Health authorities in the United States have urged millions of residents of the New York region to avoid non-essential travel due to surging coronavirus infections there as deaths in the country passed 2,000, more than double the level two days earlier.
The advisory late on Saturday applies to New York City, the hardest-hit US municipality, and the states of New York, New Jersey and Connecticut.
The advisory cited “extensive community transmission” in the area and urged residents to avoid travel for 14 days.
Worldwide infections surpassed the 660,000 mark, with 135,000 people recovered and more than 30,000 deaths, according to a tally by Johns Hopkins University.
The US now leads the world with more than 120,000 reported cases. Five other countries have higher death tolls: Italy, Spain, China, Iran and France. Italy tops the list with 10,000 deaths.
The disease has spread to other major US cities including Detroit, New Orleans and Chicago and into rural areas, where hotspots erupted in Midwestern towns and Rocky Mountain ski havens.
New York Governor Andrew Cuomo said defeating the virus will take “weeks and weeks and weeks”, and delayed the state’s presidential primary from April 28 to June 23.
The travel advisory said employees of trucking, food supply, financial services and some other industries were exempt from the measure, and that the states’ governors had “full discretion” over how to implement the advisory.
Earlier, Cuomo and governors of the other states had rejected a suggestion by President Donald Trump that he might impose a quarantine on the region. Cuomo said that would be illegal, economically catastrophic and unproductive since other areas are already seeing a surge.
In a Twitter post late on Saturday, Trump reversed his stance, saying: “A quarantine will not be necessary.”
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. But for others, especially older adults and people with pre-existing health problems, the virus can cause more severe illnesses, including pneumonia, and lead to death.
One of the US deaths announced on Saturday was that of a Chicago infant less than a year old, marking an extremely rare case of juvenile death in the pandemic.
Illinois Governor J B Pritzker said the cause of death is under investigation. Officials did not release any further information, including whether the child had other health problems.
In Detroit, which has a large low-income population, the death toll rose to 31 with 1,381 infections as of midday Saturday.
“The trajectory of Detroit is unfortunately even more steep than that of New York,” said Dr Teena Chopra, the medical director of infection prevention and hospital epidemiology at the Detroit Medical Center. Chopra said many patients already have chronic ailments including asthma, heart disease, diabetes and hypertension.
“This is off the charts,” she said. “We are seeing a lot of patients that are presenting to us with severe disease, rather than minor disease.”
European nations have been harder hit than the US on a per capita basis with over 20,000 deaths – approximately half in worst-hit Italy.
Spain, with the world’s second-highest toll, added 832 deaths on Saturday for a total of 5,812.
Madrid toughened a nationwide lockdown, halting all non-essential activities, though officials said the epidemic in the country seemed to be nearing a peak.
Russia said it would close its borders on Monday, despite reporting relatively low levels of the virus.
In France, which has seen close to 2,000 deaths, Prime Minister Edouard Philippe warned the “battle” was just beginning.
The British toll passed 1,000 on Saturday while Belgium saw a steep climb in deaths, with 353 recorded on Saturday – up from 289 the day before.
Elsewhere, Iran announced 139 more deaths, and India sealed a dozen villages that had been visited by a guru now known to be infected and a possible “super-spreader”.
South African police used rubber bullets in Johannesburg to enforce social distancing on a crowd queueing for supplies outside a supermarket during a national lockdown.