The coordinator of the coronavirus response emphasized that social distancing, not masks, was still the most important step people could take. Critical medicines are running low, and nearly 10 million Americans have lost their jobs.

RIGHT NOWThere are now more than 1 million coronavirus cases worldwide, according to a Times database.

The C.D.C. is expected to advise all Americans to wear cloth masks in public. Trump says it won’t be mandatory.
The Trump administration appeared to be conflicted Thursday about whether to recommend that all Americans wear cloth masks if they go out in public, even as federal health officials were revising guidance to reflect new concerns that the coronavirus is being spread by infected people who have no symptoms.

Until now, the federal Centers for Disease Control and Prevention, like the World Health Organization, 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, including N95 respirator masks, for health care workers who desperately need them at a time when they are in continuously short supply.

At a White House briefing Thursday evening, President Trump said his administration was “coming out with regulations” on mask wearing but stressed that the guidance would be entirely voluntary. “If people want to wear them, they can,” he said.

According to a federal official, the C.D.C. has been preparing to recommend that everyone wear face coverings in public settings, like pharmacies and grocery stores, to avoid unwittingly spreading the virus. Public health officials have continued to stress, however, that N95 masks and surgical masks should be saved for front-line doctors and nurses, who have been in dire need of protective gear.

For weeks, the administration has sent conflicting messages on masks. At first, officials clearly stated that masks should only be worn by sick people. For some time, Mr. Trump has been saying masks might be useful, but scarves would be fine as well. Chinese officials have expressed alarm at how few ordinary Americans are covering their noses and mouths.

Earlier this week, Dr. Robert Redfield, the director of the C.D.C., confirmed in a radio interview that the agency was reviewing its guidelines on who should wear masks. Citing new data that shows high rates of transmission from people who are infected but show no symptoms, he said the guidance on mask wearing was “being critically re-reviewed, to see if there’s potential additional value for individuals that are infected or individuals that may be asymptomatically infected.”

Dr. Deborah Birx, the coordinator of the virus response, pleaded with Americans on Thursday to follow the federal guidelines on social distancing “to a tee,” emphasizing that it was still the most important step Americans could take to slow the spread. Masks, she said, weren’t enough.

Failing to follow the guidelines would keep the United States on a steep trajectory of new cases and deaths.

“We have to change that slope; we have to change the logarithmic curve that we’re on,” she said of the steep increases in cases in many parts of the country. “We see country after country having done that, what it means in the United States is not everyone is doing it.”

Under prodding by Mr. Trump, Dr. Birx noted that some communities in the United States are doing a better job lowering the steep curve of cases by keeping people inside with social distancing.

She added: “We see Spain, we see Italy, we see France, we see Germany, when we see others beginning to bend their curves. We can bend ours, but it means everybody has to take that same responsibility as Americans.”

Dr. Birx said that recommendations against gatherings of more than 10 do not mean people should be having dinner parties or cocktail parties of less than 10 people.

“We’re only as strong as every community, every county, every state, every American following the guidelines to a tee,” she said. “And I can tell by the curve, and as it is today that not every American is following it. And so this is really a call to action.”

There are now more than 1 million coronavirus cases worldwide.

The coronavirus pandemic has sickened more than 1 million people, according to official counts, almost a quarter of them in the United States . As of Thursday afternoon, at least 51,000 people have died, and the virus has been detected in at least 171 countries, as these maps show. There is evidence on six continents of sustained transmission of the virus.

The New York Times is engaged in an effort to track the details of every confirmed case in the United States, collecting information from federal, state and local officials around the clock. The numbers in this article are being updated several times a day based on the latest information our journalists are gathering from around the country. The Times has made that data public in hopes of helping researchers and policymakers as they seek to slow the pandemic and prevent future ones.

In only two weeks, 10 million U.S. jobs have vanished.

When the first cases of the coronavirus were reported in the United States in January, President Trump mostly dismissed the looming threat, Wall Street chugged ever upward and people set about their business with scant recognition of the calamity that lay ahead.

On Thursday, the scope of the economic disaster became clearer as the Labor Department reported the loss of 10 million jobs in only two weeks. Wall Street has seemingly imploded, and the global economy has shuddered as the fallout of the pandemic reaches into every country.

Hopes for a dramatic but brief downturn followed by a quick recovery have faded, and in their place are fears that the world may be on the cusp of an economic shock unseen since the Great Depression.

The speed and scale of the job losses is without precedent. Until last month, the worst week for unemployment filings was 695,000 in 1982.

At his evening coronavirus briefing, President Trump again said he would not reopen the Affordable Care Act’s federal insurance exchange to make it easier for the newly unemployed or the already uninsured to buy deeply subsidized health insurance. But Vice President Mike Pence said on Friday that the administration will unveil a plan to directly pay hospitals to treat uninsured coronavirus patients.

Despite the news that 6.6 million people had filed for unemployment benefits last week, the S&P 500 rose more than 2 percent after Mr. Trump said he expected Russia and Saudi Arabia to announce oil production cuts. Oil prices had been hammered as the pandemic all but eliminated travel and demand for energy, and a price war between Saudi and Russia had intensified the decline.

Mr. Trump’s statement led crude oil futures, which had already been climbing on Thursday, to surge, and shares of oil and gas companies also rallied. But by Thursday afternoon the agreement Mr. Trump said he expected had yet to materialize, and neither Russia nor Saudi Arabia publicly committed to such a cut. A Saudi statement issued on Thursday called only for a meeting of oil producing nations to reach a “fair agreement.” The Kremlin cast further doubt on the possibility, denying a claim that Mr. Trump made on Twitter that Mr. Putin had discussed the matter with the crown prince.

With or without a deal, Mr. Trump’s unusual oil diplomacy and his eagerness to claim a victory reflects his growing anxiety about the United States’ coronavirus-gripped economy. It also underscores his sudden reliance, after years of upbeat talk about growing American energy independence, on foreign oil industries. But if Russia and Saudi Arabia fail to strike an agreement that bolsters global oil prices, Mr. Trump will find himself left twisting in the wind by two repressive leaders whose good will he has spent years cultivating at significant political cost.

U.S. UNEMPLOYMENT SOARSRead the full story: “This thing is going to come for us all.” Follow live updates on the stock market.

Hospitals report some critical medicines are beginning to run low.
Across the country, as hospitals confront a harrowing surge in coronavirus cases, they are also beginning to report shortages of critical medications — especially those desperately needed to ease the disease’s assault on patients’ respiratory systems.

The most commonly reported shortages include drugs that are used to keep patients’ airways open, antibiotics, antivirals and sedatives. They are all part of a standard cocktail of medications that help patients on mechanical ventilators, control secondary lung infections, reduce fevers, manage pain and resuscitate those who go into cardiac arrest.

Demand for these drugs significantly increased in March as the pandemic took hold. Orders for antibiotics like azithromycin and antiviral medicines like ribavirin nearly tripled. Requests for medicines used for sedation and pain management, including fentanyl, midazolam and propofol, increased by 100 percent, 70 percent and 60 percent respectively.

Demand for albuterol, a common asthma inhaler medication, also has risen significantly, given its importance in easing the breathing of patients with severe infection.

“Just like we’re seeing shortages of other materials, like masks and ventilators, medications are right there in the mix of things that we don’t always have enough of on hand,” said Erin Fox, a drug shortage expert at the University of Utah. “So we were not prepared for this kind of surge.”

NEW SHORTAGESMedicines to alleviate breathing difficulty, relieve pain and sedate coronavirus patients are in very high demand, depleting stocks around the country.
The 1,000-bed Comfort was supposed to aid New York. It has 20 patients.

Such were the expectations for the Navy hospital ship U.S.N.S. Comfort that when it chugged into New York Harbor this week, throngs of people, momentarily forgetting the strictures of social distancing, crammed together along Manhattan’s west side to catch a glimpse.

On Thursday, though, the huge white vessel, which officials had promised would bring succor to a city on the brink, sat mostly empty, infuriating local hospital executives.

Only 20 patients had been transferred to the ship, officials said, even as New York hospitals struggled to find space for the thousands infected with the coronavirus.

The Comfort was sent to New York to relieve pressure on city hospitals by treating people with ailments other than Covid-19.

But the reality has been different.

A tangle of military protocols and bureaucratic hurdles has prevented the Comfort from accepting many patients at all. On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.

“If I’m blunt about it, it’s a joke,” said Michael Dowling, the head of Northwell Health, New York’s largest hospital system. “Everyone can say, ‘Thank you for putting up these wonderful places and opening up these cavernous halls.’ But we’re in a crisis here, we’re in a battlefield.”