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Coronavirus Upends College Admissions Tests, Creating Chaos for Students

An Iowa school district that defied a reopening order is moving toward a “hybrid” model. South Korea suspends a plan to provide free flu shots to 19 million people.

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Between coronavirus concerns and wildfires in the West, many ACT tests were postponed last weekend.Credit...Eric Thayer for The New York Times

After a spring and summer when most opportunities to take college admissions tests were lost to the pandemic, many students were counting on taking the ACT on Saturday, one of the first big standardized testing dates of the fall.

But once again, disaster intervened. More than 500 ACT testing centers across the country were closed because of the coronavirus, the wildfires on the West Coast, or both. Students hoping to take the test at one center in Reno, Nev., learned it was closed only after arriving to find a sign taped to a nearby car: “Canceled due to poor air quality.”

The last time the test was offered, in July, some 1,400 students who had signed up experienced problems with closed testing centers.

The organization that administers the ACT has not said how many students were affected by closures on Saturday. It said earlier this month that it would help any affected students re-register for a later testing date.

The College Board has similarly struggled to administer the rival SAT test amid the pandemic. Of the 402,000 students who were registered in August, nearly half were unable to take it because of closed testing centers.

Many high school seniors have been left in limbo as they scramble to find an open test center, and some have even crossed state lines.

“It’s going on 18 months since I first started studying for the test,” said Ava Pallotta, a high school senior in New Rochelle, N.Y., whose spring test date was canceled. “Month after month, not knowing what my test score is has been so nerve-racking.”

The next SAT testing date is coming up on Saturday, and Ms. Pallotta is registered to take it in Albany, 150 miles from home. Like thousands of others, she is praying for no last-minute closure that would leave her applying for college without an SAT score.

Most colleges and universities have moved to “test optional” admissions policies since the coronavirus outbreak began, but many students still want to submit scores. More than 1,600 of the country’s 2,330 colleges and universities have at least temporarily stopped requiring the tests, according to FairTest, a group pushing to end standardized testing for college admission.

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The Centers for Disease Control and Prevention headquarters in Atlanta. On Monday, the agency revised information on its website about how the virus is transmitted.Credit...Audra Melton for The New York Times

The Centers for Disease Control and Prevention quietly introduced — and then on Monday quietly withdrew — guidance on its website acknowledging that the coronavirus is transmitted mainly through the air.

The rapid reversal is another in a string of confusing missteps from the agency regarding official guidance that it posts on its website. The latest debacle concerns the spread of the virus by aerosols, tiny particles containing the virus that can stay aloft for long periods and travel farther than six feet.

Aerosol experts noticed on Sunday that the agency had updated its description of how the virus spreads to say that the pathogen is spread primarily by air.

The virus is spread through “respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes,” the C.D.C. said in its guidance posted on Friday. These particles can be inhaled and seed an infection, the agency added: “This is thought to be the main way the virus spreads.”

But that language disappeared on Monday morning.

“A draft version of proposed changes to these recommendations was posted in error to the agency’s official website,” the agency said, and that once the final version is complete, “the update language will be posted.”

The document was posted to the C.D.C.’s website “prematurely” and is still being revised, according to a federal official familiar with the matter.

More than 200 experts in aerosol transmission appealed to the World Health Organization in July to review the evidence on aerosol transmission of the coronavirus. The W.H.O. acknowledged that this route appears to contribute significantly to the spread of the pandemic, but health experts disagree as to its importance relative to the heavier respiratory droplets that are sneezed or coughed by infected patients.

In another change of guidance on its website, the C.D.C. said in August that people who were in close contact with an infected person but had no symptoms didn’t need to get tested. But last week, after The New York Times reported that the guidance was dictated by political appointees in the administration rather than by scientists, the agency reversed its position and said all close contacts of infected people should be tested regardless of symptoms.

A public affairs official at the National Institutes of Health is retiring after reports that he had surreptitiously attacked his employer in wild and conspiratorial terms as a managing editor of the right-wing website RedState.

The official, William B. Crews, worked for the National Institute for Allergy and Infectious Diseases while simultaneously denouncing the agency’s work and its chief, Dr. Anthony S. Fauci, dismissing their research and public health advice in wild and conspiratorial terms under the pen name “streiff.”

His writing on the blog was first reported by The Daily Beast, along with a slew of posts on Twitter which spread misinformation about the coronavirus.

One post referred to Dr. Fauci as a “mask Nazi” while another warned of people being forced to “cooperate with the public health Gestapo” under “Fascist Governor Jay Inslee,” the Democratic governor of Washington.

The revelation comes after reporting by The New York Times last week showing that the head of communications at the N.I.H.’s parent agency, the Department of Health and Human Services, also accused federal scientists of using the coronavirus to try to defeat Mr. Trump. That official, Michael R. Caputo, went on medical leave on Wednesday, and his science adviser, Dr. Paul Alexander, left the government.

“I can’t think of a precedent for these vicious attacks against Dr. Fauci from someone in his own agency,” said Joshua M. Sharfstein, a professor at the Johns Hopkins Bloomberg School of Public Health. “It adds a terrible new twist to the pressure that many public health officials are facing.”

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The new rules are the most stringent since restaurants, pubs and many other businesses were allowed to emerge from full lockdown in July.Credit...Andrew Testa for The New York Times

Prime Minister Boris Johnson of Britain plans to impose new restrictions on nightlife, including the early closure of pubs and restaurants in England, as he ramps up the country’s efforts to curb a rising tide of coronavirus infections.

Pubs and restaurants will be restricted by law to offering table service only and must close at 10 p.m., beginning on Thursday, Downing Street said late on Monday; ordinarily, there is no mandatory closing time, though many close at 11 p.m. The new rules are the most stringent since restaurants, pubs and many other businesses were allowed to emerge from full lockdown in July.

Mr. Johnson was scheduled to officially announce his latest move in Parliament on Tuesday before making a broadcast address in the evening. The intervention comes after days of speculation that Britons could face tougher enforcement of existing rules, new curbs on different households meeting up with each other and shorter opening hours for pubs and restaurants.

The restrictions imposed by the central government apply only to England; Scotland, Wales and Northern Ireland set their own policies, which have followed a similar pattern.

Tighter restrictions are already in place in some parts of the country, and the virus alert rating was raised on Monday to Level 4, signifying that it is in general circulation, with transmission high or rising exponentially.

Like much of Europe, Britain is firmly in the grip of a second wave of the pandemic. Confirmed new infections fell from more than 5,000 a day in April and May to about 600 in early July, but have rebounded to about 3,600.

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As a new wave of coronavirus cases emerges in Europe, residents in Madrid protested increased restrictions in Spain.CreditCredit...Pablo Blazquez Dominguez/Getty Images

Much of Europe is scrambling to avoid another round of economically devastating widespread lockdowns as new spikes emerge in France, hospitals begin to fill in Spain, and officials in Britain warn that a six-month fight to contain the virus remains ahead.

New targeted lockdown measures took effect in Madrid on Monday, restricting nearly a million residents from traveling outside of their neighborhoods except for essential activities like work, school or emergency medical care.

The rules, which some residents protested over the weekend, come amid a spike in cases around the country, but concentrated in Madrid, where virus-related hospitalizations have tripled. New cases in Spain have risen to more than 10,000 per day on average over the past week, exceeding the official tally in the spring, when Spain was one of the worst-hit nations in Europe. Testing is more widely available now.

Though deaths countrywide have not risen to the levels seen earlier this year, the authorities in Madrid said on Sunday that 37 people there had died of Covid-19 in the past 24 hours, and about 4,000 patients were hospitalized, including some 300 in intensive care. The authorities there were preparing to reopen field hospitals if necessary.

In Britain, top scientific and medical advisers warned on Monday that infections could reach 50,000 a day by next month and spur a significant new spike in fatalities, as Wales announced an expansion of lockdown orders to take effect on Tuesday.

“We have, in a bad sense, literally turned the corner,” said Chris Whitty, England’s chief medical officer, in a rare televised statement alongside Patrick Vallance, the chief scientific adviser.

They cautioned that Britain faces a six-month battle to control the virus. Britain has imposed fines of at least 1,000 pounds, about $1,300, on those who do not self-isolate after testing positive or being exposed to the virus. The fines, which begin on Sept. 28, can increase to a maximum of £10,000 for repeat offenders or for the most serious breaches.

Though Britain has fewer cases or fatalities than some European countries, like France and Spain, the fear is that it is following the same trajectory, with cases rising sharply as children return to school, students to colleges and workers to offices.

Italy’s health minister, Roberto Speranza, announced Monday that the country would mandate virus testing for people traveling from Paris and other parts of France where the virus is “significantly circulating.”

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Public school students and supporters marched this month in Des Moines, Iowa, to protest the cancellation of fall and winter extracurricular activities.Credit...Olivia Sun/The Des Moines Register, via Associated Press

An Iowa school district that had openly defied the state’s Republican governor by teaching remotely decided on Monday to begin moving toward a hybrid of in-person and online learning, starting next month.

But the district has still not decided what level of coronavirus prevalence in the community would force it to send students home.

The dispute between the Des Moines Independent Community School District and Gov. Kim Reynolds is a stark example of tension between Republican state officials, who have followed President Trump’s lead on education policy, and local administrators, often in Democratic-leaning cities, who fear that in-person instruction is too much of a public health risk.

Ms. Reynolds has said she is prioritizing the needs of the most vulnerable students, and the state’s Education Department has threatened to require Des Moines to extend its school year — at a cost of about $1.5 million a day — if it does not comply with state regulations.

But the local school board has argued that the high caseload in Polk County, which includes Des Moines, makes it unsafe to hold in-person classes.

Of the more than 80,000 coronavirus cases in Iowa, Polk has more than 15,000, the most of any county in the state by far, according to a New York Times database.

At a board meeting on Monday night, the Des Moines school board voted 6 to 1 to start phasing in a “hybrid return to learn” plan. Preschool students will begin returning on Oct. 12, followed by elementary, middle and then high school students by Nov. 10, the Des Moines Register reported.

However, the board delayed setting an infection rate that would force the district to revert to remote learning, deciding instead to invite public health issues to provide guidance on the subject at a subsequent meeting. That means the planned return to class could still be delayed.

Iowa officials have said that 15 percent of a county’s coronavirus tests must be positive over a two-week period before its schools can close their doors — a threshold that is at least triple what many public health experts have recommended. The rules also say that districts in counties that remain below 15 percent must offer at least 50 percent of their classes in person.

In two weeks across late August and early September, Polk County had an average positivity rate of about 8 percent.

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Prime Minister Jacinda Ardern of New Zealand on the campaign trail in the city of Palmerston North last week.Credit...Ben Mckay/EPA, via Shutterstock

Prime Minister Jacinda Ardern of New Zealand has apologized after being photographed with supporters without social distancing or masks last week while on the campaign trail, drawing criticism from the public and opposition politicians.

Ms. Ardern, who on Monday announced an easing of coronavirus restrictions across the country, said that she had “made a mistake” by standing close to workers while touring a construction site at Palmerston North, a city on the north island of New Zealand. She also took a selfie with a group of students who were huddled together without masks.

David Seymour, an opposition politician, criticized Ms. Ardern on Twitter for what he described as “self-serving” behavior on the campaign trail. Judith Collins, the leader of the National Party and Ms. Ardern’s main challenger in the upcoming election, said she was “staggered” by the prime minister’s choices. On Tuesday, Ms. Collins and Ms. Ardern will engage in the first of four debates ahead of the election, which will be held Oct 17.

Speaking to reporters on Monday, Ms. Ardern apologized, saying she had worked hard through her campaign trail not to shake people’s hands. “I sanitize, I wear my mask in Auckland. And I work hard to try and keep my social distance,” she said.

“I should have stepped further forward,” she added, acknowledging that it could be difficult to refrain from shaking hands in “those awkward moments.”

After a virus outbreak in Auckland and a resulting lockdown last month, New Zealand has again begun easing restrictions. While masks are not mandatory in public, they are compulsory on public transport in Auckland and are recommended across the rest of the country. Good hygiene practices are also recommended for all New Zealanders.

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A pop-up coronavirus test site at Union Station in Los Angeles earlier this month. California’s average positivity rate over the past two weeks dipped to 3.1 percent.Credit...Etienne Laurent/EPA, via Shutterstock

California’s new coronavirus case numbers have been on a steady decline in recent weeks, Gov. Gavin Newsom said on Monday, suggesting that the state’s second major attempt to reopen businesses is going better than its first.

As of Monday, the state’s average positivity rate over the past two weeks dipped to 3.1 percent, even as the state continued to ramp up testing. On average over the past two weeks, more than 108,000 tests were administered each day, a number that Mr. Newsom has said may be depressed because of the wildfires burning across the state.

And he cautioned that Californians shouldn’t get complacent; it’s still unclear whether there will be a spike in cases stemming from increased travel over Labor Day weekend. Furthermore, flu season is on the way.

Still, Mr. Newsom hinted that more counties would be able to move ahead in their phased reopenings, and described the numbers as encouraging.

Mr. Newsom said that significant increases in testing, coupled with much faster turnarounds of those tests, would allow the state and counties to better gauge when to reopen schools and lift restrictions on other types of businesses.

Countries accounting for about 64 percent of the world’s population are supporting an initiative led by the World Health Organization for buying and distributing coronavirus vaccine doses around the world.

Despite the notable absence of the United States, China and Russia in the project, officials emphasized on Tuesday that 64 high-income countries — including Japan, Britain and Canada — were now part of the effort involving a total of 156 countries.

“At a time when the world has been so worried about countries going bilaterally, we now have 64 percent of the world’s population, and this is growing still,” Bruce Aylward, a senior adviser to the W.H.O.’s director general, said in a news conference. “This is huge progress.”

The participation of rich countries in the project, known as the COVAX global vaccine allocation plan, is viewed as essential for pooling the resources needed for doses to be distributed equitably around the world. Officials said they are hoping to deliver about two billion doses worldwide by the end of 2021.

The W.H.O.-led project is intended to build on various efforts in different parts of the world to curb the spread of Covid-19. CEPI, a public-private partnership to develop vaccines, is part of the W.H.O. initiative and is currently supporting nine potential vaccines, eight of which are in clinical trials. More than 130 potential vaccines are estimated to be in development globally.

The W.H.O. said on Monday that governments, vaccine manufacturers and other funding sources, including philanthropic organizations and individuals, have committed $1.4 billion for research and development of the vaccine. The W.H.O. added that between $700 million and $800 million more was still needed to advance the vaccine efforts.

GLOBAL ROUNDUP

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What food is available in Cuba is often found only in government-run stores that are stocked with imports and charge in dollars.Credit...Alexandre Meneghini/Reuters

Cuba, a police state with a strong public health care system, was able to quickly control the coronavirus, even as the pandemic threw wealthier nations into crisis. But its economy, already hurting from crippling U.S. sanctions and mismanagement, was particularly vulnerable to the economic devastation that followed.

As nations closed airports and locked down borders to combat the spread of the virus, tourist travel to Cuba plummeted and the island lost an important source of hard currency, plunging it into one of the worst food shortages in nearly 25 years.

What food is available is often found only in government-run stores that are stocked with imports and charge in dollars. The strategy, also used in the 1990s, during the economic depression known as the “special period,” is used by the government to gather hard currency from Cubans who have savings or get money from friends or relatives abroad.

Even in these stores, goods are scarce and prices can be exorbitant: One shopper recently couldn’t find chicken or cooking oil, but there was a 17-pound ham going for $230 and a seven-pound block of manchego cheese with a $149 price tag.

And the reliance on dollar stores, a move intended to prop up the socialist revolution in a country that prides itself on egalitarianism, has exacerbated economic inequality, some Cubans say.

In other international news developments:

  • South Korea on Tuesday suspended a plan to provide free flu shots for about 19 million people, amid reports of problems with storing some of the vaccines during transport. The number of newly confirmed cases in the country, which is battling a second wave of infections, has stayed below 100 for the last three days. But millions are set to travel domestically next week to celebrate a five-day holiday.

  • The Taj Mahal, one of India’s most famous landmarks and a huge tourist draw, reopened on Monday after being closed for more than six months as part of efforts to curb the spread of the virus. The monument, which receives an average of 20,000 visitors daily, will restrict admittance to 5,000 people a day. The site reopened despite India having more than 5.4 million cases, and daily case counts of more than 90,000, the second-highest caseload behind the United States.

  • The German city of Munich will require masks in some of its open-air spaces, including busy streets and popular squares, starting Thursday, the mayor announced on Monday. Though masks are required when shopping, on public transportation or other indoor spaces in most of Germany, public outdoor spaces have avoided the kind of mask rules in place in other European cities.

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A 107-page safety manual dictates the working environment on the set of “Jurassic World: Dominion.”Credit...John Wilson/Universal Pictures and Amblin Entertainment

The Hollywood unions representing the interests of the directors, actors, below-the-line crafts people and the Teamsters have reached a deal with the major studios to restart production during the Covid-19 pandemic.

The agreement focuses on testing regimens, personal protective equipment, and a zone-based system similar to the one used by Universal Pictures for its film “Jurassic World: Dominion,” which began shooting in July outside London after the studio negotiated its terms individually with the various unions.

“The new measures will be implemented by employers in order to minimize the risk of transmission,” the unions said in a statement. “To ensure workers’ livelihoods are not burdened with added uncertainty during the pandemic, the agreement also includes Covid-19 sick leave and quarantine pay.”

The detailed testing program spells out everything from pre-employment testing to how frequently actors, who are unable to wear PPE or physically distance themselves from others when shooting, will be tested (three times a week). It delineates how sick leave will be paid out, an early sticking point between the organizations, food catering protocols and how the productions will handle contact tracing.

The agreement extends until April 30, 2021.

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“We need to own up to the fact that we didn’t do a good job,” Bill Gates said on “Fox News Sunday.”Credit...Jeff Pachoud/Agence France-Presse — Getty Images

One of the world’s wealthiest and most influential donors on health issues, Bill Gates, said it is “outrageous” that coronavirus test results for most people are not returned within 24 hours.

“We need to own up to the fact that we didn’t do a good job,” Mr. Gates, a founder of Microsoft, said on “Fox News Sunday.” “You know, part of the reluctance, I think, to fix the testing system now is that nobody wants to admit that it’s still outrageous.”

Turnaround time depends in part on which type of test is used and on laboratory processing capacity. For the types most widely used in the United States, results can take up to two weeks, leaving people who may be infected in the dark about whether they could endanger others. Tests that yield faster results, including 24-hour tests, come with a high price tag, giving those who can afford them an advantage over those who cannot.

Mr. Gates has been critical of the Trump administration’s handling of the pandemic, including its failure to develop a national testing plan. The president has blamed testing for increases in virus cases around the country and has allowed politics to shape policy against the advice of experts.

The Bill and Melinda Gates Foundation is financing research and development programs related to the virus, Mr. Gates said. Early in the crisis, he helped back a popular testing program in Seattle that included at-home virus tests. But the Food and Drug Administration ordered the program to shut down.

U.S. ROUNDUP

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Lana Spencer, a third-grade teacher, behind a plexiglass shield during a Zoom class at Blossom Creek Elementary School in El Cajon, Calif.Credit...Sandy Huffaker for The New York Times

Students attending schools in the Cajon Valley Union School District in California, which serves a mostly low-income community in San Diego County, have been going to in-person classes as part of a hybrid learning model — a rarity in the state where more than nine out of 10 of California’s 6.3 million public school students are doing only distance learning.

And so far, it’s working.

The district’s 27 schools have not experienced any outbreaks, even as the county saw nearly 2,000 new cases over the past seven days. In one instance, a group of students had to quarantine for 14 days after a parent tested positive for the virus. But no student or teacher cases have materialized.

Two additional factors contributing to the district’s early success are its policy of providing every student with a laptop, and the extensive high-tech training for teachers that it has offered for the past seven years.

In other developments around the United States:

  • The “Fox & Friends” host Steve Doocy apologized on Monday on behalf of the network for a recent report on a local affiliate that alleged the Nashville mayor, a Democrat, had hidden virus data. The affiliate retracted its story, but not before the allegations made the rounds on conservative media.

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N.Y.C. Schools Reopen for Limited In-Person Learning

Thousands of children in pre-K and students with advanced disabilities returned to in-person school in the nation’s largest school district.

“I mean, I think everybody is a little nervous. You know, I have a family at home. But we’re all here because we all love to teach, and we’re doing what we can. So, we have our thermometers. We have our masks. We’re washing our hands, but we know this is really important for the children and the city. So that’s why we’re here.” “You know we did talk about it for a long time. You know, we were thinking should we do all remote or should we do mixed? And you know, after a little bit of time, a lot of you know going back and forth — the pros and cons — we thought it would be best for him to go back to school and socialize with other kids and whatnot. You know, we really appreciate what the teachers are doing and we understand how they’re putting themselves out there.”

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Thousands of children in pre-K and students with advanced disabilities returned to in-person school in the nation’s largest school district.CreditCredit...Amr Alfiky/The New York Times

A mix of joy, confusion and hope coursed throughout New York City on Monday, on a first day of school unlike any other for the nation’s largest school district.

Up to 90,000 children in pre-K as well as students with advanced disabilities streamed into about 700 school buildings for the start of in-person classes. But the vast majority of the city’s 1.1 million students started the school year on Monday online and will have the option of returning to classrooms over the next few weeks.

The city’s roughly 1,400 school buildings have sat largely empty for six months, after the city abruptly closed classrooms in mid-March to help slow the spread of the coronavirus.

Early in the morning, Tiyanna Jackson, who had quit her job in the spring to care for her 4-year-old daughter, Zuri, was flooded with relief as she arrived at a pre-K center in the South Bronx. Finally, she said, with Zuri starting school, she could get back to work.

In the East New York section of Brooklyn, Balayet Hossain’s day began with disappointment after he brought his two daughters to school, only to find that the children, a kindergartner and first grader, could not return to school buildings until next week.

And in Corona, a Queens neighborhood that was hit particularly hard by the virus in the spring, Baryalay Khan said dropping off his daughter, Fathma, at pre-K made him feel that the city was finally recovering.

“Schools are reopening, it’s a good sign,” he said.

Though Monday’s reopening falls far short of what Mayor Bill de Blasio originally promised — all students having the option to return to classrooms — it still marks a significant milestone in New York City’s long path to fully reopening. It is one of the few cities in the country where some children are now back in classrooms.

“Something great is happening today in New York City,” the mayor said during a news conference on Monday, shortly after he visited a pre-K program in Queens.

Still, the start of the school year here is freighted with anxiety and unknowns, many of which were on display on Monday morning.

The Department of Education’s login page for remote learning crashed for about 10 minutes at 9 a.m., just when hundreds of thousands of students were attempting to sign in for their first day of classes. Dozens of parents vented their frustration on Twitter about technology problems, and some lamented that only a few students were able to sign on at all.

An organization of Black doctors is forming a task force to screen federal decisions about coronavirus vaccines and treatments, the latest sign of the medical community’s eroding trust in the Food and Drug Administration and the Centers for Disease Control and Prevention under President Trump.

The panel is being set up by the National Medical Association, which was founded in 1895 when Black doctors were being excluded from other professional medical societies, STAT News reported on Monday.

Nonwhite communities have suffered disproportionately more from the virus, as hospitalization and death rates have been higher, particularly in Black communities.

“It’s necessary to provide a trusted messenger of vetted information to the African-American community,” Dr. Leon McDougle, the association’s president, told STAT news.

Dr. McDougle cited the Trump administration’s push to approve the malaria drug hydroxychloroquine as a treatment for Covid-19. The F.D.A. gave the drug an emergency use authorization in March but revoked it in June when studies found significant risks and no benefit to Covid-19 patients.

Many experts are worried that the push to deliver a vaccine on a short timeline will yield an inoculation that has not been rigorously screened and tested, Dr. McDougle told STAT News, and that could lead Black people — who have long been underrepresented in drug trials — to believe that a vaccine endorsed by the government may still not be safe.

The foundations of trust between Black Americans and the medical establishment have been shaken over the years by unequal and sometimes unethical treatment, and especially by an infamous 40-year research study known as the Tuskegee experiment, in which Black men infected with syphilis were deliberately left untreated by federal health officials so they could observe the course of the disease. The experiment ended in 1972. (An earlier version of this item incorrectly said the men were infected by the officials as part of the experiment; they were not.)

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The burial service for Conrad Coleman Jr. in Rye, N.Y., in July. Mr. Coleman, 39, died of the coronavirus shortly after his father also died of the disease.Credit...John Moore/Getty Images

It is a staggering toll, almost 200,000 people dead from the coronavirus in the United States, and close to one million people around the world.

And the pandemic, which sent cases spiking skyward in many countries and then trending downward after lockdowns, has reached a precarious point. Will countries like the United States see the virus continue to slow? Or is a new surge on the way?

“What will happen, nobody knows,” said Catherine Troisi, an infectious disease epidemiologist at The University of Texas Health Science Center at Houston. “This virus has surprised us on many fronts, and we may be surprised again.”

In the United States, fewer new cases have been detected week by week since late July, after outbreaks first in the Northeast and then in the South and the West.

But in recent days, the nation’s daily count of new cases is climbing again, fueling worries of a resurgence of the virus as universities and schools reopen and as colder weather pushes people indoors.

Around the world, at least 73 countries are seeing surges in newly detected cases.

In India, more than 90,000 new cases are now being detected daily, sending the country’s total cases soaring past five million.

In Europe, after lockdowns helped smother the crisis in the spring, the virus once again is burning its way across the continent.

Israel, with nearly 1,200 deaths attributed to the virus, imposed a second lockdown last week, one of the few nations to do so.

When the first wave of infections spread around the world, governments imposed sweeping restrictions: More than four billion people were under some sort of stay-at-home order at one point. Now, many countries are desperately trying to avoid such intense measures.

“We have a very serious situation unfolding before us,” Hans Kluge, the World Health Organization’s regional director for Europe, said last week. “Weekly cases have now exceeded those reported when the pandemic first peaked in Europe in March.”

Deaths in the United States from the virus neared 200,000 as of Monday morning. It was only four months ago, in late May, that the nation’s death roll reached 100,000. Even the current tally may be a significant undercount of the toll, analyses suggest.

Dr. Tom Inglesby, the director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, said it was conceivable that the death toll in the United States could reach 300,000 if the public lets down its guard.

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In Caracas, Venezuela, in July. The country is one of several whose populations have been particularly vulnerable during the pandemic, according to a new report.Credit...Adriana Loureiro Fernandez for The New York Times

People in some of the world’s most vulnerable communities have been left close to economic catastrophe by measures taken to stop the spread of the virus, according to a new report.

Economies around the world have been decimated by the pandemic, but for people in Afghanistan, Iraq, Kenya, Venezuela and 10 other countries included in the report from the Norwegian Refugee Council, the financial crises have exacerbated the challenges they were already facing.

In countries where conflict and displacement are commonplace, many are experiencing hunger, homelessness and a crisis in education amplified as a result of lost work, income and increased debt.

With businesses and markets closed and travel restricted, nearly 80 percent of people in already precarious situations have seen their incomes drop because of lost jobs. Without the means to pay rent, many have been evicted or forced from their homes, according to the report. With so few resources, people said they were less likely to send their children to school and had been unable to afford medical treatment or even the most basic food products.

“The world’s most vulnerable communities are in a dangerous downward spiral,” said Jan Egeland, the secretary general of the Norwegian Refugee Council.

Hunger is increasing around the world, and the United Nations World Food Program expects the number of people confronting potentially life-threatening levels of so-called food insecurity in the developing world to nearly double this year to 265 million. Seventy percent of survey respondents said they had cut the number of meals for their households since the pandemic began.

Women and girls in vulnerable communities have been most affected by the economic crisis, the report said. Not only have they lost jobs and shouldered the burden of unpaid care, but like many across the world, the financial constraints have led to an increase in domestic violence.

“Without urgent action, this crisis will spiral out of control,” Mr. Egeland said.

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People protested mandates to wear masks outside the State Capitol in Salt Lake City this month.Credit...Rick Bowmer/Associated Press

From resistance to face masks and scorn for the science of the virus to predicting the imminent arrival of a vaccine while downplaying the death count, President Trump and a sizable number of his supporters have aligned behind an alternate reality minimizing a tragedy that has killed an overwhelming number of Americans and gutted the economy.

This mix of denial and defiance runs contrary to the overwhelming evidence about the spread and toll of the virus, and it is at the center of Mr. Trump’s re-election effort as early voting begins in Minnesota, Virginia and other states.

To some extent, this viewpoint reflects the resentments of Americans living in regions of the country, like upstate New York and the upper reaches of Michigan, that have been relatively untouched by the virus but have had to endure drastic business shutdown measures.

“The people who need to shelter in place should do so, but I do not feel that that should ruin the economy,” said Karla Mueller, a Republican and church custodian who lives in Fond du Lac, Wis. “I think it’s ruined a lot of people’s small businesses. I just don’t feel that that’s necessary.”

But it is also a direct result of the look-the-other-way message that the Trump administration has sent with increasing urgency, pollsters and strategists say, as the president faces a strong challenge to re-election from Joseph R. Biden Jr., his Democratic opponent. Mr. Trump has called on Twitter for people to “LIBERATE” states that have imposed stay-at-home orders, threatened to withhold aid from Democratic governors and undercut medical professionals who have cautioned against the use of unproven medical treatments and premature school reopenings.

The president’s critics say his confrontational approach has kept the country from forming a consensus about how to fight the worst public health crisis in more than 100 years.

“The emotion, the passion — it’s out of hand,” said Representative Debbie Dingell, Democrat of Michigan, who pointed to two violent episodes in her state that stemmed from disagreements over wearing masks. “People have been shot and killed. A security guard in a dollar store. There was another fight at Walmart. This is insane.”

Polls show that Republicans approve of how Mr. Trump has handled the response to the virus by overwhelming margins and — unlike much of the country — think the United States has moved too slowly to reopen. A majority of them also support wearing masks, though not by the same margin as Democrats or the nation at large.

Reporting was contributed by Livia Albeck-Ripka, Jenny Anderson, Stephen Castle, Manny Fernandez, Emma Goldberg, Apoorva Mandavilli, Raphael Minder, Zach Montague, Adam Nagourney, Jeremy W. Peters, Simon Romero, Marc Santora, Anna Schaverien, Christopher F. Schuetze, Eliza Shapiro, Nicole Sperling, Eileen Sullivan, Sameer Yasir and Karen Zraick.

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