Trump Threatens to Leave W.H.O. and Permanently End Funding

The New York Times

The president says the W.H.O. must change or he will permanently end funding.

President Trump told the director-general of the World Health Organization he would permanently end all funding to the organization if it did not “commit to substantive improvements within the next 30 days,” according to a copy of a letter he posted to Twitter late Monday night.

Mr. Trump also wrote that the United States would reconsider its membership in the W.H.O. because it was “so clearly not serving America’s interests.”

“It is clear the repeated missteps by you and your organization in responding to the pandemic have been extremely costly for the world,” the president wrote in a four-page letter outlining his grievances against the organization and its leader, Dr. Tedros Adhanom Ghebreyesus.

Mr. Trump had halted the United States’ contributions to the W.H.O. last month, accusing it of promoting disinformation from China about the outbreak. The organization has denied the claims and insisted that it was transparent and open.

Last year, the United States contributed about $553 million of the W.H.O.’s $6 billion budget, with China providing $43 million. Before Mr. Trump posted his letter, President Xi Jinping of China offered to provide $2 billion in the fight against the pandemic and called on other nations to increase their contributions to the W.H.O.

Alex M. Azar II, the secretary of Health and Human Services, also sharply criticized the W.H.O. on Monday, saying its handling of the outbreak in China led to unnecessary deaths.

“We must be frank about one of the primary reasons that this outbreak spun out of control,” Mr. Azar said in a prepared video to the World Health Assembly, the global health agency’s annual meeting. “There was a failure by this organization to obtain the information that the world needed, and that failure cost many lives.”

Trump says he takes hydroxychloroquine, an unproven drug against the virus.

President Trump said on Monday that he has been taking hydroxychloroquine, an antimalarial drug whose effectiveness against the coronavirus is unproven, for about a week and a half as a preventive measure.

“All I can tell you is, so far I seem to be OK,” he said, explaining that he takes a daily pill. The White House physician said later that Mr. Trump had no symptoms and had regularly tested negative for the virus.

The drugs can cause dangerous abnormalities in heart rhythm in virus patients, the F.D.A. warned, saying they should be used only in clinical trials or hospitals where patients can be closely monitored for heart problems.

Several doctors said they were alarmed that Mr. Trump was using the bully pulpit of the presidency to tell the public he takes a drug that has not been proven to be effective against the coronavirus, but which does have known risks.

Dr. Steven E. Nissen, the chief academic officer of the Miller Family Heart, Vascular & Thoracic Institute at the Cleveland Clinic, said he had treated patients who developed a life-threatening arrhythmia.

“This disorder can be lethal,” Dr. Nissen said. “My concern would be that the public not hear comments about the use of hydroxychloroquine and believe that taking this drug to prevent Covid-19 infection is without hazards.

“In fact, there are serious hazards.”

Dr. Nissen noted that hydroxychloroquine had stayed on the market because it treated serious conditions such as lupus and rheumatoid arthritis. Other drugs with the same dangerous side effect have been withdrawn because they treated less serious ailments.

Mr. Trump has in recent weeks stopped talking about the drug that he had been touting as a possible miracle cure. But on Monday, he appeared to relish telling reporters that he was taking it, with approval from the White House physician, Dr. Sean P. Conley.

“After numerous discussions he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risks,” Dr. Conley said in a statement on Monday night.

Early studies of hydroxychloroquine in the laboratory showed that the drug could block the virus from attacking cells prompted enthusiasm. But the studies of the drug in humans have largely proved disappointing, and some have pointed to serious side effects in people with heart problems.

“I’m not going to get hurt by it,” said Mr. Trump, 73, explaining that he was making the disclosure in order to be transparent with Americans. “It has been around for 40 years for malaria, for lupus, for other things. I take it. Front-line workers take it. A lot of doctors take it.”

Government reaches deal with new company to make drug ingredients in the U.S.

The Trump administration will announce on Tuesday that it has signed a $354 million four-year contract with a new company in Richmond, Va., to manufacture generic medicines and pharmaceutical ingredients that are needed to treat Covid-19 but are now made overseas, mostly in India and China.

The contract, awarded to Phlow Corp. by the Biomedical Advanced Research and Development Authority, meshes President Trump’s “America First” economic promises with concerns that coronavirus treatments be manufactured in the United States. It may be extended for a total of $812 million over 10 years, making it one of the largest awards in the authority’s history.

“This is an historic turning point in America’s efforts to onshore its pharmaceutical production and supply chains,” Peter Navarro, Mr. Trump’s trade adviser, whose White House portfolio includes the global supply chain, said in a brief interview on Monday evening. The project, he told Sheryl Gay Stolberg of The New York Times, “will not only help bring our essential medicines home but actually do so in a way that is cost competitive with the sweatshops and pollution havens of the world.”

Manufacturers that operate in the United States generally make finished products using raw ingredients imported from elsewhere. Eric Edwards, an entrepreneur and physician who founded Phlow, said the company intended to create a stockpile for pharmaceutical ingredients to be used in the event of drug shortages or an emergency.

“There are not a lot of people wanting to bring back generic medicine manufacturing to the United States that has been lost to India and China over decades,” he said. “You need someone like the federal government saying this is too important for us not to focus on.”

Stocks climbed after encouraging data emerged about a vaccine tested in people.

The drugmaker Moderna said on Monday that the first coronavirus vaccine to be tested in people appeared to be safe and able to stimulate an immune response against the virus.

The findings, which helped give Wall Street its best day in about six weeks, are based on results from the first eight people who each received two doses of the experimental vaccine starting in March.

Those people, healthy volunteers ages 18 to 55, made antibodies that were then tested in human cells in the lab and were able to stop the virus from replicating — the key requirement for an effective vaccine. The levels of those so-called neutralizing antibodies matched the levels found in patients who had recovered after contracting the virus in the community. Two more age groups — 55 to 70, and 71 and over — are now being enrolled to test the vaccine.

Though encouraging, the findings do not prove the vaccine works. Only larger, longer studies can determine whether it can prevent people from getting sick. Moderna’s technology, involving genetic material from the virus called mRNA, is relatively new and has yet to produce any approved vaccine.

If its next trials go well, a vaccine could become available for widespread use by the end of this year or early 2021, Dr. Tal Zaks, Moderna’s chief medical officer, said in an interview.

The company’s announcement rapidly encouraged investors, who also welcomed a pledge from the Federal Reserve chairman that there was “really no limit” to what the central bank could do with its emergency lending facilities. The S&P 500 rose more than 3 percent on Monday, with Moderna’s shares up 20 percent.

Autoworkers return to factories as states ease restrictions.

Texas, the second-most populous state, took more steps to reopen on Monday when Gov. Greg Abbott, a Republican, announced that office workers could return to work in limited capacities and child care services could reopen immediately. Little League games, sleepaway camps and vacation Bible camps could open beginning May 31, he said.

Mr. Abbott’s latest round of easing restrictions came after the state reported its deadliest day yet last week — 58 deaths between Wednesday and Thursday — and recorded 1,801 new infections on Saturday, the highest single-day increase the state has seen.

Mayor Eric Johnson of Dallas said he believed that the increase was connected to Mr. Abbott’s earlier lifting of constraints, telling CNN that he thought it was “more than likely connected in some way to the opening of restaurants and movie theaters and retail and our malls up to 25 percent occupancy a couple weeks ago.” Mr. Abbott attributed the higher number to increased testing in hot spots, including in the Amarillo area, which he said would not reopen as fast as the rest of the state.

In Michigan, where thousands of autoworkers began returning to work on Monday for the first time in weeks, Gov. Gretchen Whitmer, a Democrat, announced that retail businesses, bars and restaurants with limited seating could reopen with restrictions in the Traverse City area and in the Upper Peninsula, two regions hit less hard than other parts of the state.

“Keep your wits about you,” she urged. “Let’s not all go rushing out and force a closure eventually. What we want to do is keep moving forward.”

The order is especially important for the tourist hub of northwest Michigan, which has already canceled the popular National Cherry Festival and Traverse City Film Festival in July.

“We want to be measured about how we invite people back and how we reopen our businesses,” Mayor Jim Carruthers of Traverse City said. “It’s been horrible to see all the shops and restaurants closed.”

In Massachusetts, another hard-hit state, Gov. Charlie Baker, a Republican, on Monday presented a four-phased strategy to gingerly resume public life, replacing his stay-at-home advisory with a new one, “safer at home.”

The four stages, which begin on Monday and last for three weeks each, are known as “start,” “cautious,” “vigilant” and “new normal,” with each new phase replacing the previous guidelines with slightly looser ones. Progress from one stage to the next is contingent on a continuing decline in the spread of the virus, Mr. Baker said.

“If we don’t keep up the fight, and don’t do the things that we all know we have to do and know we can do, we run the risk of creating a second spike in the fall,” he said.

Across the country, governors are weighing the risks of reopening their states with the need to minimize economic harm. The pendulum will move further toward the economy this week, when several more states, including Connecticut, Kentucky and Minnesota, move to reopen. If current trends hold, New York City is expected to meet the state’s criteria to begin reopening in the first half of June, the mayor said.

More than two-thirds of states have relaxed restrictions in some significant way, or begun a regional reopening. The shift has come as reported cases of the virus have declined nationally in recent weeks. Mr. Trump on Monday tweeted a call to “REOPEN OUR COUNTRY!”

But even governors who have allowed certain returns to business have expressed hesitance, and public health officials have been warning for weeks that reopening too soon could lead to a devastating second outbreak.

“This is really the most crucial time,” Gov. Mike DeWine of Ohio, a Republican, said Sunday on CNN. “And the most dangerous time.”

Stores and malls could reopen in Minnesota beginning Monday. The enormous Mall of America, in Bloomington, has said that it does not plan to reopen its shops until June 1. On Wednesday, hard-hit Connecticut is expected to reopen salons, museums and office buildings. By Friday, stores and restaurants are expected to open back up in Kentucky.

Oregon judge says the state’s stay-at-home order has lasted too long.

A judge in Oregon has rejected the state’s coronavirus restrictions, saying on Monday that Gov. Kate Brown did not have the authority to keep orders in place for more than 28 days.

Ms. Brown’s office immediately escalated the decision to the Oregon Supreme Court, days after the Wisconsin Supreme Court rejected that state’s extended stay-at-home order. Late Monday night, the Oregon Supreme Court halted the effect of the ruling, by Judge Matthew Shirtcliff of the Baker County Circuit Court, until the full court had a chance to settle the matter.

The case was brought by a group of churches that contended that Oregon law prohibited the governor from issuing long-term mandates. The governor’s office has argued that Ms. Brown’s orders were issued under a different part of the law with no such limitations.

“Reopening the state too quickly, and without ongoing physical distancing, will jeopardize public health and cost lives,” she said.

Lawmakers urge bolder use of bailout funds for midsize businesses.

On the eve of a hearing to assess federal relief measures, a group of Democrats on the Senate Banking Committee wrote a letter to Jerome H. Powell, the chairman of the Federal Reserve, and Steven Mnuchin, the Treasury secretary, urging them to take greater risks in a lending program meant to keep credit flowing to midsize businesses.

The so-called Main Street lending program, unveiled on March 23, has yet to get up and running. When it does, it will be backed by $75 billion of the $454 billion that Congress gave the Treasury Department as part of the CARES relief law to support the Fed’s emergency loan efforts.

Senator Mark Warner of Virginia, a Democrat, has expressed concern that the program is taking too long to get started, and that its terms are too cautious, limiting the chances that it will lose taxpayer money but also potentially curbing its effectiveness.

“The vast majority of these firms are not seeking public assistance due to risky behavior,” the senators wrote, adding that “should firms fail to receive affordable financing terms under these facilities, many will be left with a choice between declaring bankruptcy, posing long-term risks to the economy or opening up too quickly.”

They wrote the letter as a new Congressional Oversight Commission raised questions about how the Federal Reserve and Treasury Department were administering emergency bailout funds in its inaugural assessment of the $500 billion program.

The report is the first in what will be a monthly review of how the funds are being used. The money, which was allocated as part of the $2 trillion CARES Act, is being used to provide grants and loans to airlines and companies that are vital to national security and to backstop lending programs designed by the Fed.

The report said that Treasury had yet to disburse the $46 billion in grant and loan money to airlines or businesses critical to national security. Thus far, it has used only $37.5 billion for the Fed’s Secondary Market Corporate Credit Facility, which purchases outstanding corporate bonds through a special purpose vehicle.

In California, undocumented immigrants can begin applying for aid.

Hotlines in California were deluged on Monday as the state began taking applications for $75 million in cash assistance to help undocumented immigrants weather the economic downturn. Many work in jobs in homes, hotels and restaurants that have been closed during the lockdowns.

The one-time grants of $500 per person or $1,000 per household will be awarded to about 150,000 people who phone in on a first-come, first-served basis, state officials said. Philanthropic organizations and private donors pledged an additional $50 million, for another 100,000 immigrants.

There are an estimated 10.6 million undocumented immigrants in the United States; 2 million live in California, more than any other state. To qualify for the money, applicants must prove they are undocumented, out of work because of the health crisis and not eligible for federal stimulus checks or unemployment benefits.

Groups opposed to the program sued to block the state from using taxpayer dollars, arguing that it was illegal. The cases were dismissed by the courts.

Trump says he supports relaxing terms of small-business loan program.

President Trump said on Monday that he was open to relaxing the terms of a federal program to help distressed small businesses weather the crisis, even as new questions arose about who is able to benefit from the program.

During a round table at the White House, restaurant executives pressed Mr. Trump to extend the forgiveness period for loans under the Paycheck Protections Program from eight weeks to 24 weeks, a change the president said “should be easy.”

Treasury Secretary Steven Mnuchin, who oversees the program with the Small Business Administration, said he believed there was bipartisan support for such a change. For the loans to be forgiven, businesses must show they kept their workers on payroll and used three quarters of the money on employment costs.

Monday was the deadline for businesses that got money from the program — which was designed to help mom-and-pop shops struggling during the pandemic — to return it under tightened eligibility rules that the administration imposed after several big companies benefited.

So far, at least 61 public and private companies have returned their small-business loans, according to data compiled by The Times. Among the companies that have returned loans are Ruth’s Chris Steak House, Shake Shack and the shoe start-up Allbirds.

But the majority of money extended to public companies has not been returned, and a new survey found that many minority-owned businesses are on the brink of closing permanently because they have been unable to obtain the federal loans.

“If we don’t get policies to protect these communities,” said Rashad Robinson, the president of the equal rights organization Color of Change, “we will lose a generation of black and brown businesses, which will have deep impacts on our entire country’s economy.”

N.Y.C. is expected to meet reopening criteria in the first half of June, the mayor said.

The state’s standards that New York City has yet to meet are:

A rate of new hospitalizations below 2 per 100,000 residents a day. In New York City, that works out to around 170 per day. According to the state, the number in the city is around 200 per day.

In the regions that can restart, construction, manufacturing, and wholesale trade can resume. Some retail businesses may open for curbside service only. Five regions became eligible on Friday and a sixth, around Buffalo, can reopen on Tuesday, Gov. Andrew M. Cuomo said on Monday.

Other activities that are allowed include drive-in movies, landscaping and gardening businesses and “low-risk recreational activities” like tennis.

For Memorial Day weekend, beaches in New York City will be technically open, Mr. de Blasio said, but there cannot be any swimming, sports or gatherings.

Virginia Beach will reopen before Memorial Day, and the Florida Keys next month.

Gov. Ralph Northam of Virginia announced on Monday that the city of Virginia Beach would be allowed to reopen its beaches with some restrictions on Friday, just before Memorial Day weekend.

Several states on the East Coast, including Delaware, New Jersey and New York, have recently announced plans to reopen their beaches before the unofficial start of summer.

And the Florida Keys will reopen to visitors on June 1, officials announced, after two months under lockdown, with the only access roads closed off by checkpoints.

The archipelago has been blocked off to anyone who does not work or live there since late March. Hotels were ordered closed, and visitors who flew in through the airport were screened and instructed to self-isolate for two weeks.

The stringent measures worked: Monroe County had just 100 confirmed cases and three deaths, according to state data. The three heavily populated counties to the north — Miami-Dade, Broward and Palm Beach — had a total of more than 25,000 cases and 1,000 deaths.

Under Virginia Beach’s new plan, residents and visitors will be permitted to sunbathe, swim, fish and surf, with beach parking being limited to 50 percent capacity. Group sports, alcohol consumption, speakers, tents and umbrella groupings will still be banned.

“These rules must be followed — you must be responsible,” said Mr. Northam, who added that he would close beach access if social distancing measures were not followed.

Virginia began to relax restrictions on businesses and places of worship last week as part of the three-phase plan to reopen the state, which has a stay-at-home order until June 10.

The order has not stopped residents from going to the beaches even when they were still considered closed. Over the weekend, the Oceanfront in Virginia Beach felt like any other hot summer’s day, with children playing in the water and beachgoers catching some rays.

“Virginia’s beaches offer important mental health benefits, rest, relaxation and exercise,” Mayor Bobby Dyer of Virginia Beach said. “I believe we have a great plan, and I am prepared to stand by this great plan to ensure that when we open, we will be the safe beach that is required.”

The virus could take a toll in areas where chronic health conditions are common.

As the virus continues to spread over the next months, and maybe even years, it could exact a heavy new toll in areas of the United States that have not yet seen major outbreaks but have high rates of diabetes, obesity, high blood pressure and other chronic health conditions.

Even in lower-risk counties, a significant proportion of the population is living with these conditions.

Public health experts warn that these areas may not be adequately prepared for new waves of infection, even as some have lifted restrictions meant to curb the spread of the virus.

A federal whistle-blower reports to a new position at the N.I.H.

Dr. Rick Bright, who became a federal whistle-blower after he was stripped of his position running a medical research agency, has reported to his new assignment at the National Institutes of Health, his lawyers said.

Dr. Bright was ousted as the head of the Biomedical Advanced Research and Development Authority on April 21, he has said, after he objected to the widespread use of an unproven malaria drug being touted by Mr. Trump as a treatment for Covid-19.

While his new mission is unclear, Francis Collins, the director of the health institutes, recently told reporters that Dr. Bright is now a “senior adviser” to him. “His precise role is under development,” Dr. Collins said.

Dr. Bright had been on medical leave for hypertension and then vacation leave, he told Congress last week — an admission that prompted sharp criticism from Republican lawmakers, as well as Peter Navarro, Mr. Trump’s trade adviser, who called him “a deserter.”

In a statement, his lawyers, Debra S. Katz and Lisa Banks, said Dr. Bright went to the N.I.H. on Monday. “Following the required on-boarding process, he is prepared to begin working when N.I.H. is ready,” they said.

One type of job is on the rise: contact tracing.

More than 11,000 people across the United States are employed as contact tracers working to track and stop the spread of the virus, and local health departments plan to hire thousands more. The work is mostly phone-based and can be done from home. The jobs can be full- or part-time, often with an hourly wage of $17 to $25; some include benefits.

Want to use the crisis to help your children grow?

Keep up with Times correspondents around the globe.

Japan’s economy becomes the largest to officially enter a recession. A Canadian military jet crashes during a flyover for virus workers.

Reporting was contributed by Mike Baker, Ellen Barry, Alan Blinder, Neal E. Boudette, Max Brimelow, Jane E. Brody, Julie Chang, Matthew Conlen, Michael Cooper, Pedro Cota, Melina Delkic, Emily Flitter, Jacey Fortin, Dana Goldstein, Abby Goodnough, Denise Grady, Kathy Gray, Kristen Hwang, Andrew Jacobs, Miriam Jordan, Annie Karni, Adam Liptak, Michael Mason, Alex Matthews, David McCabe, Sarah Mervosh, David Montgomery, Andy Newman, Sharon Otterman, Nadja Popovich, Alan Rappeport, Frances Robles, Rick Rojas, Marc Santora, Michael Schwirtz, Anjali Singhvi, Jeanna Smialek, Kaly Soto, Sheryl Gay Stolberg, Eileen Sullivan, Katie Thomas, Neil Vigdor, David Waldstein and Michael Wilson.

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