April 22 coronavirus news

By Joshua Berlinger, Adam Renton, Rob Picheta and Zamira Rahim, CNN

Updated 8:51 p.m. ET, April 22, 2020
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10:28 p.m. ET, April 21, 2020

Excavators are digging mass graves in northwest Brazil

Aerial view of coffins being buried at the Parque Taruma cemetery in Manaus, Brazil, on April 21.
Aerial view of coffins being buried at the Parque Taruma cemetery in Manaus, Brazil, on April 21. Michael Dantas/AFP/Getty Images

In the Brazilian city of Manaus, the capital of the northwestern state of Amazonas, excavators are digging mass graves, which are later filled with several coffins by cemetery workers, according to CNN affiliate CNN Brasil.

The city is handling more than 100 burials a day due to coronavirus, according to the office of Manaus Mayor Arthur Virgilio Neto. Before the spread of the disease, the average was 30 burials a day.

The department responsible for burials in the city started to dig trenches to carry out the burials of Covid-19 victims.

This practice is used by other countries and preserves the identities of the bodies, with distance between the coffins and the respective identifications.

"The measure was necessary to meet the demand for burials in the capital," Virgilio Neto's office said in a statement.

In an interview with CNN Brasil Tuesday evening, Virgilio Neto said the health system is no longer able to serve those who need treatment and people have started to die at home.

"Although we are living in such a critical situation, probably the most serious in Brazil, we have not received any help from the federal government to expand our specialized medical care at the city’s field hospital," he said.
10:22 p.m. ET, April 21, 2020

More than 824,000 coronavirus cases have now been reported in the US

From CNN's Keith Allen

Researchers work with live coronavirus specimens at Downstate's BioBank on April 20, in New York City.
Researchers work with live coronavirus specimens at Downstate's BioBank on April 20, in New York City. Misha Friedman/Getty Images

At least 824,438 people in the United States have been diagnosed with Covid-19, according to Johns Hopkins University's tally of cases. The total includes at least 45,039 deaths.

The University has reported at least 37,179 new cases and 2,731 deaths so far on Tuesday.

The number of fatalities could begin to increase significantly in the coming days because some states will begin including “probable deaths” in their tallies, and so will Johns Hopkins. Those could look like surges in the number of Covid-19 related deaths in the United States. 

CNN is tracking US coronavirus cases here:

10:02 p.m. ET, April 21, 2020

South Korea reports 11 new coronavirus cases

From CNN's Sophie Jeong in Seoul

South Korea recorded 11 new cases of Covid-19 and one coronavirus-related fatality on Tuesday, the country's Centers for Disease Control and Prevention said.

Six of the new cases were imported from abroad.

Total numbers: South Korea has recorded 10,694 coronavirus infections and 238 fatalities since the pandemic began, according to public health authorities.

Sixty-four more recovered patients have been discharged from isolation, bringing the national total of recovered cases to 8,277 -- 77.4% of all people diagnosed with the virus.

9:45 p.m. ET, April 21, 2020

China reports 30 new coronavirus cases

From CNN's Eric Cheung in Hong Kong

China reported 30 new cases of novel coronavirus and no additional deaths on Tuesday, according to the country's National Health Commission.

Among the new cases, 23 were imported and seven were locally transmitted. The local cases were reported in the country's northernmost Heilongjiang province, which shares a border with Russia.

Another 28 patients were discharged.

Total numbers: The NHC has reported 82,788 Covid-19 infections as of the end of the day Tuesday. Since the pandemic began, 77,151 people have recovered, while 4,632 deaths have been reported, according to the NHC.

9:28 p.m. ET, April 21, 2020

"This is no time to pop the champagne bottles," New York Gov. Andrew Cuomo says

From CNN's Elizabeth Joseph

New York Gov. Andrew Cuomo.
New York Gov. Andrew Cuomo. State of New York

Now is "no time to pop the champagne bottles" despite the fact that construction has stopped on temporary field hospitals, New York Gov. Andrew Cuomo warned.

New York state identified and received federal government approval for eight facilities for use as temporary field hospitals, CNN previously reported.

However, as of Tuesday, not all are needed or in use at this time, according to a state government administration official. If the need for hospital beds or facilities spikes then “we’re ready to re-engage with our federal partners,” the official said.

But while new construction has stopped on temporary field hospitals, Cuomo said he is not ready to stop those projects completely.

“We stopped any new construction when we saw the rates starting to stabilize but I’m not ready to close anything down yet, either,” Cuomo said Tuesday night. “Now you have some health experts, CDC today starts to warn about an outbreak in the fall, I don’t even want to think about that yet.”

“This is no time to pop the champagne bottles, right,” Cuomo added. “I said a couple days ago, don’t get cocky, don’t get arrogant.”

New York state has recorded more than 258,000 coronavirus cases, including at least 19,114 deaths, according to data compiled by Johns Hopkins University.

2:12 a.m. ET, April 22, 2020

Indonesia bans citizens from traveling to their hometowns for Eid al-Fitr celebrations

From Eric Cheung in Hong Kong

Indonesia has banned all citizens from traveling to their hometowns for Eid al-Fitr celebrations in an effort to contain the spread of novel coronavirus, the country’s President Joko Widodo said Tuesday.

"I have decided on banning the 'mudik' (Eid al-Fitr exodus) tradition for all citizens," Widodo said after a cabinet meeting on Tuesday, according to the state-run Antara news agency.

Millions of people normally go back to their hometowns to see their families every year in a homecoming tradition known as "mudik," the report said.

Jokowi did not provide specifics on how the ban will be enforced.

The President also said the decision was taken to curb travel after a recent government study showed the majority of the population did not intend to return home for the festival. However, around 24% of Indonesians were still planning to make the journey, Antara reported.

Indonesia has recorded more than 7,000 coronavirus cases and at least 616 deaths, according to Johns Hopkins University.

This post was updated to reflect that Jokowi did not provide specifics on enforcement of the ban.

8:44 p.m. ET, April 21, 2020

Trump agreed to help testing manufacturers get supplies for kits, Cuomo says

US President Donald Trump and New York Gov. Andrew Cuomo.
US President Donald Trump and New York Gov. Andrew Cuomo.

New York Gov. Andrew Cuomo said Tuesday that US President Donald Trump agreed to take ownership of the national supply chain to get coronavirus testing kit manufacturers the supplies they need to produce kits

The problem with bringing testing up to scale is the national manufacturers who make the testing kits and send them to state labs, Cuomo said. Those companies say they have a problem with the supply chain getting swabs, vials and chemicals to produce the testing kits, Cuomo added.

The governor said his meeting at the White House was “very productive, positive, got a lot done."

Some of the meeting focused on the importance of dividing the responsibilities between states and federal government to scale up testing, he said.

The state will be responsible for managing diagnostic and antibody testing, who to test, where to test and tracing cases, Cuomo said.

The goal is to double New York State’s testing from 20,000 diagnostic tests to 40,000 diagnostic and antibody tests, he said.

“It will take several weeks at best, this is an enormous undertaking,” Cuomo added.

8:39 p.m. ET, April 21, 2020

Top health experts caution against reopening society before coronavirus testing capacity expands

From CNN’s Shelby Lin Erdman

As several states make plans for reopening their communities during the coronavirus pandemic, a group of top public health experts cautioned Tuesday against reopening society before testing capacity expands significantly.

Different parts of the country are in different stages of the epidemic, with New York well into the first wave and other places just beginning to see the impact of the disease. This matters, said Dr. Caroline Buckee, Harvard associate professor of epidemiology and the associate director of the university’s Center for Communicable Disease Dynamics. 

Knowing the location of the virus is key to relaxing social distancing and returning to normalcy, Buckee told a symposium sponsored by Harvard’s T.H. Chan School of Public Health and the New England Journal of Medicine.

The lack of testing capacity is a big problem because the disease has “a very broad clinical spread,” Buckee said. So even when people show up at the hospital and get tested there are many more cases in the community, including mild and asymptomatic cases. “And those are the people that are spreading the disease,” she said.

It’s important to learn whether people who have recovered can still spread the disease, noted NEJM editor Dr. Eric Rubin.

“What we really need is some epidemiological data to tell us, 'Are people who have left the hospital going on to transmit the disease?'” Rubin said. “That’s kind of the shoe leather epidemiology, contact tracing, following what happens to the context of those patients, which takes some manpower. 

Buckee added that without knowing the answers, the nation could reopen too soon and risk a deadly second pandemic wave.

“Right now, we don’t have good estimates for where we are on the epidemic curve in different places. So, discussions of relaxation of physical distance, which do seem to be having an effect, curbing some of the worst impacts of the outbreak, need to be based on the capacity to test people so we know where we are,” she said.

8:38 p.m. ET, April 21, 2020

Covid-19 virus lingers longer in sicker patients, Chinese study finds

From CNN’s Maggie Fox

The novel coronavirus lingers for as long as three weeks in the bodies of patients with severe disease, Chinese researchers reported Tuesday.

The virus can be found deep in the lungs and in the stool of patients, and the sicker they are, the longer it stays, the team at a hospital in China’s Zhejiang province reported. But the virus was found in the urine of patients less than half the time, and rarely in the blood at first. 

Their report provides another piece of evidence about the pattern of disease in Covid-19 patients. It was published in the BMJ. Unlike many recently released studies about the coronavirus, this one has gone through peer review, which means other experts have reviewed the findings.

The team tested 96 patients treated in their hospital for Covid-19 between January and March. They tested samples from the nose and throat, from deeper in the respiratory system, in the blood, stool and urine. They wanted to see how long people had virus in their systems and whether it was likely to spread in various ways. The findings support other studies showing that the virus could spread in stool from infected people.

In general, the sicker people were, the longer the virus could be detected. That could be important for doctors to know, so they can predict which patients will fare better, and, perhaps, how long they may remain infectious to others. 

“The median duration of virus in respiratory samples was 18 days,” they wrote. 

More on this: An earlier Chinese study showed that people without symptoms had just as much virus in their noses as people who had Covid-19 symptoms -- something that indicated people who are not sick could be just as likely to spread virus as people who are.

The team in Zhejiang found that sicker people had more virus deeper in their respiratory tracts, however.

They also found differences between men and women with Covid-19. “In this study, we found that the duration of virus was significantly longer in men than in women,” they wrote.

“Our results shed light on the causes of disease severity in men in terms of the duration of the virus. In addition to differences in immune status between men and women, it has also been reported to be related to differences in hormone levels,” the team wrote.