An unexpected new source of coronavirus infections in China: Russia.
A surge of Chinese people returning from Russia, which is now experiencing its own spike in infections, has fueled the largest increase in reported new cases in China in more than a month.
Chinese officials said on Monday that 98 new infections were reported among people who recently arrived in China. Most of those were Chinese citizens who had apparently scrambled to return to their homeland after China limited flights in and out of the country.
Previously, an Aeroflot flight from Moscow to Shanghai on April 10 carried 60 people who ultimately tested positive for the coronavirus. The passengers were all quarantined.
That flight arrived just days after China said that it would close, effective Monday, its last overland crossing at Suifenhe, a small city across the border from Russia’s Far East.
Many Chinese people seeking to leave Russia have flown from Moscow to Vladivostok in hopes of completing the last leg by land. The Chinese Consulate in Vladivostok said in a statement on Sunday that 243 Chinese citizens infected with the coronavirus had already crossed the border.
So many cases have emerged in the borderlands that the local government has opened a temporary hospital to deal with the caseload.
Russia closed its borders with China in January, hoping to staunch the spread of the pandemic, only to find itself facing a belated spike in cases. By Monday, Russia had nearly 16,000 cases and at least 130 deaths.
In an example of how initial successes of a social distancing campaign can fade once restrictions are relaxed, Hokkaido, Japan’s northernmost island, declared a state of emergency for a second time on Sunday and called on residents to stay at home for all but the most essential outings.
Hokkaido’s governor said the government was taking action because of a second wave of infections. Long before Japan’s central government issued a state of emergency for the country’s seven largest prefectures last week, Hokkaido called for a soft lockdown of the region on Feb. 28. As cases appeared to come under control, the prefecture lifted the state of emergency two weeks later and slowly allowed schools to reopen.
Overall case numbers remain low in Hokkaido, but the government is concerned about how quickly they are multiplying. Four new cases were confirmed on April 7, and that figure tripled within five days.
On Sunday, Hokkaido and Sapporo, the provincial capital, asked residents to refrain from going out, cease traveling and avoid restaurants — particularly for “business entertainment.”
In Osaka, Japan’s third largest city, the governor urged on Monday that businesses like night clubs, internet cafes, karaoke venues, pachinko parlors, movie theaters, gyms, museums and libraries close until May 6. The move followed similar requests in Tokyo.
Under the law authorizing the state of emergency, governors have the power only to request that businesses close. Those who do not comply can be publicized, but not officially punished.
Japan’s health ministry reported 530 new cases and four deaths on Sunday, taking Japan’s total to 7,255 cases and 102 deaths. Tokyo reported 166 new cases on Sunday, more than half of which were concentrated in one hospital — the latest of several recent clusters at the country’s hospitals.
Italian officials reported just 431 new coronavirus-linked deaths on Sunday — the lowest increase in fatalities in two weeks and a significant drop from the peak of the country’s crisis late last month.
And even as the total number of fatalities inched toward 20,000, officials and public health experts in the country said the reductions of new cases and fatalities were evidence of a hopeful turn.
“The trend is now trustworthy,” Luca Richeldi, a pulmonologist who is on the scientific committee that is advising the government, said at a news conference. “Putting together the drop of people being hospitalized, patients in I.C.U. and the number of people dying, we can say that the measures that were adopted and extended are having an impact on this virus.”
Officials also said that for the ninth day in a row, fewer people were being hospitalized in intensive care.
The drop in numbers has considerably relieved the pressure on Italy’s national health system, Dr. Richeldi said, which had been strained by an influx of patients last month.
More than 156,000 people in Italy have tested positive for the coronavirus, surpassed in Europe only by Spain — and increase that Dr. Richeldi attributed in part to an uptick in testing.
Angelo Borrelli, the head of the Civil Protection Department, said that the group of experts who are managing the next phase of the government’s response had met with Prime Minister Giuseppe Conte over the weekend. The committee is working on an “inventory of solutions and proposals,” Mr. Borrelli said.
While the government has extended lockdown measures until May 3, businesses like children’s clothing stores and stationery and book shops will reopen on Tuesday.
President Recep Tayyip Erdogan declined on Sunday to accept the resignation of Turkey’s interior minister, who offered it after taking responsibility for an abruptly announced curfew over the weekend that set off panic buying.
The minister, Sulyeman Soylu, announced his resignation late Sunday on Twitter. Within an hour, the president’s director of communications said that Mr. Erdogan had refused to accept his resignation.
Mr. Soylu is one of the most powerful ministers of Mr. Erdogan’s cabinet, and his attempted resignation, after the removal of another minister two weeks ago, underscores the political fallout of the coronavirus pandemic.
Confirmed cases have risen to more than 56,000 in Turkey’s population of 80 million, and deaths are at 1,198.
The lockdown for 31 provinces was announced two hours before it went into force at midnight on Friday, sending thousands of people rushing to late-night stores to buy provisions.
At the time, Mr. Soylu said the lockdown was ordered by the president, but on Sunday he said that the responsibility for “implementing the weekend curfew decision, which was aimed at preventing the epidemic, belongs entirely to me.”
Mr. Erdogan has introduced gradual restrictions while keeping some businesses working. The country was suffering double-digit unemployment and inflation even before the pandemic began.
Mr. Erdogan has sought to reassure people that the government will manage the health and financial fallout of the pandemic, but complaints are rising that a government compensation plan is inadequate. Many casual laborers are without income, and thousands of workers are being laid off.
A small study of chloroquine, which is closely related to the hydroxychloroquine drug President Trump has enthusiastically promoted, was halted in Brazil after coronavirus patients taking a higher dose developed irregular heart rates that increased their risk of a potentially fatal arrhythmia.
The study involved 81 hospitalized patients in the city of Manaus and was sponsored by the Brazilian state of Amazonas. Roughly half the study participants were given a dose of 450 milligrams of chloroquine twice daily for five days, while the rest were prescribed a higher dose of 600 milligrams for 10 days. Within three days, researchers started noticing heart arrhythmias in patients taking the higher dose. By the sixth day of treatment, 11 patients had died, leading to an immediate end to the high-dose segment of the trial.
“To me, this study conveys one useful piece of information, which is that chloroquine causes a dose-dependent increase in an abnormality in the E.C.G. that could predispose people to sudden cardiac death,” said Dr. David Juurlink, an internist and the head of the division of clinical pharmacology at the University of Toronto, referring to an electrocardiogram, which reads the heart’s electrical activity.
The researchers said the study did not have enough patients in the lower-dose portion of the trial to conclude if chloroquine was effective in patients with severe cases of Covid-19, the disease caused by the coronavirus. More studies evaluating the drug earlier in the course of the disease are “urgently needed,” the researchers said.
Despite its limitations, infectious disease doctors and drug safety experts said the study provided further evidence that chloroquine and hydroxychloroquine, which are both used to treat malaria, can pose significant harm to some patients, specifically the risk of a fatal heart arrhythmia. Patients in the trial were also given the antibiotic azithromycin, which carries the same heart risk. Hospitals in the United States are also using azithromycin to treat coronavirus patients, often in combination with hydroxychloroquine.
President Trump has enthusiastically promoted them as a potential treatment for the novel coronavirus despite little evidence that they work, and despite concerns from some of his top health officials. Companies that manufacture both drugs are ramping up production.
Israel’s powerful spy service has been deeply involved in the country’s fight against the coronavirus, and has been one of its most valuable assets in acquiring medical equipment and manufacturing technology abroad, according to Israeli medical and security officials.
As countries around the world compete ferociously for limited supplies during the pandemic, they are turning to any help available, and flexing their muscles unapologetically.
And with the Mossad having determined that Iran — struggling with its own coronavirus crisis — no longer represents an immediate security threat, the agency could afford to immerse itself in the health emergency, according to multiple people knowledgeable about its operations.
In early March, a command and control center was set up to handle the distribution of medical gear across the country, with Yossi Cohen, the Mossad chief, at its head and headquartered at Sheba Medical Center, Israel’s biggest hospital.
Professor Yitshak Kreiss, Sheba’s director general, said the Mossad had been pivotal in helping Sheba secure vital medical equipment and expertise from abroad.
Professor Kreiss declined to say precisely how Mossad officers had helped the Israeli medical establishment or where the imported equipment came from. But according to six current or former Israeli officials with knowledge of the Mossad’s operations, the agency used international contacts to avert shortages that might have overwhelmed Israel’s health system.
In Britain, where the total number of reported coronavirus deaths surpassed 10,600 this weekend, Prime Minister Boris Johnson was released from the hospital on Sunday.
It was a major step forward in his recovery from the coronavirus and a welcome relief for a nation whose political leadership has been harder hit by the contagion than that of any other Western country.
In a video posted on Twitter, he credited the National Health Service with saving his life, calling it “the beating heart of this country.”
“It’s hard to find words to express my debt,” he said, looking a bit wan but speaking with his usual vigor.
He thanked Britons for adhering to social distancing measures and said they were helping to slow the spread of the virus.
Mr. Johnson, who spent three nights in intensive care at St. Thomas’ Hospital in London, will convalesce at Chequers, the prime minister’s country house, the government said in a statement. But he will soon be able to sign off on major decisions, including when to ease the country’s lockdown.
His release came a day after Queen Elizabeth II released a recorded Easter message in which she said that the holiday was a time of “light overcoming darkness.”
“We know that coronavirus will not overcome us,” the queen said. “As dark as death can be, particularly for those suffering with grief, light and life are greater. May the living flame of the Easter hope be a steady guide as we face the future.”
The total number of confirmed cases in the country is nearly 79,000, and the virus has also emerged in the country’s prisons.
Airlines have canceled a staggering number of flights, but thousands still take off every day, leaving many of the people needed to keep them running to reckon with whether to continue working and how to stay safe if they do.
Already, hundreds of flight attendants and pilots have fallen ill and at least five have died from the coronavirus, according to to the labor unions that represent them.
Tens of thousands of airline employees have taken unpaid leave, staying home out of necessity or concern or to free up slots for colleagues who may need the income more. But some have continued to show up reluctantly, either because they need the money or fear losing their jobs once the crisis has ebbed.
Flight attendants and pilots at several major airlines, many of whom requested anonymity for fear of losing their jobs, said they have had to take their own gloves and masks to work. Even when airlines have committed to providing protective equipment, many have run into the same supply problems that have plagued hospitals across the country.
Air travel has fallen to new lows: For the first time since its formation, the Transportation Security Administration screened fewer than 100,000 people at its checkpoints. It screened more than two million people on the same day last year.
And even though the industry secured $25 billion from the federal government to pay employees through September, many airlines are likely to emerge from the crisis with fewer employees.
Saudi Arabia, Russia and other oil-producing nations completed an agreement to slash production, aiming to bolster prices that collapsed when global demand cratered amid the pandemic.
The Organization of the Petroleum Exporting Countries and Russia had reached a tentative agreement on Thursday. The final agreement will cut 9.7 million barrels a day.
The plan was delayed after the lone holdout, Mexico, stood firm on its position to cut 100,000 barrels a day and not the 400,000 barrels that Saudi Arabia had pushed for. The United States, Brazil and Canada promised to make up the 300,000-barrel-a-day difference.
The collapse in economic activity caused by the virus reduced demand by an estimated 30 million to 35 million barrels a day, according to international energy agencies and oil consultants. Analysts expect oil prices, which soared above $100 a barrel only six years ago, to remain below $40 for the foreseeable future.
Russia and Saudi Arabia — which only a month ago hoped to undercut American producers — have retreated from threats to pump more oil into the already-saturated market. President Trump had lobbied both countries to lower production.
Reporting was contributed by Elisabetta Povoledo, Motoko Rich, Carlotta Gall, Mark Landler, Steven Lee Myers, Claire Fu, Ronen Bergman, Niraj Chokshi, Clifford Krauss and Ruth Maclean.