Federal health officials on Monday added pregnancy to the list of conditions that put people with Covid-19 at increased risk of developing severe illness, including a heightened risk of death.
While most pregnant women infected with the coronavirus have not become severely ill, the new caution is based on a large study that looked at tens of thousands of pregnant women who had Covid-19 symptoms.
The study found they were significantly more likely to require intensive care, to be connected to a specialized heart-lung bypass machine, and to require mechanical ventilation than nonpregnant women of the same age who had Covid-19 symptoms. Most importantly, the pregnant women faced a 70 percent increased risk of death, when compared to nonpregnant women who were symptomatic.
The study from the Centers for Disease Control and Prevention examined the outcomes of 409,462 symptomatic women ages 15 to 44 who tested positive for the coronavirus, 23,434 of whom were pregnant.
“We are now saying pregnant women are at increased risk for severe illness. Previously we said they ‘might be’ at increased risk for severe illness,” said Sascha Ellington, a health scientist with the C.D.C., and one of the authors of the new study.
Still, Dr. Ellington emphasized that the overall risk of both complications and death was small.
“The absolute risk of these severe outcomes are low among women 15 to 44, regardless of pregnancy status, but what we do see is an increased risk associated with pregnancy,” she said.
An earlier study did not find a higher risk of dying among pregnant Covid-19 patients but the pregnant patients in the new study were 1.7 times more likely to die than nonpregnant patients. That amounted to a death rate of death of 1.5 per 1,000 cases among the symptomatic pregnant women, compared with 1.2 per 1,000 cases of symptomatic women who were not pregnant.
Even after adjustments were made for differences in age, race, ethnicity and underlying health conditions like diabetes and lung disease, the pregnant women were three times more likely than nonpregnant women to be admitted to an intensive care unit and 2.9 times more likely to receive mechanical ventilation.
Dr. Ellington emphasized the importance of taking precautions to avoid infection, saying pregnant women should not only wear masks, practice social distancing and wash their hands frequently, but also limit interactions to avoid people who may have been exposed.
“Pregnant women should be counseled about the importance of seeking prompt medical care if they have symptoms,” the authors wrote.
A smaller study, also released Monday from the C.D.C., reported that women who tested positive for the coronavirus were at increased risk for delivering their babies prematurely, finding that 12.9 percent of live births among a sample of 3,912 women were preterm births, compared with 10.2 percent in the general population. The sample was not nationally representative, but the finding echoes earlier reports that warned of a higher risk for preterm deliveries.
Germany entered a new partial lockdown on Monday amid skyrocketing coronavirus cases across Europe, a specter that Chancellor Angela Merkel called a test not seen in her country since the end of World War II.
Under the new rules, labeled “lockdown light” by the German media, restaurants, bars and gyms will have to close for a month. The policy is designed to bring Germany’s per capita rate of new cases below 50 per 100,000 residents, from 128, so that health authorities can once again trace individual infections.
Ms. Merkel will meet with state governors in two weeks to gauge progress, and promised that if all goes well, Germans would be able to “allow ourselves more freedom at Christmas,” though wild New Year’s parties remain unimaginable.
Germany is still recording far fewer cases per capita than many other European nations, but there are grave fears that the second wave of infections could prove even more difficult than the spring.
Ms. Merkel pushed back against criticism of her government’s decision to focus on curtailing social life, saying it was the only way to keep schools and shops open, while still cutting back on interactions.
“Freedom is the possibility to decide from various options, but freedom is also freedom for everyone,” Ms. Merkel said. “That means, I don’t have endless freedom and everyone else has to live with my version of freedom.”
Europe as a whole surpassed 10 million confirmed cases and 268,000 Covid-19 deaths on Sunday, as many countries imposed tough new restrictions. France began a national lockdown on Sunday, and Britain is set to enter one on Thursday.
Prime Minister Boris Johnson of Britain laid out his lockdown plan before Parliament on Monday, and faced a mutiny from members of his Conservative Party, who said he went too far, and scalding criticism from Labour Party leaders, who said he waited too long to act. The measure is expected to be approved when it comes up for a vote on Wednesday.
Italy’s prime minister, Giuseppe Conte, told lawmakers on Monday that restrictions there would be tightened, but that there would not be a national lockdown. Some measures, though, will apply throughout the country, including a nighttime curfew and limiting travel between high-risk areas. Other restrictions would be applied depending on the perceived risk level in a specific territory.
“We are aware of the frustration, sense of disorientation and exhaustion on the part of citizens, as well as the anger that has been manifesting itself in recent days,” Mr. Conte said, a reference to the sporadic protests in various cities. He also acknowledged the significant impact that past restrictions have had on the national economy, adding that the government had sought to alleviate the hardships with aid.
Greece on Monday announced a full lockdown in the country’s second-largest city, Thessaloniki, and of the region of Serres, also in northern Greece. A government spokesman described the situation in those regions as “extremely serious,” as he announced the new measures, which go into effect on Tuesday for two weeks.
The restrictions include an overnight curfew and the reinstatement of a system requiring people to send a text message to the Greek government citing their reasons for venturing out — for work and health reasons only. All flights to and from Thessaloniki will be suspended. Schools will remain open.
The announcement came after Prime Minister Kyriakos Mitsotakis on Saturday heralded a new set of restrictions nationwide that are set to go into effect on Tuesday morning.
Portugal’s president said on Monday that he was considering a state of emergency that would give the government greater powers to impose lockdown restrictions to stop a second wave of Covid-19. Marcelo Rebelo de Sousa, Portugal’s president, sought to reassure citizens that the measures would be more limited than those imposed last spring. Portugal has registered in recent days a daily death toll of over 40, its highest since April.
President Trump suggested at a rally early Monday morning that he might fire Dr. Anthony S. Fauci after Election Day, further escalating the tension between his administration and the nation’s top infectious disease expert as the number of new coronavirus cases in the United States reaches record highs.
Mr. Trump spoke well past midnight at the Miami-Opa Locka Executive Airport in Florida at his fifth and final rally on Sunday. At one point, he began reciting a familiar complaint about the news media’s continued coverage of the virus.
His grousing led the crowd to chant, “Fire Fauci! Fire Fauci!” Mr. Trump listened in silence for a few moments before remarking: “Don’t tell anybody, but let me wait until a little bit after the election. I appreciate the advice.”
Dr. Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases, has civil service protections, and it would be extremely difficult for the president to have him removed. Under federal law, the president does not have authority to fire Dr. Fauci. Mr. Trump could try ordering his political appointees, such as Health Secretary Alex M. Azar II or Dr. Francis Collins, the director of the National Institutes of Health, to dismiss Dr. Fauci. But the process would be lengthy and arduous, because Dr. Fauci could appeal.
Dr. Fauci has run his institute since 1984; in years past, when he has been mentioned as a possible candidate for director of the N.I.H., he has demurred because that position is a political appointee, and he did not want his job to be tied to any president’s term.
The president’s remarks came toward the end of what was a whirlwind day of campaigning across five states — Michigan, Iowa, North Carolina, Georgia and Florida — and he spoke even as a local curfew aimed at curbing the spread of the coronavirus took effect at midnight. According to a New York Times database, the country set records on Sunday for the average number of new virus cases over a seven-day period — more than 82,000 daily — and the total number of new cases over the same amount of time — more than 579,000 cases.
Nonetheless, Mr. Trump has maintained without citing evidence that the United States has “turned the corner” in fighting the virus, a point he reiterated at the rally early Monday.
That assertion is strongly disputed by Dr. Fauci, who told the The Washington Post in an interview published on Saturday that the United States “could not possibly be positioned more poorly” as it heads into the winter. A White House spokesman later called Dr. Fauci’s comments “unacceptable.”
Former Vice President Joseph R. Biden Jr., the Democratic nominee, has said repeatedly that if he were to win the presidency, he is hopeful Dr. Fauci would remain in his role and serve in his administration.
In his interview with The Post, Dr. Fauci offered praise for the Biden campaign, saying it was taking the coronavirus “seriously from a public health perspective.”
Ordinarily circumspect, Dr. Fauci also took the opportunity to unload on another Trump pandemic adviser, Dr. Scott W. Atlas, who has won the president’s favor by questioning mask use and espousing a number of other contrarian views.
“I have real problems with that guy,” Dr. Fauci said, suggesting that Dr. Atlas, a neuroradiologist with no background in infectious disease, is out of his depth.
Dr. Atlas, on Saturday, appeared on RT, a Russian state-sponsored television network that has helped Moscow spread false health information about the pandemic. American intelligence agencies consider RT a propaganda arm for Russia, and it is registered in the United States as a foreign agent.
“The lockdowns will go down as an epic failure of public policy by people who refuse to accept they were wrong,” Dr. Atlas said in the interview. “The argument is undeniable, the lockdowns are killing people.”
The interview with RT was not approved by the White House press office, an administration official said, and Dr. Atlas apologized for giving it.
“I regret doing the interview and apologize for allowing myself to be taken advantage of,” he said in a tweet. “I especially apologize to the national security community who is working hard to defend us.”
The White House has had no public criticism of Dr. Atlas, though it did for Dr. Fauci.
In a statement to The Post, a White House spokesman, Judd Deere, said it was “unacceptable and breaking with all norms” for Dr. Fauci to “play politics” three days before the election. Dr. Fauci, he said, had made “his political leanings known by praising the president’s opponent, exactly what the American people have come to expect from the swamp.”
On a cold weekend in mid-February, when the world still harbored hope that the coronavirus could be contained, a World Health Organization team arrived in Beijing to study the outbreak and investigate a critical question: How did the virus jump from animals to humans?
At that point, there were only three confirmed deaths from Covid-19 outside China, and scientists hoped that finding an animal source for the virus would unlock clues about how to stop it, treat it and prevent similar outbreaks.
“If we don’t know the source, then we’re equally vulnerable in the future to a similar outbreak,” Dr. Michael Ryan, the emergency director of the W.H.O., had said that week.
What the team members did not know was that they would not be allowed to investigate the source at all. Despite Dr. Ryan’s pronouncements, and against the advice of its emergency committee, the organization’s leadership had quietly negotiated terms that sidelined its own experts. They would not question China’s initial response or even visit the live-animal market in the city of Wuhan where the outbreak seemed to have originated.
Nine months and more than 1.1 million deaths later, there is still no transparent, independent investigation into the source of the virus. China has impeded the effort, while leaders of the W.H.O., if privately frustrated, have largely ceded control, even as the Trump administration has fumed.
From the earliest days of the outbreak, the W.H.O. — the only public health body with a global remit — has been both indispensable and impotent. The Geneva-based agency has delivered key information about testing, treatment and vaccine science. When the Trump administration decided to develop its own test kits, rather than rely on the W.H.O. blueprint, the botched result led to delays.
At the same time, the health organization pushed misleading and contradictory information about the risk of spread from symptomless carriers. Its experts were slow to accept that the virus could be airborne. Top health officials encouraged travel as usual, advice that was based on politics and economics, not science.
The W.H.O.’s staunchest defenders note that, by the nature of its constitution, it is beholden to the countries that finance it. And it is hardly the only international body bending to China’s might.
Now, as a new Covid-19 wave engulfs Europe and the United States, the organization is in the middle of a geopolitical standoff between the world’s two greatest powers, the United States and China.
China’s authoritarian leaders want to constrain the organization; President Trump, who formally withdrew the United States from the body in July, seems intent on destroying it; and European leaders are scrambling to reform and empower it.
A new study casts doubt on whether rapid coronavirus tests, widely hailed as a potential solution to the nation’s testing woes, perform as promised under real-world conditions, especially when used in people without symptoms.
In a head-to-head comparison, researchers at the University of Arizona found that, in symptomatic people, a rapid test made by Quidel could detect more than 80 percent of coronavirus infections found by a slower, lab-based P.C.R. test. But when the rapid test, called the Sofia, was used instead to randomly screen students and staff members who did not feel sick, it detected only 32 percent of the positive cases identified by the P.C.R. test.
“That’s worse than flipping a coin,” said Jennifer Dien Bard, the director of the clinical microbiology and virology laboratory at Children’s Hospital Los Angeles, who was not involved in the study.
When asked about the Sofia’s poorer performance in asymptomatic people, David Harris, an author on the study, said, “I think everybody expected that.”
But he and his colleagues argued in their manuscript that some of the asymptomatic people who tested positive with P.C.R., but negative with the rapid test, might have been missed for good reason: They were carrying too little of the coronavirus to spread it to others, based on data obtained by P.C.R.
Doug Bryant, Quidel’s president and chief executive, who received an early copy of the University of Arizona study, praised the results as “very, very good,” citing the Sofia’s ability to root out “people who are infectious.”
Other experts advised caution, however, noting that there is no definitive test for infectiousness.
For now, people with symptoms or known exposures to the coronavirus should still get the most precise and reliable tests available — those that use P.C.R., said Susan Butler-Wu, a clinical microbiologist at the University of Southern California who was not involved in the study. More data, she added, would be needed to figure out how rapid tests fit into the larger diagnostic landscape.
Over the next two weeks, more than one million parents in New York City must make a wrenching decision: Should they send their children into classrooms this school year or keep them learning from home, likely until at least next fall?
Last week, Mayor Bill de Blasio announced that parents would have until Nov. 15 to decide whether to enroll their children in hybrid learning, a mixture of in-person and remote instruction, for the remainder of the school year.
The city had originally promised parents they could opt into the hybrid program every few months. But the mayor changed the rules because about only a quarter of the district’s 1.1 million students have shown up for in-person classes since September, far fewer than predicted. That has made it difficult for the city to know how to allocate teachers, the mayor said.
Now, the many parents who have kept their children home, whether for safety, convenience or consistency, need to decide: Is hybrid learning working?
It is a question parents in many other places across the country and world are also facing, as more districts prepare to open for at least some mixture of in-person and remote classes. But the choice is particularly fraught in New York City, once a global epicenter of the virus and now one of the few large urban districts in the United States to offer any classroom instruction.
“Intuitively, parents understand that the best place for kids is in school,” said Eric Goldberg, an elected parent leader in Manhattan who has chosen hybrid learning for his own children. “But what is it about the New York City public school experience that is leading families to choose remote learning? When the in-school experience is so compromised and inferior, people think, ‘Why am I doing this?’”
On Monday, Mr. Bill de Blasio said that the citywide seven-day rolling average virus positivity rate was 1.81 percent, and that the city wanted to start “knocking down” that figure.
“We’re keeping a very close eye on the situation,” he said. “We’re obviously at a point where that has gone up in recent weeks and we take that very seriously.”
The mayor has said he will require all students to take all their classes remotely if the seven-day rolling average reaches 3 percent.
The death of an eighth grader from Covid-19 complications in Missouri over the weekend is rattling his community and may add to the already fraught debate over the risks and benefits of reopening schools in a pandemic.
The school district in Washington, Mo., about 35 miles west of St. Louis, said the student was 13 and attended Washington Middle School. It was not known whether he caught the virus in school or elsewhere, according to Julie Bell, an assistant to the district superintendent, Dr. Lori VanLeer.
Very few of the people who have died from the coronavirus around the world have been children, and the eighth grader may have been the first in Missouri. The state health department’s coronavirus data dashboard does not show any previous virus-related death of someone younger than 18.
Dr. VanLeer informed families in the school district about the boy’s death in an email on Sunday. She wrote that he had last attended school on Oct. 22 and had gone into quarantine on Oct. 26.
“Later, his family shared that he eventually began experiencing symptoms that required hospitalization, but he did not improve,” Dr. VanLeer wrote.
She said that the middle school would have extra counselors available on Wednesday, when students return to class after two days off for parent-teacher conferences and professional development.
The coronavirus has been surging in Missouri since late summer, and the state is now averaging more than 2,400 new cases a day. Franklin County, where Washington is located, is averaging more than 45 new cases a day per 100,000 population, according to a New York Times database, somewhat higher than the state average of 39 per 100,000 and well above the threshold at which some experts say that stay-at-home orders are necessary.
The governor of Massachusetts announced on Monday a curfew and new restrictions on gatherings and nonessential businesses in an attempt to curb a spike in cases in the commonwealth.
Gov. Charlie Baker issued a stay-at-home advisory for the hours of 10 p.m. to 5 a.m., beginning on Friday. The advisory urges people to “only leave home to go to work or school, or for essential needs,” such as emergency medical care or going to the grocery store. It also discourages gatherings at home with “anybody outside of your household.”
New cases per day in Massachusetts have increased by 92 percent over the past two weeks, according to a New York Times database. As of Sunday, there was an average of 1,306 new cases per day over the past week.
Governor Baker also issued an executive order on Monday that requires certain nonessential businesses to close at 9:30 p.m., effective on Friday. Restaurants, bars and liquor stores must stop serving liquor at that time, and restaurants must end in-person dining, though they may continue takeout and delivery services.
The order will shutter businesses like movie theaters, casinos, gyms and pools at 9:30 p.m. Indoor and outdoor events, as well as youth and adult sports activities, will not be allowed.
A separate, revised order released on Monday by the governor put restrictions on private events, regardless of the time. Indoor gatherings will be limited to 10 people and outdoor gatherings will be capped at 25 people.
At public event venues and other public settings, indoor gatherings will be limited to 25 people. Dependent on the community’s risk level, outdoor events in public will be limited to a maximum of 50 or 100 people.
In Connecticut, Gov. Ned Lamont announced similar restrictions at a news conference on Monday. Starting Friday, restaurants will be required to close at 9:30 p.m., he said, though takeout and delivery will still be allowed after that time.
Event venues will be limited to 25 people indoors and 50 people outdoors, he said, and restaurants and churches will be limited to 50 percent capacity. Restaurants will be limited to eight people per table.
Mr. Lamont urged people to stay at home between 10 p.m. and 5 a.m., adding that gatherings should end by 9:30 p.m.
CRITIC’S NOTEBOOK
Covid-19 has changed New York City’s restaurant culture more than any event since Prohibition. The most obvious effect will be the death of hundreds and possibly thousands of small, independent businesses, each loss radiating out to employees, communities and suppliers. The crisis is so immediate and overwhelming that it is hard to imagine what life will be like after it’s over.
But when the pandemic is under control and restrictions on dining have been lifted, at least one emergency measure will remain. The outdoor dining program that allowed more than 10,000 restaurants to set out tables and chairs on the city’s sidewalks and streets is here to stay, according to Mayor Bill de Blasio and the City Council.
In the general calamity, it has been easy to overlook the enormous implications this move will have: The line between restaurant food and street food will disappear, street music will become as deeply woven into street life in New York as it is in New Orleans, and now that we have gotten used to enjoying dinner and a cocktail on a patch of blacktop that would otherwise be taken up by a RAV4, we might begin to wonder what else could sit in the street.
The stripped-down approval process that allows restaurants to set up sidewalk and street seating has turned out to be more fair than the former system. The whole city has benefited by encouraging restaurants, from the most well-off to the leanest and scrappiest, to lend their own flavor to public spaces. Our economy is struggling, but our street culture, after decades of changes that made it more boring, is interesting again.
Skidmore College, a small liberal arts school in upstate New York, suspended 46 students this weekend, the majority of whom had violated rules meant to protect against the spread of the coronavirus, a college spokeswoman said. The college enrolls about 2,500 students, most of whom are back on campus this fall.
The spokeswoman, Sara Miga, said that some of the suspensions were connected to “unsanctioned parties” and that 31 students had been placed in a “precautionary quarantine” after on- and off-campus events. Ms. Miga said some of the suspensions involved rules pertaining to alcohol consumption. She did not immediately provide further details.
The quarantines were in response to potential exposure, Ms. Miga said, and whether any students had tested positive after the events was not immediately clear. It was also not clear how many of the 46 suspensions were not related to infractions regarding the coronavirus rules.
Ms. Miga said on Monday that the “health and safety of our entire community is our highest priority, and we have urged all students to follow the guidelines they agreed to in order to bring the semester to a successful close.”
She said the campus was investigating a report of a student who was attacked while trying to break up a party at the Case Campus Center on Saturday. The student was briefly hospitalized and has a concussion, said Mark Reyes, 20, a friend of the student, who was also present during the incident.
Mr. Reyes said that students had been regularly holding parties at the center in violation of social distancing guidelines, and had again gathered in a group of more than 50 people on Saturday night when he and his friend sought to intervene.
Ms. Miga said the school was “not aware of unsanctioned parties” in the center. She said a school safety coordinator makes sure students adhere to public health guidelines during campus-sanctioned events there.
As rapid coronavirus tests are becoming more widely available, delivering results in minutes, officials warn of a significant undercount, blurring the virus’s spread in the United States and in communities where such tests are more commonly used.
Public health officials say that antigen tests, which are faster than polymerase chain reaction (P.C.R.) tests but less able to detect low levels of the virus, are an important tool for limiting the spread of the virus. But they caution that with inconsistent public reporting, the case undercount may worsen as more “point-of-care” antigen tests, as well as D.I.Y. and home test kits, come on the market.
“We want to be sure that we’re not now saying, ‘there’s no disease,’ when there is lots of disease. All that’s happened is that the science with which we identify it has evolved,” said Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists, the group that helps the Centers for Disease Control and Prevention define cases of the coronavirus.
Despite C.D.C. guidance to report cases based on P.C.R. and antigen testing, Washington, D.C., and seven states don’t publicly share case counts for those with antigen positive tests, including California, New Jersey and Texas.
Another six states keep these tallies separate from their total counts, and most of these report them less frequently.
The differences among states are in part because of each state’s comfort level with the rapid tests, which aren’t “confirmatory” like P.C.R. tests because they can miss low levels of the virus. Yet most states treat antigen positive cases or “probable” cases the same as “confirmed” cases, by following up with interviews and contact tracing.
And a growing number of states, including New Mexico, Oregon and Utah, include individuals with positive antigen tests in their total confirmed case counts.
Scientists who follow the development of coronavirus tests say that rapid testing capacity — most of it antigen-based — could reach 200 million tests a month by early next year, and help the country reach recommended testing levels.
President Trump’s illness from a coronavirus infection last month was the most significant health crisis for a sitting president in nearly 40 years. Yet little remains known about how the virus arrived at the White House and how it spread.
The administration did not take basic steps to track the outbreak, limiting contact tracing, keeping cases a secret and cutting out the Centers for Disease Control and Prevention.
One standard public health technique may still shed some light: tracking the cluster’s genetic fingerprints.
To better understand the outbreak, The New York Times worked with geneticists to determine the genetic sequence of viruses that infected two Times journalists believed to have been exposed as part of their work covering the White House.
The study reveals, for the first time, the genetic sequence of the virus that may have infected Mr. Trump and dozens of others, researchers said. That genome is a crucial clue that may allow researchers to identify where the outbreak originated and whether it went on to infect others across the country.
Additional sequencing could help establish the path of the virus through the White House, the role of a possible super-spreading event for Judge Amy Coney Barrett and the origin of an outbreak among the staff of Vice President Mike Pence.
The journalists, Michael D. Shear and Al Drago, both had significant, separate exposure to White House officials in late September, several days before they developed symptoms. They did not spend any time near each other in the weeks before their positive tests.
The viral genomes of the two journalists shared the same distinct pattern of mutations, the research found. The findings suggest that they were infected as part of the broader White House outbreak, said Trevor Bedford, a geneticist at the Fred Hutchinson Cancer Research Center and the University of Washington who led the research team.
The study, which has been posted online but not yet peer reviewed or published in a science journal, followed academic protocols that require genetic samples to be anonymous. Mr. Shear and Mr. Drago chose to disclose their identities for this article.
Global Roundup
Cambodia on Monday announced that schools could reopen for the first time since March if they meet certain safety standards.
Like some of its regional neighbors, the Southeast Asian nation has avoided a large outbreak of the coronavirus. The country of over 16 million has reported no deaths and just 292 coronavirus cases total throughout the pandemic, most during March and July, according to data from Johns Hopkins University.
A poor country with underfunded schools, Cambodia has few resources to combat a major virus outbreak. Its highest daily case total was 31 new cases on March 22.
“We are also worried that the reopening will be risky,” Hang Chuon Naron, the minister of education, said on Monday. The education ministry said that the number of students in each classroom would be limited but did not specify whether students had to wear masks.
In other news around the world:
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Over the weekend, Australia reported its first 24-hour period of no new coronavirus cases in nearly five months, paving the way for further easing of restrictions. Greg Hunt, the country’s health minister, told local media that Australia was on track for restrictions on travel between states to be removed by Christmas. Residents of New South Wales, where one case was reported late Saturday, and Victoria are barred from visiting some states and must quarantine for 14 days when entering other states.
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At Mount Everest in Nepal, the trails snaking through the Himalayas are deserted. Fewer than 150 climbers have arrived this fall season, immigration officials said, down from thousands last year. Last year, the industry brought in more than $2 billion to Nepal, one of Asia’s poorest countries, and employed a million people, from porters to pilots.
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Prince William contracted Covid-19 in England in April but kept his diagnosis a secret, the BBC and The Sun, England’s largest paper, have reported, citing information from sources within Kensington Palace. A person close to the palace confirmed the accuracy of the reports, but did not offer additional details. Prince William’s decision not to disclose his diagnosis raised questions about the palace’s secrecy since he is second in line for the throne. Buckingham Palace disclosed his father’s illness in March.