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Models Project Sharp Rise in Deaths as States Reopen

An internal Trump administration report expects about 200,000 daily cases by June. The White House bars coronavirus task force officials from testifying to Congress without approval.

This briefing has ended. Follow our latest coverage of the coronavirus pandemic.

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A burial in New Jersey last week.Credit...Todd Heisler/The New York Times

As President Trump presses for states to reopen their economies, his administration is privately projecting a steady rise in the number of coronavirus cases and deaths over the next several weeks. The daily death toll will reach about 3,000 on June 1, according to an internal document obtained by The New York Times, a 70 percent increase from the current number of about 1,750.

The projections, based on government modeling pulled together by the Federal Emergency Management Agency, forecast about 200,000 new cases each day by the end of the month, up from about 25,000 cases a day currently.

The numbers underscore a sobering reality: The United States has been hunkered down for the past seven weeks to try slowing the spread of the virus, but reopening the economy will make matters worse.

“There remains a large number of counties whose burden continues to grow,” the Centers for Disease Control and Prevention warned.

As the administration privately predicted a sharp increase in deaths, a public model that has been frequently cited by the White House revised its own estimates, doubling its projected death toll.

The Institute for Health Metrics and Evaluation at the University of Washington is now estimating that there will be nearly 135,000 deaths in the United States through the beginning of August — more than double what it forecast on April 17, when it estimated 60,308 deaths by Aug. 4. (The country has already had more than 68,000 deaths.)

The institute wrote that the revisions reflected “rising mobility in most U.S. states as well as the easing of social distancing measures expected in 31 states by May 11, indicating that growing contacts among people will promote transmission of the coronavirus.”

The projections confirm the primary fear of public health experts: that a reopening of the economy will put the nation back where it was in mid-March, when cases were rising so rapidly in some parts of the country that patients were dying on gurneys in hospital hallways.

On Sunday, Mr. Trump said deaths in the United States could reach 100,000, twice as many as he had forecast two weeks ago. But that new number still underestimates what his own administration is now predicting to be the total death toll by the end of May — much less in the months to come. It follows a pattern for Mr. Trump, who has frequently understated the impact of the disease.

“We’re going to lose anywhere from 75, 80 to 100,000 people,” he said in a virtual town hall on Fox News on Sunday. “That’s a horrible thing. We shouldn’t lose one person over this.”

The White House responded that the new federal government projections had not been vetted.

“This data is not reflective of any of the modeling done by the task force or data that the task force has analyzed,” said Judd Deere, a White House spokesman.

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An antiques store in Charleston, S.C., was open on Friday.Credit...Cameron Pollack for The New York Times

After a wave of new state orders easing restrictions over the weekend, at least half a dozen more states began allowing certain businesses to reopen on Monday, some even as cases continued to rise.

Indiana, Kansas and Nebraska were among the states that allowed the reopening of some businesses on Monday even though they were seeing increasing cases, according to a New York Times database. Other states that have partly reopened while cases have continued to rise include Iowa, Minnesota, Tennessee and Texas, according to the data.

About half of all states have now begun reopening their economies in some significant way, which public health experts have warned could lead to a new wave of cases and deaths.

“The vast majority of Americans have not been exposed to the virus, there is not immunity, and the initial conditions that allowed this virus to spread really quickly across America haven’t really changed,” said Dr. Larry Chang, an infectious-diseases specialist at Johns Hopkins University.

While the country has stabilized, it has not really improved, as shown by data collected by The Times. Case and death numbers remain on a numbing, tragic plateau that is tilting only slightly downward.

At least 1,000 people with the virus, and sometimes more than 2,000, have died every day for the last month. On a near daily basis, at least 25,000 new cases of the virus are being identified across the country.

And even as New York City, New Orleans and Detroit have shown improvement, other urban centers, including Chicago and Los Angeles, are reporting steady growth in the number of cases.

The situation has devolved most significantly in parts of rural America that were largely spared in the early stages of the pandemic. As food processing facilities and prisons have emerged as some of the country’s largest case clusters, the counties that include Logansport, Ind.; South Sioux City, Neb.; and Marion, Ohio, have surpassed New York City in cases per capita.

In New Mexico, Gov. Michelle Lujan Grisham invoked the state’s Riot Control Act to lock down the entire city of Gallup, on the edge of the Navajo Nation. As of Sunday, the Gallup area had the third-highest rate of infection of any metropolitan area in the United States.

“We’re scared to death, so this had to be done,” said Amber Nez, 27, a shoe store saleswoman and Navajo Nation citizen who lives in Gallup. “I only wonder why we didn’t do this sooner.”

Many other states are already entering their next chapters.

Restaurants, stores, museums and libraries in Florida are allowed to reopen with fewer customers, except in the most populous counties, which have seen a majority of the state’s cases. In Clearwater, some beachgoers used seaweed to mark a six-foot barrier around them.

The White House has barred members of its coronavirus task force and their aides from appearing before Congress this month without the express approval of Mark Meadows, the White House chief of staff, according to an email obtained by The New York Times.

In addition, officials with “primary response departments,” including the Departments of State, Health and Human Services and Homeland Security, will be restricted to appearing at four hearings department-wide for the duration of May.

The White House Office of Legislative Affairs laid out the policy in an email to senior congressional aides, noting that it could change before the end of the month.

“Agencies must maximize their resources for Covid-19 response efforts and treat hearing requests accordingly,” the message said. That argument was repeated by a senior administration official, who spoke on condition of anonymity because he was not authorized to comment.

Democrats condemned the move, saying it reflected an impulse by the president to silence health experts.

“By muzzling science and the truth, it will only prolong this health and economic crisis,” said Senator Chuck Schumer, Democrat of New York and the minority leader. “The president’s failure to accept the truth, and then his desire to hide it, is one of the chief reasons we are lagging behind so many other countries in beating this scourge.”

Senator Lamar Alexander, Republican of Tennessee and the chairman of the committee, said on Monday that a May 12 hearing — what he called a “status report on going back to work, back to school” — would include appearances by Dr. Anthony Fauci, the administration’s top infectious disease official; Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention; Dr. Stephen Hahn, the commissioner of the Food and Drug Administration; and Admiral Brett P. Giroir, the assistant secretary of health at the Department of Health and Human Services.

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Chief Justice John G. Roberts Jr. spoke during oral arguments before the Supreme Court, as seen in a photograph of the court’s first-ever live stream, as displayed on a laptop.Credit...Drew Angerer/Getty Images

Chief Justice John G. Roberts Jr. played traffic cop. Justice Clarence Thomas asked his first questions in more than a year. Justice Sonia Sotomayor disappeared for a few moments, apparently having failed to unmute her phone.

On the whole, the Supreme Court’s first argument held by telephone went smoothly. The justices asked short bursts of quick questions, in order of seniority, as the world — also for the first time — listened in.

Chief Justice Roberts asked the first questions and then called on his colleagues. When lawyers gave extended answers, he cut them off and asked the next justice to ask questions.

The question before the court was whether an online hotel reservation company, Booking.com, may trademark its name. Generic terms cannot be trademarked, and all concerned agreed that “booking,” standing alone, was generic. The question for the justices was whether the addition of “.com” changed the analysis.

The court will hear 10 cases by phone over the next two weeks, including three on May 12 about subpoenas from prosecutors and Congress seeking Mr. Trump’s financial records, which could yield a politically explosive decision as the presidential campaign enters high gear.

The justices may not return to the bench in October, the start of their next term, if the virus is still a threat, as several of them are in the demographic group thought to be most at risk: Six members of the court are 65 or older.

While the Supreme Court went remote, the top House Republicans on Monday urged caution on new rules proposed by Democrats to allow committees to meet virtually and House members to vote by proxy from outside of Washington.

The Senate, after weeks of sporadic meetings and curtailed operations, returned for the first time in a month to restart the process of confirming federal judges and Trump administration nominees, with new social distancing and other health precautions in place.

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Closed stores in the fashion district of Los Angeles on Monday.Credit...Marcio Jose Sanchez/Associated Press

The governor of California said on Monday that some stores could reopen on Friday, and that individual counties, if they desired, could relax restrictions further as long as they took precautions.

Gov. Gavin Newsom, a Democrat, said the businesses, including clothing stores, bookstores, florists and sporting goods stores, would be allowed to reopen with modifications. The manufacturing businesses that supply these shops would also be permitted to reopen.

The announcement was a cautious but serious step toward removing some of the most severe restrictions that California had placed on everyday life. Dozens of states — led largely by those with Republican governors — have undone restrictions issued to slow the spread of the coronavirus.

“This is a very positive sign, and it’s happened only for one reason,” Mr. Newsom said at a news conference. “The data says it can happen.”

Mr. Newsom and the state’s top health official, Dr. Sonia Angell, sounded optimistic, trumpeting the state’s testing capabilities — about 30,000 a day — and its stable number of daily hospitalizations.

Store owners will be allowed to open for pickup on Friday only if they alter their workplaces, and they must enforce social distancing. Mr. Newsom added that more details about the required modifications would be released on Thursday.

The governor also said that if local health officials and county governments certify that they are ready to reopen further, they will be able to open restaurants and other hospitality-sector businesses, with modifications. The counties will have to submit plans to the state health agency.

And in a further development to the saga of closed beaches that has extended to several coastal states, Mr. Newsom said he would allow two beaches in Orange County — Laguna and San Clemente — to reopen, after he had previously banned all of the county’s beaches from opening.

Prime ministers, a king, a prince and Madonna all chipped in to an $8 billion pot to fund a coronavirus vaccine.

Mr. Trump skipped the chance to contribute, with officials in his administration noting that the United States was pouring billions of dollars into its own research efforts.

During a three-hour fund-raising conference on Monday organized by the European Union and conducted over video link, representatives from around the world — from Japan to Canada, Australia to Norway — took turns announcing their countries’ contributions to fund laboratories that have promising leads in developing and producing a vaccine. For Romania, it was $200,000. For Canada, $850 million.

The European Commission, the executive branch of the European Union that spearheaded the initiative, said the money would be spent over the next two years. The goal is to deliver universal and affordable access to medication to fight Covid-19, the disease caused by the coronavirus.

The multilateral effort stood in sharp contrast to the solo road the United States was on as scientists scrambled to develop a vaccine.

In Washington on Monday, senior Trump administration officials did not explain the U.S. absence at the European-organized conference. Instead, they pointed to American contributions to vaccine efforts worldwide and noted that the government had spent $2.6 billion on vaccine research and development through an arm of the Department of Health and Human Services.

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Cuomo Describes Framework for Reopening Businesses

Gov. Andrew M. Cuomo of New York provided details about which businesses will open first.

You open businesses first that are most essential, and pose the lowest risk, OK — most essential and the lowest risk. Phase 1, we’re talking about construction, manufacturing and select retail with curbside pickup. They are the most essential with the lowest risk. Second phase: professional services, retail, administrative support, real estate. Third phase: restaurant, food services, accommodation. Fourth: arts, entertainment, recreation, education. Remember, density is not your friend here. Large gatherings are not your friend. That’s where the virus tends to spread. That’s why those situations would be down at the end. And then we need businesses to also reimagine how they’re going to do business, and get ready to protect their workforce, to change their physical environment to the extent they need to and to change their processes to make sure people can socially distance, people remain at a safe — in a safe environment. And that’s going to be up to businesses to come up with ways to reconfigure their workplace and their processes.

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Gov. Andrew M. Cuomo of New York provided details about which businesses will open first.CreditCredit...Victor J. Blue for The New York Times

Gov. Andrew M. Cuomo of New York listed seven requirements that each of the state’s 10 regions would need to meet before restrictions could be eased:

  • A 14-day decline in hospitalizations, or fewer than 15 hospitalizations a day.

  • A 14-day decline in virus-related hospital deaths, or under five a day.

  • A rate of new hospitalizations below 2 per 100,000 residents per day.

  • A hospital-bed vacancy rate of at least 30 percent.

  • At least 30 percent of I.C.U. beds available.

  • At least 30 virus tests per 1,000 residents per month.

  • At least 30 contact tracers per 100,000 residents.

Some areas, including central New York and the sparsely populated North Country region of the state, were already meeting five of the seven requirements, Mr. Cuomo said.

New York City is meeting only three: Hospital deaths and new hospitalizations are declining steadily, and the city is conducting the appropriate number of tests each month.

The governor reported 226 more deaths in the state — the lowest one-day figure since March 28 and down more than 70 percent from early April, when nearly 800 people per day were dying. The number of hospitalized patients and new admissions to hospitals also continued to fall, though much more gradually than they had increased.

In New Jersey, all public and private schools will remain closed for the rest of the academic year, Gov. Philip D. Murphy announced on Twitter on Monday, a week after saying there was “a chance” they would reopen. His decision followed similar steps by New York and Pennsylvania.

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Carnival Cruise Lines ships docked in Miami in April.Credit...Angel Valentin for The New York Times

The cruise giant Carnival Corporation said on Monday that it planned to reopen cruising on eight of its ships before the end of the summer.

Carnival has canceled service on some of its lines through September, but it said it was planning to offer cruises from ports in Galveston, Texas; Miami; and Port Canaveral, Fla., as early as Aug. 1. Carnival, the world’s largest cruise line, has more than 100 ships across its various brands.

Carnival has been at the center of the pandemic since the beginning, when it was widely blamed for a series of major outbreaks that spread the disease across the world. Last week, Congress began investigating the company’s handling of the virus, asking it to turn over internal communications related to the pandemic.

In its statement on Monday, Carnival said all North American cruises set to depart between June 27 and July 31 would be canceled.

“We will use this additional time to continue to engage experts, government officials and stakeholders on additional protocols and procedures to protect the health and safety of our guests, crew and the communities we serve,” the company said.

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Maalik Mitchell, center, said goodbye to his father, Calvin Munerlyn, at a vigil on Sunday night. Mr. Munerlyn was shot and killed on Friday at a Family Dollar store in Flint, Mich.Credit...Jake May/The Flint Journal, via Associated Press

Three people have been charged with murder in the shooting death of a security guard at a Family Dollar store in Flint, Mich., after a dispute with a customer whose daughter was not wearing a mask in the store as required under a state order.

The Genesee County prosecutor, David Leyton, on Monday announced first-degree murder and weapons charges against the customer, along with her husband and son, who is accused of shooting the security guard, Calvin Munerlyn, on Friday afternoon.

According to the prosecutor, after Mr. Munerlyn told the customer, Sharmel Teague, that her daughter needed to wear a mask inside the store, Ms. Teague yelled and spat at him, prompting the security guard to tell her to leave and instructing a cashier not to serve her.

Ms. Teague left the store and called her husband, Larry Teague, who returned to the store with her son, Ramonyea Travon Bishop, according to Mr. Layton. Mr. Bishop is accused of then shooting Mr. Munerlyn in the head.

Ms. Teague has been arrested, while Mr. Teague and Mr. Bishop are being sought by the police, according to the prosecutor.

The shooting comes at a time when wearing a face mask — or refusing to — has become a flash point.

In Holly, Mich., the police are looking for a man who wiped his nose and face on a Dollar Tree store clerk’s shirt on Saturday after she advised him that all customers must wear a mask inside the store.

In California, officials condemned a man who was photographed wearing a makeshift Ku Klux Klan hood while shopping at a supermarket outside San Diego.

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A rendering of the outer shell of an adeno-associated virus with the exterior partially removed. The shell is used as a Trojan horse to deliver a genetic component of the coronavirus to raise an immune response.Credit...Eric Zinn and Luk H. Vandenberghe

Researchers at two Harvard-affiliated hospitals are adapting a form of gene therapy to develop a potential coronavirus vaccine, which they expect to test in people later this year, they announced on Monday.

Their work uses a method already present in gene therapy for two inherited diseases, including a form of blindness: A harmless virus serves as a vector, or carrier, to bring DNA into the patient’s cells. In this case, the DNA should instruct the cells to make a coronavirus protein that would stimulate the immune system to fight future infections.

So far, the researchers have studied the vaccine candidates only in mice. But two of seven promising versions are already being readied for studies in humans. The research is one of at least 90 vaccine projects speeding ahead around the world.

Like other vaccine projects, this one is focusing on the so-called spike on the coronavirus, which the virus uses to grab onto cells and invade them. In theory, if the immune system can be trained to make antibodies to block the spike, the virus will not be able to establish an infection.

One advantage of this approach, if it proves safe and effective, is that many drug and biotech companies already produce the type of vector it relies on. That means production could be scaled up quickly. As with other vaccine projects, much is still unknown, including the possibility that the vaccine could actually make the disease worse.

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Elmhurst Hospital Center in Queens in April.Credit...Ryan Christopher Jones for The New York Times

They did not treat patients, but Wayne Edwards, Derik Braswell and Priscilla Carrow held some of the most vital jobs at Elmhurst Hospital Center in Queens.

As the virus tore through the neighborhood, their department managed the masks, gloves and other protective gear inside Elmhurst, a public hospital at the center of New York City’s outbreak. They ordered the inventory, replenished the stockroom and handed out supplies, keeping count as the number of available masks began to dwindle.

By April 12, they were all dead.

The pandemic has taken an undisputed toll on doctors, nurses and other front-line health care workers. But it has also ravaged the often invisible army of nonmedical workers in hospitals, many of whom have fallen ill or died with little public recognition of their roles.

The victims included the security guards watching over emergency rooms. They were the chefs who cooked food for patients. They assigned hospital beds and checked patients’ medical records. They greeted visitors and answered phones. They mopped the hallways and took out the garbage.

“You know how people clap for health workers at 7 o’clock? It’s mainly for the nurses and doctors. I get it. But people are not seeing the other parts of the hospital,” said Eneida Becote, whose husband died last month after working for two decades as a patient transporter.

The Food and Drug Administration announced on Monday that companies selling coronavirus antibody tests must submit data proving accuracy within the next 10 days or face removal from the market.

The antibody tests are an effort to detect whether a person had been infected with the virus, but results have been widely varied and little is known about whether those who became ill will develop immunity — and if so, for how long. Government and health officials have hoped that antibody tests would be a critical tool to help determine when it would be safe to lift stay-at-home restrictions and reopen businesses.

Since mid-March, the agency has permitted dozens of manufacturers to sell the tests without providing evidence that they are accurate. Many are wildly off the mark.

The F.D.A.’s action came after a report by more than 50 scientists, which found that only three out of 14 antibody tests gave consistently reliable results, and that even the best had flaws. An evaluation by the National Institutes of Health also found “a concerning number” of commercial tests that were performing poorly, the agency said.

A vice president of Amazon’s cloud computing arm said on Monday that he had quit “in dismay” over the recent firings of workers who had raised questions about workplace safety during the pandemic.

The vice president, Tim Bray, wrote in a blog post that his last day at the company was on Friday. He criticized a number of recent firings by Amazon, including that of an employee in a Staten Island warehouse, Christian Smalls, who had led a protest in March calling for the company to provide workers with more protections. Mr. Smalls’s firing has drawn the scrutiny of New York State’s attorney general.

Mr. Bray also criticized the firing last month of two Amazon employees, Maren Costa and Emily Cunningham, who circulated a petition on internal email lists in March calling for Amazon to expand sick leave, hazard pay and child care for warehouse workers.

Mr. Bray, who had worked for the company for more than five years, called the fired workers whistle-blowers and said that firing them was “evidence of a vein of toxicity running through the company culture.”

Amazon did not immediately respond to a request for comment.

The intelligence agencies sought on Monday to back Mr. Trump’s assertions that he was given only minimal warnings about the threat of the coronavirus early in the year, singling out their own lapses without noting that around the same time, scientists, public health officials and national security officials were sounding alarms.

Mr. Trump was first briefed by intelligence agencies about the novel coronavirus on Jan. 23, said Susan Miller, the spokeswoman for the Office of the Director of National Intelligence. But she acknowledged that the initial briefing downplayed its threat. Mr. Trump was “told that the good news was the virus did not appear that deadly,” Ms. Miller said. As the world painfully learned, that assessment was wrong.

Ms. Miller’s statement came after weeks of Mr. Trump and administration officials railing at what they have called inaccurate accounts in the news media that intelligence agencies put multiple warnings about the virus in the president’s daily intelligence briefing. On Sunday, Mr. Trump said the intelligence agencies in January had told him the virus was “not a big deal.”

Though information about the virus in late January was imperfect, the warnings from other officials were stark enough to prompt the Trump administration to decide by the end of January to restrict travel from China.

Some intelligence officials have said that the pandemic’s spread had never been fundamentally an intelligence issue and that the warnings of scientists had always been far more important. When the warnings that intelligence agencies did give to officials were combined with what public health and biodefense officials were learning, a clearer picture of a global threat emerged early.

By focusing on what Mr. Trump was told in January, administration officials are also able to distract from the timeline of events in February. It was during that month that critical missteps by the Trump administration led to wasted time and delays in responding to the crisis.

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A salon in Bangkok on Sunday. Thailand is among the countries that have begun tentatively allowing businesses to reopen.Credit...Adam Dean for The New York Times

At least 12 countries began easing restrictions on public life on Monday, as the world tried to figure out how to placate restless populations tired of being inside and reboot stalled economies without creating opportunities for the virus to re-emerge.

The steps, which include reopening schools and allowing airports to begin domestic service, offer the rest of the world a preview of how areas that have managed to blunt the toll might work toward resuming their pre-pandemic lives. They also serve as test cases for whether the countries can maintain their positive momentum through the reopenings, or if the desire for normalcy could place more people at risk.

Most of the countries easing their restrictions are in Europe, including Italy, one of the places where the virus hit earliest and hardest, leaving more than 29,000 dead. The country plans to reopen some airports to passengers.

In Germany, where widespread testing has kept the pandemic under control, children will return to schools. Austria also plans to restart its school system.

In Lebanon, bars and restaurants will reopen, while Poland plans to allow patrons to return to hotels, museums and shops.

India allowed businesses, local transportation and activities like weddings to resume in areas with few or no known infections. Wedding ceremonies with fewer than 50 guests will be permitted and self-employed workers like maids and plumbers can return to work.

Mr. Trump accused the Chinese government of making a “horrible mistake” in its virus response and of then orchestrating a cover-up that allowed the pathogen to spread.

“They tried to cover it, they tried to put it out. It’s like a fire,” Mr. Trump said on Sunday night during a virtual town hall on Fox News. “You know, it’s really like trying to put out a fire. They couldn’t put out the fire.”

China did eventually suppress the disease with a harsh lockdown, but public health experts have criticized Beijing for withholding information and acting too late.

Mr. Trump, who has come under fierce criticism for his handling of the crisis, also issued the latest in a series of accusations from members of his administration laying blame on China for the creation and spread of the virus.

“We’re going to be giving a very strong report as to exactly what we think happened,” Mr. Trump said. “And I think it will be very conclusive.”

Secretary of State Mike Pompeo was even more explicit, saying on Sunday that the coronavirus originated in a research laboratory in Wuhan, China. That conflicts with the judgment of most virologists and of U.S. intelligence agencies, which say the virus was “not man-made or genetically modified.”

It is not just the Trump administration that has been increasingly critical of China. The Times’s chief diplomatic correspondent for Europe, Steven Erlanger, reports that a backlash against Beijing is building across the globe, creating a deeply polarizing battle of narratives and setting back China’s ambition to fill the leadership vacuum left by the United States.

China has denied that the virus originated in a laboratory.

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Nearly empty Chicago O’Hare International airport in Chicago, in April. Shares of big U.S. Airlines dropped on Saturday after Warren Buffet said he dumped stakes in the companies.Credit...Hiroko Masuike/The New York Times

Stocks on Wall Street slid on Monday, following a drop in Europe and Asia, as investors remained on edge about the severity of the economic downturn.

The S&P 500 fell about 1 percent at the start of trading, putting it on track for its third straight decline.

Investors have been contending with two diverging ideas lately. Encouraged by the progress made in combating the pandemic, and hopeful that economies will begin to reopen soon, they bid stocks sharply higher in April. But evidence of the damage to employment, corporate profits and the broader economy continues to roll in.

On Monday, the focus was on the risks, with sentiment hurt by rising tensions between the United States and China.

Shares of the big U.S. airlines — Delta Air Lines, United Airlines, American Airlines and Southwest Airlines — were also sharply lower after Warren Buffett on Saturday said he had dumped his stakes in the companies. Because of the pandemic’s impact on travel, “the airline business — and I may be wrong, and I hope I’m wrong — but I think it, it changed in a very major way,” he said.

In some global markets, the drop was partly a catch up to trading on Friday. Stocks in France and Germany, which had been closed Friday, fell more than 3 percent. But the FTSE 100 in Britain, which did trade on Friday, was only slightly lower.

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Stephen Miller, right, outside the White House in February. He is the chief architect of President Trump’s immigration policies.Credit...Anna Moneymaker/The New York Times

From the early days of the Trump administration, Stephen Miller, the president’s chief adviser on immigration, has repeatedly tried to use an obscure law designed to protect the nation from diseases overseas as a way to tighten the borders.

The question was, which disease?

Mr. Miller pushed for invoking the president’s broad public health powers in 2019, when an outbreak of mumps spread through immigration detention facilities in six states. He tried again that year when Border Patrol stations were hit with the flu.

When vast caravans of migrants surged toward the border in 2018, Mr. Miller looked for evidence that they carried illnesses. He asked for updates on American communities that received migrants to see if new disease was spreading there.

In 2018, dozens of migrants became seriously ill in federal custody, and two under the age of 10 died within three weeks of each other. While many viewed the incidents as resulting from negligence on the part of the border authorities, Mr. Miller instead argued that they supported his argument that the president should use his public health powers to justify sealing the borders.

On some occasions, Mr. Miller and the president, who also embraced these ideas, were talked down by cabinet secretaries and lawyers who argued that the public health situation at the time did not provide sufficient legal basis for such a proclamation.

That changed with the arrival of the pandemic.

Within days of the confirmation of the first case in the United States, the White House shut American land borders to nonessential travel, closing the door to almost all migrants, including children and teenagers who arrived at the border with no parent or other adult guardian. Other international travel restrictions were introduced, as well as a pause on green card processing at American consular offices, which Mr. Miller told conservative allies in a recent private phone call was only the first step in a broader plan to restrict legal immigration.

Marking your calendar at the first sign of illness, and noting your fever and oxygen levels, are important steps in monitoring an infection.

Reporting was contributed by Peter Baker, Brooks Barnes, Julian Barnes, Alan Blinder, Nicholas Bogel-Burroughs, Jonah Engel Bromwich, Emily Cochrane, Michael Cooper, Caitlin Dickerson, Reid J. Epstein, Nicholas Fandos, Denise Grady, Nicole Hong, Sheila Kaplan, Dan Levin, Adam Liptak, Patricia Mazzei, Sarah Mervosh, David Montgomery, Heather Murphy, Matt Richtel, Rick Rojas, Simon Romero, David Sanger, Marc Santora, Dionne Searcey, Michael D. Shear, Eileen Sullivan, Sheryl Gay Stolberg, Tracey Tully and Neil Vigdor.

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