Spain and Italy demanded more European help as they fight still-surging coronavirus infections amid the continent's worst crisis since World War II. In the US, authorities urged millions in the hard-hit New York City region to stop travelling to keep the virus contained.
From Milan to Madrid to Michigan, medics are making tough choices about which patients to save with the limited breathing machines they have. The confirmed global death surpassed 30,000 and new virus epicentres emerged in key US cities like Detroit, New Orleans and Chicago. Even rural America has not been immune, as virus hotspots erupt in Midwestern towns and in Rocky Mountain ski havens.
Spain and Italy alone account for more than half of the world's death toll, and are still seeing over 800 deaths a day each.
Experts say, however, that virus toll numbers across the world are being seriously under-represented due to limited testing and political decisions about which bodies to count. Unlike the US, France and Italy do not count deaths that take place in nursing homes or in homes among their virus numbers — even though nursing homes are known to be key coronavirus incubators around the world.
"Europe must demonstrate that it is able to respond to this historic call," Italian Premier Giuseppe Conte said late Saturday. "I will fight until the last drop of sweat, until the last gram of energy, to obtain a strong, vigorous, cohesive European response."
President Donald Trump backtracked on a threat to quarantine New York and neighbouring states amid criticism and questions about the legality of such a move. But the centres for Disease Control and Prevention issued a travel advisory urging all residents of New York City and others in New York state, New Jersey and Connecticut to avoid all non-essential travel for 14 days.
Shocking as that is for Americans, that stopped short of the restrictions imposed in Europe or elsewhere. Parisians are fined if they try to leave the city and South Africans can't even walk their dog or buy liquor. In Italy, coffins are piling up despite three weeks of strict confinement and burials are being held with only one family member.
Spain's government moved to tighten its lockdown and ban all non-essential work Sunday as it hit another daily record of 838 dead. The country's overall official toll is more than 6,500.
Spain's emergencies chief expressed hope that "the outbreak is stabilising and may be reaching its peak in some areas."
But the crisis is pummeling world economies and putting huge strains on national health care systems. Spanish Prime Minister Pedro Sanchez called for a more vigorous response from the 27-nation European Union.
"It is the most difficult moment for the EU since its foundation and it has to be ready to rise to the challenge," Sanchez said.
Spain, Italy, France and six other EU members have asked the union to share the burden of European debt, dubbed coronabonds, to help fight the virus. But the idea has met resistance from other members, led by Germany and the Netherlands.
European countries have also resisted sharing masks with their neighbours for fear that they, too, will need them in mass quantities soon. Many countries have turned to China, where the outbreak is easing, flying in cargo planes to get masks and other protective medical equipment.
Worldwide infections surpassed 660,000 mark, according to a tally by Johns Hopkins University. The United States leads the world with more than 120,000 reported cases but five other countries have higher death tolls: Italy, Spain, China, Iran and France.
Italy has more than 10,000 deaths, the most of any country.
Egypt shut its beaches as cases in the Mideast surpassed 50,000. Poland is considering delaying its May 10 presidential election and Russia ordered borders to close on Monday. A prominent French politician with the virus died, France's first death of a senior official.
British Prime Minister Boris Johnson, who has the virus himself, warned "things will get worse before they get better" while New York Gov. Andrew Cuomo said defeating the virus will take "weeks and weeks and weeks."
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 existing health problems, the virus can cause more severe illness, including pneumonia, and lead to death.
More than 142,000 people have recovered, according to Johns Hopkins University.
Health officials around the world have been urging people to keep a social distance of 2.0 meters (6 feet) from others to slow the spread of the virus but a new report from the Massachusetts Institute of Technology says that might not be enough.
It says a sneeze or cough from an infected person can expel microscopic virus droplets as far as 7-8 meters (23-27 feet) away and those droplets can be suspended in the air for hours. The researchers said they wanted to warn the public about "the distance, timescale and persistence over which this cloud and its pathological payload can travel."
Pope Francis called Sunday for a cease-fire in all conflicts around the globe "to focus together on the true fight of our lives" against COVID-19. He also urged authorities to take special care of those in vulnerable housing situations like nursing homes, military barracks and gaols.
In Detroit, which has a large low-income population, the death toll rose to 31 with 1,381 infections in a rate that shocked health officials.
"This is off the charts," said Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at the Detroit Medical centre. "We are seeing a lot of patients that are presenting to us with severe disease, rather than minor disease."
Some U.S. states began to try to limit exposure from visitors from harder-hit areas. Rhode Island National Guard troops were going door-to-door in coastal communities to find New Yorkers. Florida is setting up checkpoints to screen visitors from Louisiana.
As others tightened controls, China eased more restrictions following the ruling Communist Party's declaration of victory over the coronavirus. Airline flights from Hubei province at the centre of the coronavirus outbreak resumed Sunday after subway and bus service resumed Saturday in the province's hard-hit capital of Wuhan.
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