'Off the charts': Virus hot spots grow in middle America

  • Members of the Rhode Island National Guard look for passengers getting off from a train from New York as it arrives Saturday, March 28, 2020, in Westerly, R.I. States are pulling back the welcome mat for travelers from the New York area, which is the epicenter of the country's coronavirus outbreak, and some say at least one state's measures are unconstitutional. Gov. Gina Raimondo ratcheted up the measures Friday afternoon, announcing she'll also order the state National Guard to go door-to-door in coastal communities starting this weekend to find out whether any of the home's residents have recently arrived from New York and inform them of the quarantine order.

    Members of the Rhode Island National Guard look for passengers getting off from a train from New York as it arrives Saturday, March 28, 2020, in Westerly, R.I. States are pulling back the welcome mat for travelers from the New York area, which is the epicenter of the country's coronavirus outbreak, and some say at least one state's measures are unconstitutional. Gov. Gina Raimondo ratcheted up the measures Friday afternoon, announcing she'll also order the state National Guard to go door-to-door in coastal communities starting this weekend to find out whether any of the home's residents have recently arrived from New York and inform them of the quarantine order. Associated Press

  • Voluntary firefighters take part in a fumigation initiative as a precaution against the spread of the new coronavirus, on the outskirts of Asuncion, Paraguay, Saturday, March 28, 2020.

    Voluntary firefighters take part in a fumigation initiative as a precaution against the spread of the new coronavirus, on the outskirts of Asuncion, Paraguay, Saturday, March 28, 2020. Associated Press

  • Emergency room nurses transport buckets of donated flowers up a ramp outside Elmhurst Hospital Center's emergency room, Saturday, March 28, 2020, in New York. The hospital has been heavily taxed by treating an influx of coronavirus patients during the current viral pandemic. Currently, New York leads the nation in the number of cases, according to Johns Hopkins University, which is keeping a running tally.

    Emergency room nurses transport buckets of donated flowers up a ramp outside Elmhurst Hospital Center's emergency room, Saturday, March 28, 2020, in New York. The hospital has been heavily taxed by treating an influx of coronavirus patients during the current viral pandemic. Currently, New York leads the nation in the number of cases, according to Johns Hopkins University, which is keeping a running tally. Associated Press

  • South African National Defense Forces patrol the Men's Hostel in the densely populated Alexandra township east of Johannesburg, Saturday, March 28, 2020, enforcing a strict lockdown in an effort to control the spread of the coronavirus. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.

    South African National Defense Forces patrol the Men's Hostel in the densely populated Alexandra township east of Johannesburg, Saturday, March 28, 2020, enforcing a strict lockdown in an effort to control the spread of the coronavirus. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. Associated Press

  • Local residents watch as the USNS Comfort departs Hampton Roads en route to New York to help in the response to the coronavirus outbreak Saturday, March 28, 2020, in Hampton, Va.

    Local residents watch as the USNS Comfort departs Hampton Roads en route to New York to help in the response to the coronavirus outbreak Saturday, March 28, 2020, in Hampton, Va. Associated Press

  • A dog walks in the Chichicastenango artisan and food market empty of shoppers during a stay-at-home curfew across the country to help prevent the spread of the new coronavirus in Santo Tomas Chichicastenango, Guatemala, Saturday, March 28, 2020. Activity at the iconic market has been limited to the sale of food and only for a few hours, in an effort to help prevent the spread of the new coronavirus.

    A dog walks in the Chichicastenango artisan and food market empty of shoppers during a stay-at-home curfew across the country to help prevent the spread of the new coronavirus in Santo Tomas Chichicastenango, Guatemala, Saturday, March 28, 2020. Activity at the iconic market has been limited to the sale of food and only for a few hours, in an effort to help prevent the spread of the new coronavirus. Associated Press

  • A person emerges from a tent set up in the driveway of the emergency entrance to Elmhurst Hospital Center in New York, Saturday, March 28, 2020, as others wait in line to be tested for coronavirus. The hospital is caring for a high number of coronavirus patients in the city.

    A person emerges from a tent set up in the driveway of the emergency entrance to Elmhurst Hospital Center in New York, Saturday, March 28, 2020, as others wait in line to be tested for coronavirus. The hospital is caring for a high number of coronavirus patients in the city. Associated Press

  • An Indian migrant laborer's family is silhouetted as they make the journey to their village by foot, following a lockdown amid concern over spread of coronavirus in New Delhi, India, Saturday, March 28, 2020. Authorities sent a fleet of buses to the outskirts of India's capital on Saturday to meet an exodus of migrant workers desperately trying to reach their home villages during the world's largest coronavirus lockdown. Thousands of people, mostly young male day laborers but also families, fled their New Delhi homes after Prime Minister Narendra Modi announced a 21-day lockdown that began on Wednesday and effectively put millions of Indians who live off daily earnings out of work.

    An Indian migrant laborer's family is silhouetted as they make the journey to their village by foot, following a lockdown amid concern over spread of coronavirus in New Delhi, India, Saturday, March 28, 2020. Authorities sent a fleet of buses to the outskirts of India's capital on Saturday to meet an exodus of migrant workers desperately trying to reach their home villages during the world's largest coronavirus lockdown. Thousands of people, mostly young male day laborers but also families, fled their New Delhi homes after Prime Minister Narendra Modi announced a 21-day lockdown that began on Wednesday and effectively put millions of Indians who live off daily earnings out of work. Associated Press

  • Pedestrians, wearing protective face masks as a precaution against the spread of the new coronavirus, walk past a mural in Quito, Ecuador, Saturday, March 28, 2020. The government has declared a health emergency, enacting a curfew and restricting movement to only those who provide basic services.

    Pedestrians, wearing protective face masks as a precaution against the spread of the new coronavirus, walk past a mural in Quito, Ecuador, Saturday, March 28, 2020. The government has declared a health emergency, enacting a curfew and restricting movement to only those who provide basic services. Associated Press

  • Hospice personnel and residents applaud from a window of the elderly people's home to a Russian team who sanitized the structure to contain the spread of the Covid-19 virus, in Albino, near Bergamo, northern Italy, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Claudio Furlan/LaPresse via AP)

    Hospice personnel and residents applaud from a window of the elderly people's home to a Russian team who sanitized the structure to contain the spread of the Covid-19 virus, in Albino, near Bergamo, northern Italy, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Claudio Furlan/LaPresse via AP) Associated Press

  • A nurse demonstrates outside the emergency entrance at Jacobi Medical Center in the Bronx borough of New York, Saturday, March 28, 2020, demanding more personal protective equipment for medical staff treating coronavirus patients. A member of the New York nursing community died earlier this week while treating coronavirus patients at another New York hospital. The city leads the nation in the number of COVID-19 cases, and the United States currently has the most cases in the world, according to the World Health Organization.

    A nurse demonstrates outside the emergency entrance at Jacobi Medical Center in the Bronx borough of New York, Saturday, March 28, 2020, demanding more personal protective equipment for medical staff treating coronavirus patients. A member of the New York nursing community died earlier this week while treating coronavirus patients at another New York hospital. The city leads the nation in the number of COVID-19 cases, and the United States currently has the most cases in the world, according to the World Health Organization. Associated Press

  • Don Marcello Crotti, left, blesses the coffins with Don Mario Carminati in the San Giuseppe church in Seriate, Italy, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.

    Don Marcello Crotti, left, blesses the coffins with Don Mario Carminati in the San Giuseppe church in Seriate, Italy, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. Associated Press

  • A lantern hangs outside an empty restaurant Saturday, March 28, 2020, in the Shimbashi section of Tokyo. okyo Gov. Yuriko Koike has repeatedly asked the city's 13 million residents to stay home this weekend, saying the capital is on the brink of an explosion in virus infections.

    A lantern hangs outside an empty restaurant Saturday, March 28, 2020, in the Shimbashi section of Tokyo. okyo Gov. Yuriko Koike has repeatedly asked the city's 13 million residents to stay home this weekend, saying the capital is on the brink of an explosion in virus infections. Associated Press

  • A priest and relatives pray as a victim of the COVID-19 is buried by undertakers at the Almudena cemetery in Madrid, Spain, Saturday March 28, 2020. In Spain, where stay-at-home restrictions have been in place for nearly two weeks, the official number of deaths is increasing daily. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.

    A priest and relatives pray as a victim of the COVID-19 is buried by undertakers at the Almudena cemetery in Madrid, Spain, Saturday March 28, 2020. In Spain, where stay-at-home restrictions have been in place for nearly two weeks, the official number of deaths is increasing daily. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. Associated Press

  • This GoPro image provided Saturday March 28, 2020 by the French Army shows doctors taking care of evacuated patients infected with the Covid-19 disease, aboard a military plane from Mulhouse, eastern France to Bordeaux, southwestern France, Friday March 27, 2020. France is evacuating its citizens infected with the coronavirus in Eastern France. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Dicod via AP)

    This GoPro image provided Saturday March 28, 2020 by the French Army shows doctors taking care of evacuated patients infected with the Covid-19 disease, aboard a military plane from Mulhouse, eastern France to Bordeaux, southwestern France, Friday March 27, 2020. France is evacuating its citizens infected with the coronavirus in Eastern France. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Dicod via AP) Associated Press

  • Indian workers arrange beds to prepare a quarantine center at the Sarusojai sports complex in Gauhati, India, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.

    Indian workers arrange beds to prepare a quarantine center at the Sarusojai sports complex in Gauhati, India, Saturday, March 28, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. Associated Press

 
 
Updated 3/28/2020 8:36 PM

DETROIT -- The coronavirus continued its unrelenting spread across the United States with fatalities doubling in two days and authorities saying Saturday that an infant who tested positive had died. It pummeled big cities like New York, Detroit, New Orleans and Chicago, and made its way, too, into rural America as hotspots erupted in small Midwestern towns and Rocky Mountain ski havens.

Elsewhere, Russia announced a full border closure while in parts of Africa, pandemic prevention measures took a violent turn, with Kenyan police firing tear gas and officers elsewhere seen on video hitting people with batons.

                                                                                                                                                                                                                       
 

Worldwide infections surpassed the 660,000 mark with more than 30,000 deaths as new cases also stacked up quickly in Europe, according to a tally by Johns Hopkins University. The U.S. leads the world in reported cases with more than 120,000. Confirmed deaths surpassed 2,000 on Saturday, twice the number just two days before, highlighting how quickly infections are escalating. Still, five countries have higher death tolls: Italy, Spain, China, Iran and France. Italy has more than 10,000 deaths, the most of any country.

Illinois Gov. J.B. Pritzker said Saturday that an infant with COVID-19 died in Chicago and the cause of death is under investigation. Officials didn't release other information, including whether the child had other health issues.

'úIf you haven't been paying attention, maybe this is your wake-up call," said Illinois Department of Public Health Director Dr. Ngozi Ezike.

New York remained the worst-hit U.S. city. Gov. Andrew Cuomo said defeating the virus will take 'úweeks and weeks and weeks.'Ě The U.N. donated 250,000 face masks to the city, and Cuomo delayed the state's presidential primary from April 28 to June 23.

As President Donald Trump made his way to Norfolk, Virginia, to see off a U.S. Navy medical ship sent to New York City to help, he suggested imposing some kind of quarantine for New York and parts of New Jersey and Connecticut, all hit hard by the coronavirus. But he later tweeted that he intended to issue a 'ústrong travel advisory'Ě instead.

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It wasn't entirely clear whether he had the power to impose such a quarantine for the three states, and the idea was met with confusion and anger from their governors. Cuomo said on CNN that it would be illegal, economically catastrophic and unproductive since other areas are already seeing a surge.

Still, some states without known widespread infections began to try to limit exposure from visitors from harder-hit areas.

Rhode Island National Guard troops were instructed to go door to door in coastal communities to find New Yorkers and advise them about a mandatory 14-day quarantine for people from the state.

And in Florida, Gov. Ron DeSantis has ordered anyone arriving from Louisiana to self-quarantine and said law enforcement officers would set up checkpoints to screen cars from the state.

Louisiana has surpassed 3,300 infections with 137 dead from COVID-19, according to the health department. Gov. John Bel Edwards said the region was on track to run out of ventilators by the first week of April.

                                                                                                                                                                                                                       
 

Cases also have been rising rapidly in Detroit, where poverty and poor health have been problems for years. The number of infections surged to 1,381, with 31 deaths, as of noon Saturday. The city's homeless population is especially vulnerable, officials said.

'úAt this time, the trajectory of Detroit is unfortunately even more steep than that of New York,'Ě said Dr. Teena Chopra, the medical director of infection prevention and hospital epidemiology at the Detroit Medical Center.

'úThis is off the charts,'Ě she said.

Chopra said many patients have ailments like asthma, heart disease, diabetes and hypertension. She also acknowledged that in Detroit, one of the nation's largest African American cities, there is a distrust among some in the community of the medical system and government due to systemic racism.

"In Detroit, we are seeing a lot of patients that are presenting to us with severe disease, rather than minor disease," said Chopra, who worried about a 'útsunami'Ě of patients.

Trump approved a major disaster declaration for Michigan, providing money for the outbreak. He has done the same for New York, Louisiana and Illinois.

Cases in Chicago and suburban Cook County accounted for about three-fourths of Illinois' 3,026 total as of Friday. Chicago Mayor Lori Lightfoot closed popular lakeshore parks after people failed to practice social distancing, despite a statewide shelter-at-home order.

The governor of Kansas also issued a stay-at-home order to begin Monday, as the virus takes hold in more rural areas where doctors worry about the lack of ICU beds.

A cluster of three counties in rural Indiana have surging rates of confirmed cases. One of them, Decatur, population 26,000, has 30 cases with one confirmed death and another suspected, said Sean Durbin, the county's public health emergency preparedness coordinator. Several cases were traced to large gatherings earlier in the month, including a religious retreat and a high school basketball tournament.

The disease threatens to be devastating for close-knit communities where everyone knows everyone, Durbin said, adding that he was a friend of the person believed to have died from the virus as well as others currently in critical condition.

The county health department has already run out of personal protective equipment, Durbin said. The last supply from the federal stockpile arrived more than a week ago and contained just 77 N95 masks and two dozen face shields.

'úI wish there was a stronger word for disappointed," he said. "I'm calling on them to do better.'Ě

Blaine County, Idaho, a scenic ski haven for wealthy tourists, now has around 100 confirmed cases of COVID-19, the highest rate per capita outside the New York area. Two people have died.

The virus continues to strain health systems in Italy, Spain and France. Lockdowns of varying degrees have been introduced across Europe, nearly emptying streets in normally bustling cities.

Germany has fewer deaths than some neighboring countries but has closed nonessential shops and banned public gatherings of more than two people until April 20. It still had its share of grim news: 12 residents of a nursing home in the northern town of Wolfsburg have died since Monday after being infected, news agency dpa reported.

Italian Premier Giuseppe Conte announced he had signed a decree freeing up 400 million euros ($440 million) for coupons and packages of food aid, to be delivered door-to-door if necessary.

'úPeople are suffering psychologically. They're not used to staying in their homes. But they are also suffering economically,'Ě Conte said. Italy has almost completed a three-week lockdown, with no end in sight.

In Spain, where stay-at-home restrictions have been in place for nearly two weeks, the death toll rose to 5,812.

Another 8,000 confirmed infections pushed that count above 72,000 cases. But Spain's director of emergencies, Fernando Sim√≥n, saw hope in that the rate of infection is slowing and figures 'úindicate that the outbreak is stabilizing and may be reaching its peak in some areas.'Ě

Spanish Prime Minister Pedro S√°nchez called for a more vigorous response from the European Union. Spain, Italy, France and six other members have asked the union to share the burden of European debt, dubbed 'úcoronabonds'Ě in the media, to help fight the virus. But the idea has met resistance from other members, led by Germany and the Netherlands.

'úIt is the most difficult moment for the EU since its foundation and it has to be ready to rise to the challenge,'Ě S√°nchez said.

As the epicenter has shifted westward, the situation has calmed in China, where some restrictions have been lifted. Some subway service was restored in Wuhan, where the virus first emerged in December, after the city of 11 million had its virus risk evaluation reduced from high to medium.

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 135,000 people have recovered, according to Johns Hopkins.

Countries are still trying to bring home citizens stranded abroad. On Saturday, 174 foreign tourists and four Nepali nationals in the foothills of Mount Everest were flown out days after being stranded at the only airstrip serving the world's highest mountain.

Indian authorities sent buses to the outskirts of New Delhi to meet an exodus of migrant workers desperately trying to reach their home villages amid the world's largest lockdown, which effectively put millions out of work.

Russian Prime Minister Mikhail Mishustin ordered his country's borders fully closed as of Monday, exempting diplomats as well as residents of the exclave of the Kaliningrad region.

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Irvine reported from Chicago. Associated Press journalists around the world contributed.

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Follow AP coverage of the virus outbreak at https://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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