The Coronavirus Outbreak

The inflammatory syndrome, which health officials said resembles toxic shock, has killed three children in the state, and Mayor Bill de Blasio urged parents to watch for symptoms.

Cases and deaths in New York State

Includes confirmed and probable cases where available

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ImageVisitors at Marcus Garvey Park in the Harlem on Sunday.
Visitors at Marcus Garvey Park in the Harlem on Sunday.Credit...Victor J. Blue for The New York Times

Mayor Bill de Blasio said Sunday that 38 New York City children have been inflicted with a serious new inflammatory syndrome that city health officials say appears to be linked to an immune response to Covid-19.

That is more than double the 15 cases the city health department warned of in an alert to city health providers on Monday.

The illness, known as pediatric multisystem inflammatory syndrome, introduces a troubling new aspect to the Covid-19 pandemic, which has largely spared children from serious disease. Statewide, three children have died of the inflammatory condition, including one in New York City, and state officials were investigating 85 potential cases, Gov. Andrew M. Cuomo said on Sunday.

Of the three children who have died, two were of elementary school age and one was an adolescent, said Dr. Howard Zucker, the state health commissioner. They lived in three different counties, and were not known to have pre-existing conditions.

“The most important thing parents should do is err on the side of caution,” Dr. Zucker said.

The syndrome was first brought to the attention of New Yorkers in the past week, but Dr. Oxiris Barbot, the city’s health commissioner, said that the health department had alerted health providers to the syndrome on May 1, after hearing reports of the condition from the United Kingdom.

The inflammatory syndrome, health officials say, resembles toxic shock or Kawasaki disease. Children with the virus-related condition may have prolonged high fevers, rash, severe abdominal pain, racing hearts and a change in skin color, such as redness of the tongue.

“This is still evolving,” Dr. Barbot said at the mayor’s Sunday briefing. She called for the federal government to assist with increased virus testing citywide to help identify children at risk.

A handful of cases have been reported in other states, including Louisiana, Mississippi and California. At least 50 cases have been reported in European countries, including Britain, France, Switzerland, Spain and Italy.

Among the other developments from Mr. de Blasio’s briefing on Sunday:

  • At least 260 city employees have died from complications of the coronavirus, Mr. de Blasio said. The city will now extend by 45 days health insurance coverage for those families, but the mayor also emphasized that federal help would be necessary to extend further benefits to all essential workers.

  • The city will increase the number of city employees acting as “social distancing ambassadors” to 2,300, up from 1,000. The move comes after criticism that city police were unfairly enforcing such rules. According to recent figures from the NYPD, 35 of the 40 people arrested for violating social distancing rules are black.

  • Mr. de Blasio said recent indicators showing the city’s attempt to curtail the spread of the coronavirus were a “mixed bag.” As of May 8, the number of new coronavirus patients hospitalized held steady at 69, the same as the prior day. The number of patients in ICU treatment was 540, down slightly from 559 the day before.

  • Mr. de Blasio also dismissed concerns that enforcing social-distancing rules was infringing on the freedom of speech of protesters, some of whom have gathered in recent days to criticize a variety of issues. Mr. de Blasio called such gatherings “idiotic” and said they were “literally out of step with the times we’re living in to believe that the only way to get something done is to gather in the middle of the pandemic.”

The Isabella House, a nursing home in Inwood, Manhattan.Credit...Gregg Vigliotti for The New York Times

Gov. Andrew M. Cuomo announced a series of new measures on Sunday to help protect the roughly 100,000 New Yorkers who are living in nursing homes, which have seen thousands of deaths due to Covid-19.

He also warned that any nursing home operator that failed to provide appropriate care for each of its residents, whether because of a shortage of personal protective equipment, staff, or inability to appropriately isolate Covid-19 positive patients, would lose its operating license.

“The rule is very simple,” Mr. Cuomo said. “If a nursing home cannot provide care for a person and provide the appropriate level of care for any reason, they must transfer the person out of the facility.”

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Gov. Andrew M. Cuomo of New York announced new rules to help protect residents in nursing homes, where there have been thousands of deaths related to Covid-19.CreditCredit...Justin Lane/EPA, via Shutterstock

Nursing homes that cannot find an appropriate place to place a patient can call the state Department of Health to seek a transfer, the governor said. The state will then put the patient in one of roughly 40,000 excess-capacity hospital beds, including the Javits Center, that have been created statewide during the Covid-19 crisis.

Going forward, all nursing home workers statewide must be tested for Covid-19 twice a week, Mr. Cuomo said. Staff must wear masks, and workers dealing with Covid-positive patients must wear appropriate personal protection equipment.

In another key change, hospitals are no longer permitted to discharge Covid-19 positive patients to nursing homes, the governor said. Instead, he said, they should either hold them or transfer them to a Covid-19 only facility.

The new guidance appeared to reverse a March 25 state order that barred nursing homes from discriminating against Covid-19 patients seeking admission. But Mr. Cuomo denied the new policy was a reversal, saying that nursing homes at any time could have refused Covid-positive patients if they were incapable of caring for them.

Other updates from Mr. Cuomo’s briefing:

  • The total number of Covid-19 patients hospitalized in the state is 7,262, down about 500 patients from the day before. The three-day average for the new Covid-19 hospitalizations is 521, down from 572. That latest figure is “basically right where we were” when Mr. Cuomo signed an executive order in late March to essentially shut down the state’s economy, he said.

  • The state reported an additional 207 deaths for May 9, which is lower than the last few days.

  • Mr. Cuomo reiterated his call for federal funding, and said the state needed $35 billion “this year just to compensate for the total amount of losses.”

  • Mr. Cuomo also said federal money should not go to any business that reduces the size of its work force. If that guarantee is not in place, Mr. Cuomo said, “You will see corporations using this pandemic to lay off workers.”

  • Tomorrow, Mr. Cuomo and county executives will discuss reopening parts of the state as early as May 15, when his order limiting nonessential business and activities is set to end. When asked about opening one region in particular, the mid-Hudson Valley, Mr. Cuomo said it was unlikely to occur by May 15.

Two weeks after New York City shut down, Poonam Sharma Mathis went into labor.

Ms. Mathis chronicled her journey bringing life into this uncertain time in a video diary for The New York Times. From the birth at NewYork-Presbyterian/Weill Cornell Medical Center, which was slammed with critically ill coronavirus patients to her first time breastfeeding her baby — while wearing a mask, Ms. Mathis shares her challenging experience.

With Asha, her new baby, in her arms, is the loveliness of having a newborn, offset by deep uncertainty about what lies ahead.

The Jay Street MetroTech subway station after a night cleaning on May 6.Credit...Hilary Swift for The New York Times

Mayor Bill de Blasio on Sunday praised the city’s efforts to engage homeless people and provide shelter for them as the subway shuts down nightly, though advocates continued to urge the city to provide more resources.

Since the Metropolitan Transportation Authority began its nightly closure of the subway system on Wednesday, the city’s Department of Homeless Services has been working with the transit agency and the police to aggressively engage homeless people on the trains to coax them into shelters.

Mr. de Blasio reported Sunday that 384 people had been engaged the previous night, and 175 of them had agreed to go to shelters while 23 went to hospitals. Friday night, when 416 people were engaged, 183 went to shelters and 29 to hospitals — though the commissioner of social services, Steven Banks, noted that not every person who was taken to a shelter necessarily entered and stayed.

But, Mr. Banks said, “simply getting you to the front door, for that individual, is a step forward.”

When temperatures dipped on Friday night into Saturday, the M.T.A. provided stationary, warming buses at some end-of-the line stations as shelter. But it did not provide the same service Saturday night, when the weather was warmer.

Kayla Shults, a spokeswoman for the M.T.A., said in a statement that the buses had been a “one-time measure due to unseasonably cold temperatures.”

“Ensuring access to shelter and social services for homeless New Yorkers continues to be a city responsibility,” she added.

The city’s homeless services agency did not immediately respond to questions about the M.T.A.’s decision. As of Friday, 73 homeless people had died of the virus, according to the agency. Nearly three out of four of those deaths have been people who had lived in shelters for single adults.

Advocates have urged the city to open hotel rooms to thousands of homeless people in shelters and on the streets. The city has moved people who have tested positive for Covid-19, elderly people, medically fragile individuals or those who lived in densely populated shelters into rooms, but has not expanded those efforts to the general homeless population.

Miguel FichCredit...Markel Bilbao

The Times is regularly profiling essential workers in the New York region during the pandemic.

Where do you live? The Bronx.

Where do you work? Unitex Services in Mt. Vernon, N.Y., for 25 years, picking up and delivering laundry — gowns, linens, towels — from hospitals.

How has your job changed?

We have five guys who caught the disease. It’s really hard to cope with but we have do the job. We have to keep working. I am blessed in the middle of this crisis that I still have a job.

Have you seen things that disturbed you?

We are in and out of the hospital, so seeing all the diseased, seeing all the bodies, putting them in the freezers, the trailers, that really takes its toll.

What keeps you going?

It’s very stressful, but it’s an honor for me to be doing it, knowing that it’s very important now, to serve the city that I live in and to serve my people.

We deliver the linen to all of the city’s major hospitals, and it’s a need for them to have the sheets, the towels, the pillow cases, all the medical equipment and special gowns for the patients. We feel like we are part of this whole ordeal, like we’re helping.

A coronavirus testing site at Gotham Health in Brooklyn last month.Credit...Dave Sanders for The New York Times

Nearly 190,000 people were tested for the coronavirus in New York City over the past two weeks. Mayor Bill de Blasio has announced plans to hire 1,000 disease detectives to track down the contacts of every infected New Yorker.

The city is also paying for hotels to house people who cannot quarantine in their cramped apartments, and it may use the USTA Billie Jean King National Tennis Center in Queens for the same purpose.

And Gov. Andrew M. Cuomo has established a framework for reopening New York State, based on seven concrete, health-related milestones, soliciting advice from dozens of advisers from the upper echelons of New York’s business world.

Still, despite all the plans and initiatives, the reopening of New York City remains a long way off.

The factors that made the city the U.S. epicenter of the pandemic — its density, tourism and dependence on mass transit — complicate a return to normalcy. The city, which has had more than 19,000 virus deaths so far, is still far from meeting the public health metrics necessary to reopen, from available critical-care beds to new hospital admissions for the virus.

And New York State is moving cautiously, anticipating a partial reopening later this month, mostly in rural areas.

So how long might it take to restart New York City’s economy?

“Nobody can tell you,” Mr. Cuomo said last week.

The key to reopening is containing the virus, and that will take a vast infrastructure of testing and contact tracing unlike anything the United States has ever seen, public health experts say.

Even when the new public health apparatus is fully staffed and running, it will merely lay a foundation for businesses and residents to feel safe returning to work and play. Many may choose to stay home.

A true reopening of the city, Mr. de Blasio said this month, remained “a few months away at minimum.”

The coronavirus outbreak has brought much of life in New York to a halt and there is no clear end in sight. But there are also moments that offer a sliver of strength, hope, humor or some other type of relief: a joke from a stranger on line at the supermarket; a favor from a friend down the block; a great meal ordered from a restaurant we want to survive; trivia night via Zoom with the bar down the street.

We’d like to hear about your moments, the ones that are helping you through these dark times. A reporter or editor may contact you. Your information will not be published without your consent.

Reporting was contributed by J. David Goodman, Sarah Maslin Nir, Sharon Otterman, Joel Petterson, Azi Paybarah, Michael Rothfeld, and Nikita Stewart.

  • Updated April 11, 2020

    • If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.