulse. His younger son, Akshay Mooliya, 16, called 911. EMTs arrived and, for about 10 minutes, aided his breathing with a respiratory device.

They then covered him with a white blanket on the kitchen floor.

It was April 8 at 9:37 p.m., according to his death certificate. Immediate cause of death was listed as "Recent Influenza-Like Illness (Possible COVID-19)." Several hours would pass before his body was lifted off the floor and taken to a morgue -- and nearly three weeks before his cremation, family members said.

"I was the last person in the family to see his face before he died," Amith, 21, recalled. "I didn't even say goodbye."

The handling of Mooliya's body isn't unusual in these times.

The corononavirus death toll has overwhelmed health care workers, morgues, funeral homes, crematories and cemeteries. Body bags pile up across the city that became epicenter of the pandemic. On the day Mooliya died, there were 799 Covid-19 deaths in the state of New York, a one-day high. To date, the state has recorded more than 24,000 deaths, most of them in New York City.

Among the many ways life has changed is how America's largest city deals with its dead.

Though the city doubled to about 2,000 its capacity to store bodies, funeral homes are still turning down cremations because they can't hold onto the bodies. A Brooklyn crematory oven broke down under the sheer volume of corpses. Cremations are delayed to mid May and beyond. Bodies rest in refrigerated trailers in funeral home parking lots. Burials are backed up.

"So many more deaths than we could have ever imagined," said Joe Sherman, the fourth-generation owner of Sherman's Flatbush Memorial Chapel in Brooklyn. "I'm doing this 43 years. I've never seen anything like it."

Two funeral homes take desperate measures

The overwhelmed funeral home ran out of space for bodies, which were awaiting cremation, according to a law enforcement source. It brought in trucks for storage. At least one truck lacked refrigeration, with body bags on ice, one source said.

"It's such a sad situation and so disrespectful to the families," Mayor Bill de Blasio told CNN Friday. "That was an avoidable situation... There were lots of ways that the funeral home could have turned to us for help. But they stayed silent. That's a rarity. Overwhelmingly, even with the horrible strain and the emotional strain, funeral homes have really stood by the families in the city and served them."

CNN sought comment from the funeral home multiple times. On Wednesday, someone identifying himself as its owner declined comment.

Mourners are forced to play a waiting game

After Mooliya's body was picked up from the kitchen floor, his family learned that it would be nearly three weeks before the Indian immigrant's body could be cremated.

In Hindu tradition, bodies are typically cremated a day or two after death, Amith Mooliya said. His father, a devout man who prayed before and after his subway station shifts, was cremated on April 27.

The family did not attend the cremation ceremony because of distancing guidelines.

"I lit a candle and put his photo in a frame on a table," said his son, a chemistry major at Brooklyn College. "We prayed for his soul. That was all we could really do."

A strained death care industry has made mourning harder.

"Every day I remember," Attavar, 50, said of the day her husband died. "I can't sleep. I never saw his face like that. He was the strong one. I never saw him that weak. He took care of us."

That Mooliya was with family in the end provided some solace. The contagion has taken many others without loved ones at their side.

"At least he was not far away from us," Attavar said. "He was home. I think that was his comfort. That he passed in the house."

Funeral directors prioritize the living

Dan Wright, secretary-treasurer of Teamsters Local 813, whose 500 members include funeral directors and cemetery workers, said the high number of deaths has slowed the back end of the system, the cemeteries and crematories.

"Obviously we can't be burying people in the dark," he said.

And social distancing has altered the way people bid loved ones farewell.

"Funerals are basically about gathering together and celebrating somebody's life and saying goodbye," Wright said. "These things have been impossible to do. Funerals directors ... have been reduced to becoming policemen to prevent people from getting together, standing too close, hugging each other."

Sherman, the Brooklyn funeral home owner, said protecting clients and workers is a priority -- ensuring distancing and providing sufficient personal protective equipment.

"In dealing with this pandemic our main concern is the living," he said.

There are no face-to-face meetings with grieving families. All business is handled online or over the phone.

"We don't want people in the building," Sherman said.

The number of funerals Sherman handles tripled in recent weeks. His business and the memorial home that shares the building with it last week had about 100 calls.

His funeral home alone has been doing about 30 deaths a week. Three weeks ago, Sherman said, he brought in a refrigerated container with space for an additional 30 bodies.

"I'm turning down cremations unless its people that have prepaid them or people I know," he said. "Cremations are one month out here in Brooklyn. I don't want to be storing bodies here that long."

A cremation oven broke down because of the volume

Richard Moylan, president of Green-Wood Cemetery in Brooklyn, started as a grass cutter in 1972. Now he's closing in on five decades there.

"The volume of burials for us all at one time is overwhelming," he said. "The volume of cremations is something we've never seen."

Cremations at Green-Wood have jumped from as many as 70 to 130 per week, Moyland said. Burials more than doubled to a dozen each day.

"And if we had the capacity we would be doing more," he said of cremations.

"People are sending bodies out of state, out of the city. We're booked through the middle of May when six weeks ago you could just call up and say, 'I'm coming in tomorrow or, even sometimes, I'm coming in an hour.' Now, sadly, you need an appointment."

Except for burials, cremations and custodial services, all other work has stopped.

"We're not doing any tree maintenance," he said. "We're not doing much lawn maintenance. We're not doing any monument preservation. It's all hands on deck."

One of five cremation ovens -- which burn up to 1,800 degrees for 18 hours a day -- broke from overuse, Moyland said.

"When we started going longer hours the chamber's brick wall basically just gave way," he said.

Moylan sometimes watches burials from his office.

"We try to keep burials as close to a traditional burial as we can," he said. "We had a Covid victim and there were our guys in Hazmat suits and the family staying on the road away from the casket. Someone said a few prayers. They got back in their cars. Then I realized there were more cars of people who didn't come out."

'He worked so hard all his life'

In Corona, Queens, Rajni Attavar and her sons celebrate Mooliya's life by telling his story. He arrived in New York in the mid-1990s from Heroor village in Karnataka, India, where he taught chemistry at a university. He managed several chain drug stores. He was a security guard and worked five years as a subway station agent.

Mooliya had two online consultations with a doctor the days before his died. His eldest son said his father was told he didn't need to be tested. Take Tylenol and stay hydrated, he was instructed.

"He worked so hard all his life," Attavar cried. "No vacations. He was the smartest man. He went through a lot in his life. I didn't know it was going to end up so bad for him."

CNN's Claudia Morales contributed to this report.

The relationship between Covid-19 and No. 2 has also sparked interest in the White House and at the Department of Homeland Security. In an April 21 document listing DHS unanswered questions about the pandemic, the department raised questions about the novel coronavirus and feces.

[T]he relative contribution of different infection sources fomites, droplets, aerosols, and potentially feces is unknown, the document reads.

John Verrico, a spokesperson for the department's Science and Technology Directorate, said it plans to study "the survivability of the virus in waste (fecal matter), which may inform decontamination processes determined by health officials."

Grevatt noted that a number of major wastewater utilities around the country have begun monitoring for the virus in their inflow. Officials in Newcastle County in Delaware are watching their wastewater for coronavirus RNA, according to CNN, as are professors in Syracuse, N.Y.

Another example is Clean Water Services, a wastewater utility serving the suburbs west of Portland, Ore. Mark Jockers, head of government and public affairs for the utility, said the utility is working with the startup Biobot to collect and analyze samples with its primary interest being to track the relative increase or decrease of evidence of COVID-19 in the samples over time. His utility is also working with researchers at Oregon State University to do finer-scale sampling in hopes of tracking the virus at specific sources like schools, hospitals and retirement homes.

Newsha Ghaeli, co-founder and president of Biobot, said in an interview that starting in late March, her company started collecting samples of wastewater from 170 treatment plants in 37 states, including Massachusetts, New York and Washington, and have been generating and sharing with local municipalities weekly case estimates of how much evidence of the virus is in the samples. Ghaeli said her company aims to help officials get early warnings if the virus appears to be reemerging so that they can try to contain new outbreaks.

"What makes wastewater epidemiology such a great addition to the surveillance framework that communities are putting together right now [is] because it's such a quick and relatively inexpensive way to get trend data or get a pulse on the scope of the outbreak in communities and understand how it's trending over time," she said.

Meanwhile, members of the White House coronavirus task force have had at least one conversation about the potential for aerosolized feces to spread the virus in buildings. Two sources with knowledge of the conversation told POLITICO that when members gathered for a meeting earlier this year, they discussed concerns about problematic plumbing systems sending high levels of fecal matter into the air. Those airborne feces could then be sucked into vents and spread throughout buildings.

According to the sources, the White House task force members who discussed the matter discounted the possibility that the illness has spread this way in New York, the city with the highest infection rate by far in the U.S.

They also discussed whether this potential method of contamination could affect the spread of the virus in Asia. One of the sources said it was not seen as a major concern in the U.S., however.

The concern isnt hypothetical; in 2003, officials said SARS also a type of coronavirus appeared to have spread in one large Hong Kong apartment building through malfunctioning bathroom pipes, according to a Washington Post report.

When the bathroom was in use, with the door closed and the exhaust fan switched on, there could be negative pressure to extract contaminated droplets into the bathroom, a top Hong Kong health official told the Post back then. Contaminated droplets could then have been deposited on various surfaces such as floor mats, towels, toiletries and other bathroom equipment.

The U.S. will need social distancing through the summer.

In Southern California, a heat wave this weekend foreshadowed the likely challenges that lay ahead for governors and mayors trying to sustain social distancing efforts as spring turns to summer.

Despite pleas from state and local leaders to stay home, tens of thousands of people flocked to beaches that were open in Orange County on Saturday. Photographs of Newport Beach and Huntington Beach showed large crowds staking out patches of sand with beach towels and umbrellas. The Orange County Register reported that as many as 40,000 people went to the beach in Newport Beach on Friday.

In neighboring Los Angeles County, all beaches remained closed this weekend.

We wont let one weekend undo a month of progress, Mayor Eric Garcetti of Los Angeles wrote on Twitter on Sunday. While the sunshine is tempting, were staying home to save lives. The places we love our beaches, hiking trails will still be there when this is over. And by staying home, were making sure our loved ones will be too.

Dr. Deborah Birx, the White House coronavirus response coordinator, said Americans should expect social distancing guidelines to continue for months. Social distancing will be with us through the summer, she said Sunday on NBCs Meet the Press.

In New York, Governor Andrew M. Cuomo, while encouraging continued social distancing, said during his daily briefing on Sunday that it was unreasonable to expect people to stay inside all the time when summer arrives, especially in the most populous part of the state.

We need summer activities in downstate New York, Mr. Cuomo said. You cant tell people in a dense urban environment all through the summer months: We dont have anything for you to do. Stay in your apartment with the three kids. That doesnt work. Theres a sanity equation here also that we have to take into consideration.

As the economy shut down, few American cities were hit harder and faster than Las Vegas.

Nevadas economy has been one of the fastest growing in the country. Then, practically overnight, the glittering Las Vegas Strip shut down, throwing thousands of waitresses, bartenders, hotel cleaners and casino workers out of work, often without severance or benefits, and leaving the most bustling and storied stretch of the states economy boarded up and empty.

If you were to imagine a horror movie when all the people disappear, thats what it looks like, said Larry Scott, the chief operating officer of Three Square, Southern Nevadas only food bank, describing the Vegas strip. You cant imagine that there is a circumstance that could possibly cause that. I couldnt have.

As the bottom fell out of the American economy, few places have been hit harder than Las Vegas, where a full third of the economy is in the leisure and hospitality industry, more than in any other major metropolitan area in the country. Most of these jobs cannot be done from home.

Nearly 350,000 people in Nevada have filed for unemployment since the crisis began, the highest number in the history of the state. Las Vegas-based economic research firm Applied Analysis estimates the citys current jobless rate is about 25 percent nearly double the rate during the Great Recession and rising.

From an analytical standpoint, this is unprecedented, said Jeremy Aguero, a principal analyst with the firm. We have no frame of reference for what we are seeing.

The dependence on tourism and hospitality means that, as governors and mayors across the country wrestle with the question of when to reopen their economies, Las Vegas faces particular pressure. Mayor Carolyn Goodman argued last week that casinos should reopen and allow people to get sick. But Nevada Gov. Steve Sisolak, said the state was clearly not ready to open.

President Trump on Sunday pushed back on news reports that some of his senior aides, including his new chief of staff, Mark Meadows, are discussing replacing Alex M. Azar II, the Health and Human Services secretary, after a string of news reports about the administrations slow response to the coronavirus and a controversy about an ousted department official.

Mr. Trump was responding to reports, first published by Politico and The Wall Street Journal, that several senior administration officials had said privately that aides including Mr. Meadows were considering removing Mr. Azar once the height of the coronavirus crisis abated. Among the possible replacements being discussed were Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, and Dr. Deborah Birx, a key member of the coronavirus task force.

The White House had been asked for comment, and issued a statement Saturday. The Department of Health and Human Services, under the leadership of Secretary Azar, continues to lead on a number of the Presidents priorities, said Judd Deere, a White House spokesman. Any speculation about personnel is irresponsible and a distraction from our whole-of-government response to Covid-19.

Governors take tentative steps to reopen their states.

As a handful of states relaxed social distancing guidelines over the weekend, they have struggled to navigate competing demands to keep residents safe and the economy open. Heres a look at how some of those states have approached that balancing act:

Although Alaska has allowed businesses and restaurants in most parts of the state to reopen with some restrictions in place on April 24, the city of Anchorage has delayed its reopening to Monday.

Arkansas will allow simple elective surgeries to take place.

With Colorados stay-at-home order expiring over the weekend, Gov. Jared Polis rolled out new rules allowing curbside retail deliveries, phasing in elective surgery and store openings. Large workplaces can open at 50 percent capacity on May 4.

In Georgia, gyms, barbershops, tattoo parlors and spas in the state reopened last Friday. Houses of worship were allowed to resume in-person services, and restaurants and theaters can reopen Monday.

Hawaiis stay-at-home order was set to end April 30 but was extended Sunday until the end of May. Gov. David Ige said he planned to ease restrictions on beaches, reopening them to allow for exercise, and would permit elective surgeries to resume under the extended order.

Kentucky will permit non-urgent health care services, such as radiology and outpatient care, to resume on Monday.

Gov. Larry Hogan of Maryland said his state would not start to reopen until the number of deaths there declined for 14 straight days. Im going to be very cautious, he said on This Week. Were going to make decisions on science.

Gov. Gretchen Whitmer of Michigan, whose aggressive coronavirus policies have been the target of protests, said on the ABC program This Week that her approach had saved lives. The governor has extended her stay-at-home order until May 15, but she relaxed a number of social distancing policies on Friday, allowing in-state travel and some recreational activities.

On Monday, Minnesota will see the partial reopening of businesses.

Mississippis statewide stay-at-home order is set to expire Monday. It will be replaced with a safer at home order, which will allow several retail businesses to reopen, but at limited capacity.

Montanas plans to reopen began Sunday with places of worship becoming operational at reduced capacity and with encouragement to follow social distancing guidelines. Some businesses will reopen Monday, with restaurants and bars expected to reopen May 4.

New Yorks governor, Andrew M. Cuomo, said that after May 15, when his executive order shutting down the state is set to expire, construction and manufacturing businesses may be able to reopen in the least hard-hit regions. But the states populous southern section, including New York City and its suburbs, would likely not reopen any time soon.

Even as states begin to loosen their social distancing restrictions, businesses are confronting deep uncertainty, and many corporate executives say it is simply too soon to come back. Businesses large and small are sticking with having employees work from home or have decided to wait to reopen.

A Michigan state senator apologizes for wearing a mask resembling the Confederate flag.

A Republican state lawmaker in Michigan apologized this weekend for wearing a mask resembling the Confederate flag on the Senate floor on Friday, saying that there were no excuses for what he called an error in judgment.

The senator, Dale Zorn, initially told the television station WLNS on Friday that the mask was made by his wife and was not a Confederate flag, though he said it will probably raise some eyebrows.

But in a statement released on Saturday, Mr. Zorn expressed remorse for the choice and said that while he hadnt meant to offend anyone, I realize that I did, and for that I am sorry.

My actions were an error in judgment for which there are no excuses, he said. I will learn from this episode.

Mr. Zorn told WLNS that the history of the Confederate battle flag should be taught in schools.

Its something we cant just throw away because it is part of our history, he said. And if we want to make sure that the atrocities that happened during that time doesnt happen again, we should be teaching it. Our kids should know what that flag stands for.

In an interview with the television station, he wore a manufactured mask, saying he switched what he was wearing because I didnt want my actions to cause a negative effect to the institution, alluding to the State Senate.

What might distance dining look like? Restaurants start to imagine.

Chefs and public health officials around the country have begun considering how a reopened restaurant might look. Although many restaurateurs are still unsure if they will ever open their doors again, there are plenty from fast-food operators to chefs at the most elite temples of haute cuisine who spend their days strategizing how to get back to hosting diners.

As the first of the nations scattered restaurant openings in Georgia and Alaska get the green light, culinary and health organizations are drawing up guidelines and protocols for re-creating the American dining room as a safe space even while acknowledging that could take many months or even longer to happen.

The first step in the long crawl back will be setting standards to protect workers and diners. The most pragmatic thing we need to figure out right now is safety protocol, said David Chang, the restaurateur and media star. We are all asking for that, and no one really knows.

The questions pile up fast. Should you rely on disposable paper menus, or is wiping down plastic-covered ones safe? What kind of thermometers are best to check employees health, and will diners submit to temperature checks? Can air-conditioning spread the virus? What is a restaurants liability if a customer gets sick? How does a sommelier taste wine while wearing a mask, and how do you rewrite a menu so cooks can stay safe in the tight confines of a restaurant kitchen?

Once you go down this rabbit hole, its going to make your brain bleed, Mr. Chang said.

African-American leaders in Georgia slam the states reopening moves.

Several African-American leaders in Georgia, including the mayors of Atlanta, Savannah and Augusta, criticized the decision by Gov. Brian Kemp to allow gyms, barbershops, tattoo parlors and spas in the state to reopen last Friday, houses of worship to resume in-person services, and restaurants and theaters to reopen on Monday.

That stance seemed to put them in agreement with President Trump, who said the move was too soon. But Stacey Abrams, who ran against Mr. Kemp in 2018, distanced herself from the president.

I give President Trump no credit, she told Jake Tapper on CNN. He actually caused this challenge, by tweeting for weeks that we should liberate our economies. And when someone took him up on it, he did as he normally does, which is bend to what he thinks public opinion is.

Critics of the early reopening include influential clergy members like Jamal Bryant, pastor of New Birth Missionary Baptist, an Atlanta-area megachurch, and the Rev. Dr. Raphael Warnock, who is running for the U.S. Senate in a special election against Senator Kelly Loeffler, a Republican appointed to the seat by Governor Kemp. Dr. Warnock is the senior pastor at Ebenezer Baptist, Martin Luther King Jr.s home church.

Mr. Bryant, in a Facebook Live video, said the reopening was derelict of responsibility and absent of moral integrity, and aimed specifically at places African-Americans like to gather, like salons and barbershops, right after many people had received their stimulus checks.

Mr. Kemp has called his policy a measured return. I think this is the right approach at the right time, he told reporters. Its not just throwing the keys back to these business owners.

When Ms. Abrams was asked about accusations that the governors move showed disregard for black people, she said, I will tell you that, in the state of Georgia, African-Americans comprise 32 percent of the population, yet were 54 percent of the deaths.

She added, We know that communities of color suffer from systemic inequities that can be addressed in this pandemic, but only if the federal government pays attention, and if states do what they can to protect their communities.

U.S. testing needs a huge technology breakthrough.

A different type of coronavirus test is required to screen the U.S. population on the necessary scale, Dr. Birx said Sunday, saying that it will take a huge technology breakthrough to get there.

Whats needed, she said on NBCs Meet the Press, is a screening test that detects antigens, like the screening tests used for flu, strep and other diseases. Antigens stimulate the body to produce antibodies, and are essentially evidence of an immune response.

We have to be able to detect the antigen, rather than constantly trying to detect the actual live virus or the viral particles itself, and to really move into antigen testing, she said. The current RNA tests, which are more precise but more laborious, would then be used to confirm diagnoses.

Dr. Birx also spoke about another category of tests, those for antibodies, which indicate past exposure rather than detect a current infection. She said she thought the World Health Organization was being very cautious in its recent report that found no evidence that people who have recovered from the virus and have antibodies are protected from a second infection.

Reliable antibody tests will be vital as states begin reopening their economies and allowing people to return to work and public spaces. A recent analysis of 14 antibody tests by a team of scientists found that only three delivered consistently reliable results, and even those had some flaws.

On CNNs State of the Union, Dr. Birx did not disagree with the W.H.O.s statement, but she said the C.D.C. and F.D.A. were gathering data that would help improve and refine antibody tests. With all of that data together, I think, its going to create a very clear picture about antibodies, she said.

Dr. Birx acknowledged that the nation was not using existing testing capacities to the fullest. She said the administration was working with states to identify all their testing sites and supply the needed swabs and chemical reagents.

The dilemma for volunteers: Save lives, or stay safe?

In Teaneck, N.J., half of the towns volunteer ambulance corps is out sick, in quarantine or staying home to avoid potential exposure to the coronavirus. In Rockville, Md., a hard-hit Washington suburb, more than 10 percent of the 160-member volunteer ambulance force has stopped taking shifts. And in a rural Iowa county with one of the states highest infection rates, the Dysart Ambulance Service has just 22 volunteers sharing two ambulances and covering 150 square miles.

As the virus has continued its spread into suburbs and rural towns, overwhelming hospitals and emergency medical workers, it also has taken a toll on scores of volunteer emergency response units, many of which are the sole responders in critical and urgent situations.

Even if the worst-case scenarios from Covid-19 dont play out, youre going to have a lot of departments that are in a really difficult spot, said David Finger, chief of legislative and regulatory affairs for the National Volunteer Fire Council, which represents firefighters and other emergency responders.

More than 80 percent of the nations 30,000 fire departments are entirely or mostly volunteer, providing emergency care to about one-third of the countrys population. And while more than 60 percent of the fire departments across the nation provide basic or advanced life support, those in smaller rural communities areas already dangerously short on health care and often dependent on part-time volunteers to transport patients to hospitals are less likely to offer emergency medical services.

Ive never seen anything like this, said Jules Scadden, the director of emergency medical services in Dysart, Iowa, a farming community in Tama County, where an outbreak at a nursing home led to more than 230 positive cases and seven deaths.

The Trump administrations abrupt sidelining last week of Dr. Rick Bright, who led the federal agency involved in developing a coronavirus vaccine, is likely to delay progress and cause other complications, according to Dr. Scott Gottlieb, who was the F.D.A. commissioner until August 2019.

Speaking Sunday on the CBS program Face the Nation, Dr. Gottlieb praised Dr. Bright, who led the Department of Health and Human Services Biomedical Advanced Research and Development Authority, or BARDA.

He was effective, Dr. Gottlieb said. I think changing leadership in that position right now, certainly, is going to set us back. Its hard to argue that thats not going to have some impact on the continuity. He added. Businesses, companies that need to collaborate with BARDA, are a little bit more reluctant now to embrace BARDA, now that there is a cloud hanging over it and some uncertainty about the leadership.

The drug was repeatedly described by President Trump and his allies as a potential game changer, but in clinical trials so far, the results have been poor.

I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit, he said.

The next aid bill must help states and cities, Democrats say.

As officials warn that a fifth round of federal aid will probably be necessary to mitigate the economic damage from the coronavirus pandemic, Democrats in Congress are doubling down on their insistence that the next round include money for state and local governments.

Unlike the federal government, states must balance their budgets, and have seen their tax revenue plummet with the shutdown of much of the economy, even as surging unemployment and emergency response needs have drained their resources.

Kevin Hassett, a senior adviser to the White House, acknowledged that the federal government would probably have to help the states. The economic lift for policymakers is an extraordinary one, he said.

Senator Mitch McConnell, Republican of Kentucky and the majority leader, has repeatedly said in recent days that he would like to wait before pursuing another sweeping package, given that Congress has already approved nearly $3 trillion in economic aid of various kinds in two months. But Democrats say aid for states and localities cannot wait.

House Speaker Nancy Pelosi, Democrat of California, blocked the most recent bill, which replenished a loan program for small businesses, until it included money for hospitals and testing. But Republicans balked at including more funds for states and localities, and the bill ultimately passed without it.

On Sunday, Ms. Pelosi rejected the suggestion that Democrats could have done more. Asked to respond to criticism from Gov. Andrew M. Cuomo of New York, Ms. Pelosi said on the CNN program State of the Union: Just calm down. We will have state and local, and we will have it in a very significant way.

As for the most recent bill, she said, Judge it for what it does. Dont criticize it for what it doesnt.

Steven Mnuchin, the Treasury secretary, declined to weigh in on the debate on Sunday.

This is something well consider but our focus right now is really on execution, Mr. Mnuchin said on Fox News. If we need to spend more money, we will, and well only do it with bipartisan support.

How the virus ravaged an immigrant city near Boston.

Separated from Boston by the Mystic River, Chelsea, Mass., is a world apart, a first stop for immigrant families Lithuanian, Polish, Irish, and more recently, Honduran and Guatemalan who cannot afford the bigger citys sky-high rents.

It has a population density of nearly 17,000 people per square mile, with whole families crowding into single rooms in triple-decker rowhouses, buildings with high rates of lead paint, asbestos and air pollution.

This spring, the virus collided disastrously with the citys overcrowded housing. A warning flare came in the second week of April, when, late at night, a young mother called the city housing authority from the street; she had disclosed her test results to her roommates, and they had kicked her out.

It dawned on me that this situation was going to replicate itself, said Thomas Ambrosino, Chelseas city manager, and we better have a solution.

For Paul Nowicki, the director of operations for the housing authority in the city, one difficulty has been safeguarding residents in a building when he cannot locate infected people.

Many leaders will face the same stubborn challenge: How, in a country that values its citizens medical privacy and autonomy, can authorities separate the sick from the well?

The question is an urgent one if public life is to resume.

In West Virginia and Ohio, much-needed hospitals are no longer operating.

A wide stretch of West Virginia and Ohio is fighting the coronavirus pandemic with 530 fewer hospital beds than it had last year, after a for-profit company shut down three of the areas larger hospitals.

Beginning in 2014, Alecto Healthcare Services acquired the three hospitals: Fairmont Medical Center in Fairmont, W.Va., Ohio Valley Medical Center in Wheeling, W.Va., and East Ohio Regional Hospital in neighboring Martins Ferry, Ohio. Employees expected the new ownership to put the institutions on solid footing after years of financial struggle.

Instead, decisions made by Alecto wound up undercutting patient care and undermining the hospitals finances, according to more than two dozen interviews with doctors, nurses, other staff members, government officials and patients, as well as a review of court records.

Doctors were fired to save on salaries; many patients followed them elsewhere. Medical supplies ran short. Vendors went unpaid. Finally, one after another, the three hospitals ceased operating.

The counties they serve have already recorded 171 coronavirus cases and nine deaths. Hundreds of people whose lungs were scarred by decades in coal mines are vulnerable to a devastating respiratory syndrome caused by the virus, doctors said.

Weve now got a hospital that existed for over 100 years that, in the middle of a pandemic, sits empty, said Jonathan Board, chairman of the Marion County Chamber of Commerces board of directors, referring to Fairmont.

Not all lockdown masterclasses involve unwelcome exertion. By now, anyone who has been watching the daily Downing Street coronavirus press briefings, even intermittently, should have acquired enough skill in evasion and excuses to present one, if not to a professional standard, certainly as persuasively as the average UK cabinet minister. The following technique can be mastered in as little as six weeks.

1. Congratulate the prime minister if he has produced another child, wish him a great recovery/holiday if he is unavoidably absent. Conscious or not, he is in great spirits. Introduce your scientists. Pray that they include Jenny Harries, Englands deputy chief medical officer, whose deflection methods are unrivalled. Recall, for instance, her wish for a more adult conversation on personal protective equipment, following evidence that shortages are endangering lives.

2. Firm voice on, before an update on the governments step-by-step battle plan to defeat the virus. Recite, slowly and clearly, the five tests. This should use up at least five minutes. Repeat, as required by ministers since 9 March, that the government is taking the right decisions at the right time, based on the latest scientific advice.

3. Solemn face. Report the latest infection and death figures. Condolences. Reflect, instructively, that these grim numbers are a reminder of just how serious the virus is, showing that your five-point plan is correct.

4. A more positive note. Congratulate the heroic frontline, ditto the sacrifice of the British people, in rising to the challenge. You are proud of their determination to turn the tide and win the war. Beating this enemy is a team effort. (The forthcoming press attacks are therefore tantamount to siding with the enemy.)

5. But admit there are challenges. Cannot sugar-coat. Unprecedented times. Select any or all of the following: you are working night and day, round the clock, fighting tooth and nail, unflinchingly and unblinkingly moving heaven and earth and straining every sinew while you move mountains in a herculean, mammoth effort to get to the light at the end of the tunnel.

6. Dont mention care homes.

7. Today, the government can announce it is ramping up something. At pace. Budget of millions. On anything from badges to research. A jingoistic comparison is, at this point, recommended. Although maybe not Boris Johnsons fantasy, from 16 March, that the UK is now leading a global campaign to fight back. Substitute: Our world-leading scientific experts.

8. Finally, recite the approved slogan (on the front of the lecterns, if youve forgotten) and its over to a scientist for the latest curve-flattening data. Since the UK figures will be among the worst in the world, emphasise that comparisons are meaningless.

What follows press questions is not always as straightforward, even now favoured civilians are, in a rare borrowing from Jeremy Corbyn, invited to use up time and, being warmly praised, show up the journalists. Even in our darkest moments, as the first secretary, Dominic Raab, recently said, the crisis has also shone a light on the best among us. Step forward, Lynne in Skipton.

Happily, the virtual plague set-up does afford some defence against hostile interrogation. Observe how the health secretary, Matt Hancock, learned smartly to introduce the next questioner, closing down an annoying one. And remember some journalists will always ask, basically: Are we nearly there yet? Take at least three minutes to revisit the five tests.

Even death-obsessed hacks, rehearsing Britains fatal delays during Johnsons sing Happy Birthday period, may feel awkward about associating an individual minister with failures, effectively, unforgivable negligence. But deploy accompanying scientists, in case of such attacks, as your bespoke, personal protection equipment. We have followed the science and always made the right decisions at the right time.

Try answering a difficult question with Raabs speciality the response to a different one. How many tests completed? Journalists still bringing up Johnsons early pledge of 250,000 a day? Also irrelevant. Were ramping up. Herculean effort. Finest military planners in the world.

On PPE, the guidance is similar: befuddle them with billions of items, deploy the heroic working night and day/all hours God sends and agree, fervently, on the need. So lets hope the heroic frontline isnt wasting it. We need, Hancock warned on 10 April, everyone to treat PPE like the precious resource that it is.

Theres no avoiding care homes. Improvise. Say these were a top priority from the start and hope nobody remembers Johnsons vague advice, as late as 16 March, against unnecessary visits. Hancock recalls, future inquiries will note, that in January one of the first things we knew about this virus was that it had a very strong age profile, as in it was much more dangerous for older people. But he wants to dispute the suggestion that the sector had been desperate for tests, thered been these index ones and no doubt many lives were saved as a result.

That the government, by way of building trust, is committed to defending clear failures with vastly tragic consequences was re-established last week when a returning Johnson depicted almost 27,000 deaths as a good outcome, for not being 500,000. Plainly, if Dominic Cummings did not calculate that such misrepresentations were, regardless of the press mischief, politically advantageous, the briefings would not be happening.

But for all the obfuscation they allow glimpses of the truth. It cant have been the intention to expose the dismaying inadequacies of Johnsons cabinet, selected, as its members mostly were, for loyalty rather than intelligence or experience. It cant have been Cummingss plan to underline the culpability of a leader who bequeaths as his substitute in a national crisis a man you would not trust with a stepladder.

Perhaps the lingering memory of these sessions will be ministers collective adherence to a script composed by the authors of Get Brexit Done, which no death toll is big enough to revise. No scientist should have to take responsibility for that.

Catherine Bennett is an Observer columnist

Governors move ahead with reopening, despite health worries.

Governors across the country forged ahead Monday with plans to reopen their economies, even as the nation hit a grim milestone of 50,000 deaths from the coronavirus and public health experts warned against lifting stay-at-home orders too quickly.

Texas, with its population of nearly 30 million, made one of the most expansive moves toward reopening when Gov. Greg Abbott announced that stores, restaurants, movie theaters and malls would be allowed to reopen with limited capacity on Friday. Mr. Abbott had previously lifted some restrictions, but his announcement on Monday brought his state to the brink of a complete reopening.

In Ohio, Gov. Mike DeWine unveiled a more incremental reopening plan that would allow manufacturing work to resume and offices to reopen next week.

Mr. DeWine was the first governor to shut down schools statewide and has taken among the most aggressive approaches, but he said there was a growing risk to the economy if Ohio did not start reopening.

I think we found the spot that is most likely to cause less damage, more likely to cause good, Mr. DeWine said. But it is a risk, and I fully understand the risk.

New coronavirus infections and deaths appear to be plateauing on a national level, but they are still surging in some of the states and counties reopening this week. Health experts worry that reopening prematurely without sufficient testing, protective equipment and other safeguards could fuel another spike in cases.

Florida and Arizona have stay-at-home orders due to expire on Thursday, but the governors of both states have been vague about their plans. Gov. Ron DeSantis said that while he had discussed how to reopen with other Southern states, Florida required its own rules.

Workers say they are living in limbo as they watch other states reopen and worry about the risks of going back to work versus the bills piling up.

In Nevada, where the stay-at-home order expires on Thursday, Deidra Young, a bartender, feels torn. If my work does call me, I honestly want to say no, Ms. Young said. But will I not get unemployment if I refuse?

It was an agonizing calculation, she said: We all want to go back to work, but we dont want to get sick.

The White House unveils a testing plan, but Democrats are skeptical.

President Trump, under growing pressure to expand testing as states move to reopen their economies, unveiled a plan on Monday to ramp up the federal governments help to states, but his proposal runs far short of what most public health experts say is necessary.

The announcement came after weeks of the president insisting, inaccurately, that the nations testing capability was fully sufficient to begin opening up the country.

An administration official said the federal government aimed to give states the ability to test at least 2 percent of their populations per month, though Mr. Trump did not use that figure at Mondays briefing and it was not in his written plan. Instead, he said the United States would double the number of tests it had been doing.

The plan was met with swift criticism from Democrats, including Senator Patty Murray of Washington, who said in a statement that it said nothing new and will accomplish nothing new.

It doesnt set specific, numeric goals, offer a time frame, identify ways to fix our broken supply chain or offer any details whatsoever on expanding lab capacity or activating needed manufacturing capacity, said Ms. Murray, the top Democrat on the Senate Health Committee.

Perhaps most pathetically, it attempts to shirk obviously federal responsibilities by assigning them solely to states instead, she said.

In the past, the Trump administration has sometimes promised large increases in testing that it has failed to deliver. The administration has also steadfastly resisted calls to nationalize the production and distribution of coronavirus test kits, and the plan Mr. Trump unveiled reiterated that stance, making clear that the states are still primarily responsible for testing and Washington is the supplier of last resort.

Rather than the more comprehensive surveillance testing sought by many public health experts, the administration is focused on a more limited goal of sentinel testing of targeted sites that are particularly vulnerable, like nursing homes and inner-city health centers.

In the seven weeks since the president promised that anyone who needed a test could get one, the United States has conducted about 5.4 million tests, far more than any other country, but still the equivalent of about 1.6 percent of the total population.

A group of experts convened by Harvard Universitys Edmond J. Safra Center for Ethics has called for five million tests a day by early June, ramping up to 20 million per day by late July.

In a call with governors, Trump suggests some states should reopen schools.

President Trump suggested to the nations governors on Monday that some should move to reopen their public schools before the end of the academic year, an indication that he is growing impatient with the widespread closures to curb the coronavirus outbreak.

Some of you might start to think about school openings, Mr. Trump said on a conference call with the governors, according to an audio recording obtained by The New York Times. The young children have done very well in this disaster that weve all gone through, so a lot of people are thinking about the school openings.

Addressing Vice President Mike Pence, who was also on the call, Mr. Trump added, I think its something, Mike, they can seriously consider and maybe get going on it.

The presidents nudge on school openings runs counter to the advice of medical experts and came unbidden during a conversation about testing and respirator use.

Mr. Trump reiterated his desire to see schools open Monday evening at the White House, saying, I think youll see a lot of schools open up, even for a short period of time.

At least one state was already moving forward with the possibility of reopening schools. Montana, which has among the fewest cases and deaths, will give schools the option to reopen starting May 7.

Earlier Monday, Gov. Philip D. Murphy of New Jersey said on CNBC that there was a chance schools in New Jersey would reopen in some fashion before the end of June.

In the portion of the recording obtained by The Times, no governor chimed in to agree or disagree with the president.

Attorney General William P. Barr on Monday asked federal prosecutors around the country to look out for emergency state or local orders issued to contain the pandemic that could also violate constitutional rights and civil liberties, and to fight them in court if needed.

If a state or local ordinance crosses the line from an appropriate exercise of authority to stop the spread of Covid-19 into an overbearing infringement of constitutional and statutory protections, the Department of Justice may have an obligation to address that overreach in federal court, Mr. Barr wrote in a memo.

Matthew Schneider, the United States attorney for the Eastern District of Michigan, will work with Eric Dreiband, the head of the Justice Departments Civil Rights division, to oversee and coordinate the effort.

Mr. Barr has signaled for weeks that he will combat shutdown orders that violate the Constitution. The Justice Department filed a motion this month in support of a Baptist church in Greenville, Miss., that sued the city and its mayor for outlawing the congregations drive-in church services even as the city allowed drive-in restaurants to serve customers. The city fined churchgoers but later withdrew the fines, and Greenville has since changed its order. Lawyers for the church said that the legal matter would most likely be dropped.

In California, a lawsuit filed on Monday in federal court on behalf of a firearms instructor at a Sacramento gun club and a Republican candidate for Congress charged that the states stay-at-home order unconstitutionally denied them a permit to demonstrate outside the State Capitol last week.

The case is the second this month brought by Harmeet Dhillon, the chairwoman of the states Republican National Committee, and the Center for American Liberty, a civil liberties nonprofit group she founded. An earlier suit argued unsuccessfully that churches had been unfairly deemed nonessential.

Some businesses reopen, but fear may keep customers away.

Many business owners in states that are easing restrictions and allowing some businesses to reopen said they were uncertain about all the new rules, and were trying to make sense of a cacophony of messages from President Trump, governors, county commissioners and mayors.

I couldnt sleep last night because I was so confused, Jose Oregel, who owns a barbershop in Greeley, Colo., said on Monday morning, an hour before he was expecting his first customers, who will get haircuts from barbers wearing masks and gloves.

In Colorado, real estate showings were allowed to restart on Monday as the governors stay-at-home order expired, and pet owners were able to take their animals to the vet for nonemergency operations. At the same time, Denver and many surrounding suburbs extended their closure orders.

In Georgia, where Gov. Brian Kemps decision to let restaurants reopen to eat-in diners on Monday despite an uptick in deaths drew criticism from Mr. Trump, many Atlanta establishments decided not to do so. One restaurant that tried was Rocky Mountain Pizza Company, near the Georgia Institute of Technology. It opened its doors Monday morning, but as of 12:30 p.m., no one had come to sit down for lunch.

I cannot imagine myself going to a pub or a restaurant right now, said Filippos Tagklis, 30, a graduate student at Georgia Tech, as he walked his dog by the restaurant.

Black and Latino Americans entered the coronavirus crisis with lower incomes and less wealth than whites. In the early months of the outbreak, they suffered disproportionately high rates of infection and job loss.

It is a pick-your-poison fact of a crisis that has exacerbated racial and socioeconomic inequality in the United States: The pandemic has knocked millions of the most economically vulnerable Americans out of work. Rushing to reopen their employers could offer them a financial lifeline, but at a potentially steep cost to their health.

Americans who earn $50,000 a year or less are more than twice as likely to say they or a family member have lost jobs amid the crisis as those who earn more than $150,000. Higher earners and whites are far more likely to say they can work from home during the pandemic than lower earners and black and Latino Americans, according to an April poll for The New York Times by the online research firm SurveyMonkey.

Simon Mongey and Alex Weinberg, economists at the University of Chicago, released a study last month that found those workers were disproportionately nonwhite, low income, born outside the United States and not college graduates.

There could be immense and devastating income effects that could be involved with this evolving depression, said William A. Darity Jr., a leading scholar of economic discrimination in the United States. Inequality, he said, has been horrendous in recent years, and I can only imagine those disparities would get worse.

The known U.S. death toll exceeds 50,000, with nearly a million cases.

More than 50,000 people have died from the virus in the United States, which has more confirmed cases and deaths than any other nation, according to a tally by The New York Times.

And as the outbreak spread, the nations total number of confirmed cases continued to climb toward one million, reaching more than 987,000.

The tally does not include more than 5,200 people in New York City and smaller numbers in other states and U.S. territories who died and are believed to have had the virus. Many of those patients were not tested, a consequence of a strained medical system and a persistent lack of testing capacity.

Even as case numbers have stabilized in some hard-hit cities, including New Orleans and Seattle, other places have seen growth.

The counties that include Los Angeles and Chicago added more than 1,000 new cases on several recent days. In Massachusetts, numbers surpassed 54,000 on Sunday, up from 38,000 a week earlier. And across the Midwest and Great Plains, production at meatpacking plants had slowed or stopped because of large outbreaks, including one that sickened more than 1,000 people in South Dakota.

In New York, hundreds of deaths are announced each day, though those numbers are far below their peak earlier this month. Now, 60 percent of voters in New York City say they personally know someone who tested positive, and 46 percent know someone who died of the virus, according to a poll by the Siena College Research Institute.

Congressional leaders announced on Monday that the House and Senate would both return to session in Washington next week despite a stay-at-home order from the citys mayor.

Senator Mitch McConnell, Republican of Kentucky and the majority leader, said that his chamber would modify routines in ways that are smart and safe, but that Americans expected senators to be working.

House leaders said they would also convene on Monday but told lawmakers to anticipate a scaled-back voting schedule and more emphasis on restarting work by committees that will conduct oversight of the Trump administrations virus response and other routine business.

Representative Steny H. Hoyer of Maryland, the No. 2 Democrat, said the House would vote next week with or without Republican support to change its rules to allow proxy voting and virtual committee meetings abilities that could allow the chamber to operate more fully on a remote basis in the weeks ahead.

Still, some Democratic lawmakers were uneasy about packing back into the Capitol at a time when health experts have repeatedly warned against travel and group gatherings. On a Democratic conference call on Monday, Representative Debbie Wasserman Schultz, Democrat of Florida, called the plan to return dangerous, according to two people on the call who described the private discussion on the condition of anonymity.

Amid high demand for small-business aid, the website for processing loans crashes.

Less than an hour after the Small Business Administration on Monday morning resumed taking requests for another $310 billion in emergency aid for small businesses, its computer system for processing the loan applications crashed.

Its obvious the system is simply flooded right now, said Craig Street, the chief lending officer at United Midwest Savings Bank in Columbus, Ohio. Its been very stop and start, with no real way to know whether it is working other than to keep hitting the submit button.

It was a rocky resumption for the Paycheck Protection Program, a stimulus initiative that offers small companies forgivable loans to cover their payrolls. The program began early this month, but its initial round of funding $342 billion was depleted in 13 days and the agency stopped accepting requests, leaving hundreds of thousands of borrowers frozen out until Congress provided a new funding round last week. The government began accepting applications for it at 10:30 a.m. on Monday.

Officials at the Small Business Administration, which is managing the program, did not immediately respond to questions about the technical problems that lenders were reporting with E-Tran, the agencys computer system for processing loans.

A New York Times investigation found that dozens of large but lower-profile companies with financial or legal problems had received large payouts under the program, according to an analysis of the more than 200 publicly traded companies that have disclosed receiving a total of more than $750 million in bailout loans. Some companies, including Potbelly Sandwich Shops, the Los Angeles Lakers and Shake Shack, said they would return their loans.

Data shows more people are going outside and more often.

The changes in behavior, tracked using cellphone location data, have been measured in the past two weeks and can be seen in all but three states.

Lei Zhang, director of the Maryland Transportation Institute at the University of Maryland, College Park, which is leading the research, said that the data suggested that people were growing increasingly restless and that they were increasing the chances that they would interact with others and possibly spread the virus.

This virus doesnt go home because its a beautiful sunny day around our coasts, Mr. Newsom said.

He said he would present more details on reopening the economy on Tuesday but stressed that any relaxation of the states shutdown would be contingent on definitive evidence of a decline in hospitalizations and a ramped up ability to test for the virus, among other conditions.

The comments came as six counties in the Bay Area that put in place the nations first shelter-in-place orders in March announced that the orders would be extended through the end of May. At the same time, the governor has come under pressure to ease restrictions in areas less affected by the pandemic.

Oil prices are collapsing again.

Oil prices plunged on Monday, with the American benchmark hurtling toward the $10 a barrel mark, as fears about a global glut in crude continued to weigh on energy markets.

But the S&P 500 rose more than 1 percent, and European benchmarks rose 1 to 3 percent after a broadly higher day in Asia.

Since last week, investors have been panicked about oil storage facilities running out of capacity as producers continued to pump oil even as demand collapsed. That concern is most acute in the United States, where storage facilities in Cushing, Okla., are expected to reach capacity in May.

It is one reason the collapse in futures of American crude has been so much sharper than the global benchmark. On Monday, West Texas Intermediate crude, the U.S. benchmark, was down about 27 percent at a little more than $12 a barrel. At the same time, Brent crude, the global benchmark, was down about 9 percent to just above $19 a barrel.

One factor behind the difference in price is that the Cushing facilities are landlocked, reachable only by pipeline, whereas Brent supplies can be reached by boat and either stored there or placed at facilities around the globe. Investors betting on an eventual rebound in oil prices are filling oil tankers up with as much as two million barrels per vessel and parking them out at sea.

Global cuts in oil production are set to start on Friday, after the Organization of the Petroleum Exporting Countries, along with Russia and other producers, agreed to reduce daily output by 9.7 million barrels a day, which is close to 10 percent of global output.

The C.D.C. expands its list of symptoms.

The Centers for Disease Control and Prevention has added six possible symptoms of the virus to its list, a step that reflects the broad variation and unpredictability of the effects of the illness.

Echoing the observations of doctors treating thousands of patients, the federal health agency this month changed its website to cite chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell as possible indicators of Covid-19.

The C.D.C. had listed just three symptoms: fever, cough and shortness of breath. The agency made no public announcement when it added the new symptoms to its website on April 18, and it did not immediately respond to questions about the revised list.

The revised C.D.C. list differs somewhat from the symptoms described by the World Health Organization on its website: fever, dry cough and tiredness. Some patients may have aches and pains, nasal congestion, sore throat or diarrhea, the W.H.O. says. These symptoms are usually mild and begin gradually.

The White House canceled and then rescheduled Mondays daily task force briefing.

Never mind. Less than two hours after the White House canceled the daily coronavirus news briefing, it rescheduled it, saying that the president would make an announcement on testing.

The White House has additional testing guidance and other announcements about safely opening up America again, Kayleigh McEnany, the White House press secretary, wrote on Twitter. President @realDonaldTrump will brief the nation during a press conference this evening.

The White House scheduled the newly slated news conference for the Rose Garden at 5 p.m., the same time the briefing was originally scheduled before it was canceled shortly before lunch. Some of Mr. Trumps aides and allies had expressed concern that the briefings had become a liability for the president, and he himself said over the weekend that they were not worth the time & effort. But Mr. Trump has rarely resisted news media appearances for long.

A House panel opens an investigation into Trumps decision to halt W.H.O. funding.

The House Foreign Affairs Committee on Monday announced it would open an investigation into Mr. Trumps decision to halt funding to the World Health Organization, calling the move a political distraction from the administrations lackluster response to the pandemic.

Attacking the W.H.O., rather than the Covid-19 outbreak, will only worsen an already dire situation by undermining one of our key tools to fight the spreading disease, Representative Eliot L. Engel of New York, the chairman of the Foreign Affairs Committee, wrote in a letter to Secretary of State Mike Pompeo.

Mr. Trump said earlier this month that he planned to cut off American funding for the organization, blaming the agency for a 20-fold increase in cases worldwide and claiming the W.H.O. had become too China-centric.

His criticisms mirrored those of Republican lawmakers who have accused the organizations leaders of being too trusting of Beijing regarding Chinas response.

The Democratic-led House recently created an oversight panel focused on the Trump administrations response.

Houston reels from oil-market chaos on top of a virus shutdown.

Cities across the country are struggling under the economic shadow of the virus. But few have to deal with the collapse of their fundamental industry the way Houston, the self-proclaimed energy capital of the world, has as oil prices have plummeted.

On the same day that the price for U.S. crude oil fell to about $30 below zero a mind-bending concept that signaled the first time oil prices had ever turned negative Mayor Sylvester Turner of Houston stood before reporters and delivered the grim news, his words muffled by the black mask covering his face.

City employees would soon be furloughed, the mayor announced, but he declined to say how many. The Houston Zoo, he said, could expect to see funding deferred under what he called the worst budget that the city will deal with in its history.

Officials there are bracing for worse.

Weve probably seen within weeks the same amount of economic shock that used to occur in years, said State Senator Paul Bettencourt, a Houston Republican whose district includes a stretch of Interstate 10 that is home to Shell, ConocoPhillips and other oil and gas giants. Weve gone through this before. The problem is we didnt do it in the middle of a pandemic.

WASHINGTON As lawmakers gathered in the well of the House in the early hours of March 14 to vote on a sweeping coronavirus relief bill, Representative Max Rose, Democrat of New York, felt that the pandemic that had already begun spreading through the ranks of Congress was about to upend life as he knew it.

Hundreds of miles away in New York, his wife Leigh Rose, unaware that votes had finished just before 1 a.m., was frantically calling him, and then his roommate, Representative Jared Golden, Democrat of Maine, to let him know that his life was about to change in a much different way.

Buddy! Mr. Rose recalled Mr. Golden saying when he finally tracked Mr. Rose down. Youre having a kid.

The baby the Roses had long planned to adopt was about to be born, three weeks early. Now, the pair is navigating the first months of parenthood in the middle of a pandemic, figuring out how to secure formula and diapers in a shuttered city all while Mr. Rose juggles trips back and forth from Washington to vote. In the middle of it all, the first-term congressman from Staten Island deployed for two weeks with the National Guard to assist with coronavirus relief.

Think about this world that hes been brought into, startlingly different than the world was just several months before, Mr. Rose said of his newborn son. We just really want him to be safe, and happy, and healthy. Its scary.

But what a story of his birth, he added.

The prospect of parenthood had been simmering beneath the tumultuous events of Mr. Roses freshman term: a month after he took office during the nations longest government shutdown, the couple began pursuing the adoption process. The months of arduous paperwork and uncertainty continued through Mr. Roses adjustment to a weekly commute between Staten Island and Washington, and a summer of congressional investigations.

In November, as the impeachment inquiry consumed Capitol Hill, the couple learned they had been matched with a birth mother, whom they declined to identify out of respect for her privacy, and began preparing to welcome their baby in April. But in the wee hours of a Saturday morning in March, as Mr. Rose voted on coronavirus relief legislation, Ms. Rose learned that their son was about to be born right then. She jumped in her car and drove through the night to reach New England.

Miles Benjamin Rose was born at 2 a.m., and Mr. Rose got the first flight out of Washington later that day to meet his son.

Theres so many families that are going through exactly what were going through I mean with newborns with young children at home, Ms. Rose said. Were definitely not alone.

As the couple drove back to New York with their son, the city had begun to completely shutter to stem the spread of the virus. They agreed that Mr. Rose, an Afghanistan combat veteran who is a captain in the Army National Guard, should deploy to help with the citys response to the pandemic. He was the first member of Congress to do so, citing a desire to take a more personal role in providing relief to his constituents.

It was a decision that kept Mr. Rose physically apart from Ms. Rose and Miles for a month, during the deployment and then the mandated two-week isolation period to ensure that Mr. Rose had not contracted the coronavirus.

It was the right thing to do, Mr. Rose said. It was important to serve in this capacity at this moment.

Everybody is sacrificing far more than we have, he added, pointing to the doctors and nurses he met who were isolating in basements or hotels for far longer periods of time to protect their families and maintain their work.

Ms. Rose acknowledged the challenge of the circumstances, but added: Theres so many people that are struggling, and its so important for Max to take care of the people in our district.

In the moments when Mr. Rose could come home during his deployment, he would eat dinner on the trunk of their car in the garage 10 feet away from where Ms. Rose would stand with the baby. But then Mr. Rose had to isolate himself for another two weeks, keeping him from holding Miles, who is just starting to coo and smile, until Friday.

The pair has also tapped into the growing network of parents on Capitol Hill with young children. They ticked off a list of Mr. Roses Democratic colleagues Representatives Abigail Spanberger of Virginia, Pete Aguilar of California, Josh Gottheimer, Mikie Sherrill of New Jersey and Antonio Delgado of New York among them and their spouses, who have repeatedly checked in on the couple in recent days.

I lean on them they understand the experiences that we have, said Ms. Rose, who recently joined a Zoom call with a dozen congressional spouses to check in.

It remains unclear, they said, how the couple will handle Mr. Roses trips to Washington, where coronavirus cases continue to escalate. The House is expected to return the week of May 11. Mr. Rose said having a newborn at home had only intensified his desire to institute a remote voting policy in times of emergency, to ease the burden on congressional families.

And the work on Capitol Hill and its consequences, he said, have become even more personal for him now that he is a father.

Were going to continue to find joy in our family, and the little moments each and every day, Mr. Rose said. And that joy and that optimism and that hope is even more important right now, because when we say that were all in this together, its our family with everyone elses.

Not even Warren E. Buffett was spared financially from the coronavirus, as his conglomerate, Berkshire Hathaway, reported a $49.7 billion loss in the first quarter on Saturday, reflecting the outbreaks toll on an investment portfolio that includes big stakes in major airlines and financial firms.

The loss was Berkshires biggest ever and a sharp swing from a $21.7 billion profit in the same quarter a year earlier. The conglomerates vast array of investments exposed it and Mr. Buffett, long considered one of the worlds top investors to huge swaths of the battered American economy.

Its total investment loss for the quarter, without accounting for operating earnings, was $54.5 billion. By comparison, its investment gain in all of 2019 was $56.3 billion.

Berkshire said it continued to sell stock in April, totaling $6.5 billion, plowing that money primarily into supersafe Treasury bills. Later Saturday, at his annual shareholders meeting, Mr. Buffett suggested that some of those sales involved Berkshires reversing its roughly 10 percent in the four largest U.S. airlines.

Berkshires investment loss tracked the overall slide in stock markets: The S&P 500 dropped 20 percent in the first quarter. (The companys biggest holdings are also mainstays of the S&P 500: American Express, Apple, Bank of America, Coca-Cola and Wells Fargo, with those stakes amounting to nearly $125 billion.)

The loss overshadowed a 6 percent rise in Berkshires operating earnings, which track the performance of the companys owned-and-operated businesses like the insurer Geico. Mr. Buffett regards that as a better measure of the companys overall performance and has long argued that quarterly paper gains or losses on its investments are often meaningless in understanding its overall health.

But it is hard to ignore the damage to a portfolio that includes stakes in financial firms like Bank of America and American Express, both of which reported steep drops in earnings for the first quarter, and four of the biggest U.S. airlines. (Berkshire also disclosed that the value of its stake in Kraft Heinz on its books exceeds the market value of that holding by about 40 percent, and warned that it might have to take a write-down on the investment in the future.)

Even some of the conglomerates wholly owned businesses, like the Burlington Northern Santa Fe railroad and retailers like Sees Candy, were hurt by the lockdowns that have shaken the U.S. economy. Still, Geico reported a 28 percent gain for the quarter, to $984 million, while Berkshires overall insurance investment profits rose modestly because of increased dividend income for the company.

The first-quarter results, in which Berkshire reported having $137.3 billion in cash, were released ahead of its first-ever online-only shareholder meeting. Sometimes described as a kind of Woodstock for capitalists, the meeting is usually a weekend-long Omaha extravaganza celebrating all things Buffett and Berkshire.

This year, it was a decidedly more subdued affair, reflecting the limits on mass gatherings and travel of the Covid-crisis era. Mr. Buffetts longtime business partner, 96-year-old Charlie Munger, did not attend, staying at home in Los Angeles.

It just didnt seem like a good idea to have him make the trip to Omaha, Mr. Buffett said, adding, Charlie is in fine shape, and hell be back next year.

Mr. Buffett was joined instead by Greg Abel, Berkshires vice chairman overseeing all of the companys non-insurance companies, who sat at a separate desk some distance from Mr. Buffett.

Instead of facing thousands of adoring and affluent shareholders, Mr. Buffett, noting that he hadnt had a haircut in seven weeks, held forth in an almost completely vacant Omaha arena that seats more than 17,000, as his comments were livestreamed.

Discussing the breakdown in the financial markets that prompted the Federal Reserve to drastically ramp up efforts to pump in fresh cash, he said, We came very close to having a total freeze of credit.

When it came to Berkshires stake in the airlines, Mr. Buffett said, I just decided that Id made a mistake.

He added that because of the pandemics impact on travel, the airline business and I may be wrong, and I hope Im wrong but I think it, it changed in a very major way.