Spain overtook China on Monday in confirmed coronavirus infections as the pandemic stretched scores of Spanish hospitals to their breaking point. As confirmed virus deaths in New York surpassed 1,000, President Donald Trump extended stay-at-home recommendations for a month in an abrupt turnaround.
With a population of only 47 million people to China's 1.4 billion, Spain's tally of infections reached 85,195, an 8% rise from the previous day but down from earlier increases that had rocketed up to 20%. Spain also reported 812 new deaths, raising its overall confirmed death toll to 7,340.
Experts say those figures — and ones in every other country — are much lower than the actual impact of the pandemic, due to limited testing, counting irregularities and mild cases that have been missed.
Spain and Italy make up more than half the world's death toll of over 34,800 people from the virus that has upended the lives of billions and devastated world economies. Their health systems have been crumbling over the weight of caring for so many desperately ill patients at once. Italy has by far the most reported virus deaths, at nearly 11,000.
At least six of Spain's 17 regions were at their limit of ICU beds and three more were close to it, authorities said Monday. Crews of workers were frantically building more field hospitals.
Despite the declining infection rate, Spanish health official Dr. Maria José Sierra said there's no end to the stay-at-home restrictions yet in sight.
"Reducing the pressure on the ICUs will be important for considering de-escalation measures," said Sierra, who took over Monday as the health emergency center's spokesperson after its director tested positive.
Nearly 15% of all those infected in Spain, almost 13,000 people, are health care workers, hurting hospitals' efforts to help the tsunami of people gasping for breath.
In hard-hit Madrid, flags were hoisted at half staff for an official mourning period. During a minute of silence for the dead, Madrid's Puerta del Sol central square was empty as bells tolled.
In a situation unimaginable only a month ago, Italian officials were cheered when they reported only 756 deaths in one day. Italy has 97,689 confirmed infections but said the number of positive cases in the last day increased just 5.4% and the number of deaths have dropped about 10% a day since Friday.
''We are saving lives by staying at home, by maintaining social distance, by traveling less and by closing schools," Dr. Luca Richeldi, a lung specialist, told reporters.
In a stark reversal of his previous stance, Trump extended federal guidelines recommending that Americans stay home for another 30 days until the end of April to slow the spread of the virus. The turnabout came after Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said up to 200,000 Americans could die and millions become infected if lockdowns and social distancing did not continue.
"We want to make sure that we don't prematurely think we're doing so great," Fauci said.
The U.S. now has more than 143,000 infections and 2,500 deaths, according to Johns Hopkins University, while around the world more than 735,000 people are infected.
Moscow went on its own lockdown Monday as all of Russia braced for sweeping nationwide restrictions. The Russian capital of 13 million accounts for more than 1,200 of the country's 1,836 coronavirus cases.
"The extremely negative turn of events we are seeing in the largest European and U.S. cities causes extreme concern about the life and health of our citizens," Moscow Mayor Sergei Sobyanin said.
Experts say the critical situations seen in hospitals in Italy and Spain will be soon heading toward the United States.
Coronavirus patient Andrea Napoli, 33, told The Associated Press he didn't remotely expect that he would be hospitalized, struggling for his life, since he was young and fit. But what he saw shocked him.
While he was being treated in Rome, three patients died in his ward. He saw doctors stressed and exhausted from the long hours, out of breath from pushing equipment around, dressed in protective masks, suits and gloves.
''What I saw was a lot, a lot of pain. It was very hard,'' Napoli said. ''I heard screams from the other rooms, constant coughing from the other rooms.''
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms like pneumonia and be fatal. More than 156,000 people have recovered, according to Johns Hopkins.
China's National Health Commission on Monday reported 31 new COVID-19 cases, among them just one domestic infection. At the peak of China's restrictions, some 700 million people were ordered to stay home, but those rules are easing.
New York state remained the epicenter of the U.S. outbreak, with the vast majority of the deaths in New York City. But infections were spiking not only in cities but in Midwestern towns and Rocky Mountain ski havens. West Virginia reported its first death, leaving only two states — Hawaii and Wyoming — with none linked to COVID-19.
The virus is moving fast through nursing homes and other places for vulnerable people, spreading "like fire through dry grass," New York Gov. Andrew Cuomo said.
Britain's National Health Service said EasyJet and Virgin Atlantic were asking cabin crew who have been laid off — especially those with first aid training — to see if they would work in makeshift hospitals under the supervision of doctors and nurses.
Britain's political elite have been hit hard by the coronavirus pandemic, with the country's prime minister, health minister, chief English medical director and Brexit negotiator all testing positive and in isolation, as well as the heir to the throne, Prince Charles.
Cases across Africa rose close to 5,000 in 46 countries. Zimbabwe began a three-week lockdown Monday and more cities across the continent were shut down.
The pandemic was also taking a harsh economical toll around the world.
A lockdown in India covering the country's 1.3 billion people has put day laborers out of work and left families struggling to eat. With no jobs, those in the country's crowded cities are walking back to their native villages.
In Europe, budget airline EasyJet grounded its entire fleet of aircraft — parking all 344 planes — amid a collapse in demand due to the COVID-19 crisis.
Japanese automaker Toyota Motor Corp. halted production at its auto plants in Europe at least until April 20. Toyota has facilities in France, Great Britain, Czechoslovakia, Poland, Turkey and Portugal. All its plants in China resumed production Monday.
Asian markets started the week with fresh losses. Japan's benchmark fell nearly 3% and other regional markets were mostly lower. Shares in Australia, however, surged 7% after the government promised 130 billion Australian dollars ($80 billion) to pay up to 6 million workers the minimum wage for the next six months.
"We want to keep the engine of our economy running through this crisis," said Australian Prime Minister Scott Morrison.
Nigerian President Muhammadu Buhari has ordered the halting of all movements and activities in the capital Abuja and commercial hub Lagos over the spread of the COVID-19 pandemic in the country.
The lockdown for an initial period of two weeks, which takes effect from Monday, will also affect the southwestern state of Ogun, the nation's industrial hub, and neighboring state to Lagos, the president said in his latest broadcast to Nigerians over the coronavirus pandemic.
Ogun State was included in the restriction list due to its close proximity to Lagos and the high traffic between the two states, the president explained.
"All citizens in these areas are to stay in their homes. Travel to or from other states should be postponed. All businesses and offices within these locations should be fully closed during this period," he further declared.
Buhari said the period will be used to contain, identify, trace and isolate all individuals that have come into contact with confirmed cases, as well as ensure the treatment of confirmed cases while restricting further spread to other states.
"This order does not apply to hospitals and all related medical establishments as well as organizations in healthcare-related manufacturing and distribution," he said.
Commercial establishments, such as food processing, distribution, retail companies, petroleum distribution, retail entities, power generation, transmission and distribution companies, and private security companies are also exempted.
"Although these establishments are exempted, access will be restricted and monitored," Buhari said, adding that "workers in telecommunication companies, broadcasters, print and electronic media staff who can prove they are unable to work from home are also exempted."
However, the president said all seaports in Lagos shall remain operational in accordance with the guidelines he earlier issued. Vehicles and drivers conveying essential cargoes from these ports to other parts of the country will be screened thoroughly before departure by the ports health authority.
"Movements of all passenger aircraft, both commercial and private jets, are hereby suspended. Special permits will be issued on a needs basis. We are fully aware that such measures will cause much hardship and inconvenience to many citizens," he said.
Over 100 cases of the novel coronavirus have been recorded across 12 states in Nigeria so far, with the country's center for disease control reporting a total of 111 confirmed cases.
Greece reported a total of 38 fatalities linked to complications due to the novel coronavirus out of a total of 1,156 confirmed infections, health authorities said at a regular press briefing on Sunday.
Six people lost their lives and 95 new cases were registered since Saturday, Greek Health Ministry's spokesman and infectious diseases professor Sotirios Tsiodras said.
Currently, 69 patients were in serious condition in intensive care units, he added.
"We continue the battle with determination," said Nikos Hardalias, Deputy Minister for Civil Protection and Crisis Management at the Ministry of Citizen Protection.
Greece has been in a two-week nationwide lockdown since Monday in the framework of efforts to contain the virus's spread.
Earlier in March, authorities had also imposed the closure of schools, universities, restaurants, coffee shops, shopping malls, retail shops, sports, and cultural centers, as well as public parks.
Travels by air, sea, train, and road with many countries and domestically have also been banned or restricted.
Stores and places of worship will not open as initially scheduled on April 6, but will remain shut until April 11, Hardalias announced.
People should not be making plans for a traditional Easter exodus to the countryside this year, he added, echoing remarks made by cabinet ministers on local media this weekend implying that an extension of the overall lockdown was also on the table.
The Greek Orthodox Easter falls on April 19.
The outbreak of the coronavirus has dealt a shock to the global economy with unprecedented speed. Following are developments on Monday related to the global economy, the work place and the spread of the virus.
REPURPOSING STAFF: Britain's health service is asking airline cabin crew who have been laid off during the coronavirus pandemic to go to work in temporary new hospitals being built to treat COVID-19 patients.
The National Health Service says easyJet and Virgin Atlantic are writing to thousands of staff - especially those with first aid training - asking them to work at hospitals being built inside convention centers in London, Birmingham and Manchester.
It said those who sign up will perform support roles under the supervision of doctors and nurses.
AIRLINES: European budget airline easyJet says it is grounding all of its 344 aircraft amid a collapse in demand. It said there was "no certainty of the date for restarting commercial flights."
The carrier based in Luton, England, had already canceled most of its flights and said it has reached an agreement with unions on furlough arrangements for its cabin crew.
Many airlines around the world are negotiating or calling for financial rescue packages from governments. Easyjet said it was in talks with financial liquidity providers.
Britain's government has so far demurred from creating a rescue package for aviation but has said it is ready for negotiations with individual firms once they had "exhausted other options." Scottish regional airline Loganair said it expects to ask for a government bailout.
HANDOUTS: South Korea will provide as much as 1 million won ($817) in gift certificates or electronic coupons to all but the richest 30% of households to help ease the financial shock of the coronavirus outbreak.
The country will spend around 9.1 trillion won ($7.4 billion) on the one-time giveaways, which will reach 14 million households. Officials are ruling out handouts of cash.
South Korea's has employed a variety of financial tools to support its economy in face of the global health crisis, such as cutting its policy rate to an all-time low, expanding short-term loans for financial institutions and introducing a rescue package for companies totaling 100 trillion won ($81.7 billion).
President Donald Trump on Sunday extended the country's voluntary national shutdown for a month, significantly changing his tone on the coronavirus pandemic only days after musing about the country reopening in a few weeks. He heeded public-health experts who told him the virus could claim over 100,000 lives in the U.S., perhaps more, if not enough is done to fight it.
COVID-19 continues its relentless spread, as the daily number of infections worldwide continues to jump sharply. World Health Organization figures show the increase in new infections is now about 70,000 per day - up from about 50,000 just days ago. More than 32,000 people have died worldwide. The U.S. had over 139,000 infections and 2,400 deaths, a running tally by a prominent university showed Sunday evening.
Italy reported more than 750 new deaths Sunday, bringing the country's total to nearly 10,800 - vastly more than any other country. But the number of new infections showed signs of narrowing again. Officials said more than 5,200 new cases were recorded in the last 24 hours, the lowest number in four days, for a total of almost 98,000 infections.
Here are some of AP's top stories Saturday on the world's coronavirus pandemic. Follow APNews.com/VirusOutbreak for updates through the day and APNews.com/UnderstandingtheOutbreak for stories explaining some of its complexities.
WHAT'S HAPPENING TODAY:
— The mammoth, $2.2 trillion stimulus package to shore up the U.S. economy during the coronavirus pandemic doesn't provide what doctors, nurses and other health care providers need most: protective equipment.
— New York state's death toll from the outbreak climbed above 1,000 on Sunday, less than a month after the disease was first detected in the state. New York state accounts for more than 40% of U.S. deaths from COVID-19.
— Risk factors other than age are becoming more apparent. As much as 10% to 15% of people under 50 have moderate to severe symptoms, according to the World Health Organization.
— German Chancellor Angela Merkel's handling of the coronavirus crisis meets with strong approval in her country.
— Coronavirus pandemic causes tensions in the hard-hit European Union.
— Impoverished Somalia has little in the way of health care to battle the coronavirus should the limited number of cases there rise.
— The family of John Prine says the American singer-songwriter is critically ill and has been placed on a ventilator while being treated for COVID-19-type symptoms.
— Parents who have to report to work are scrambling to find adequate child care.
WHAT YOU NEED TO KNOW:
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death. The vast majority of people recover.
Here are the symptoms of the virus compared with the common flu.
One of the best ways to prevent spread of the virus is washing your hands with soap and water. The U.S. Centers for Disease Control and Prevention recommends first washing with warm or cold water and then lathering soap for 20 seconds to get it on the backs of hands, between fingers and under fingernails before rinsing off.
You should wash your phone, too. Here's how.
Misinformation overload: How to separate fact from fiction and rumor from deliberate efforts to mislead.
TRACKING THE VIRUS: Drill down and zoom in at the individual county level, and you can access numbers that will show you the situation where you are, and where loved ones or people you're worried about live.
33: That's Andrea Napoli's age. The Rome lawyer was in top physical shape, thanks to regular workouts, including water polo training, when he tested positive for the coronavirus. He spent two days in intensive care and nine days breathing with an oxygen mask.
IN OTHER NEWS:
SONG FOR AFRICA: Bobi Wine, a Ugandan pop singer and opposition leader, releases song to urge the continent of 1.3 billion people to wash their hands.
PIZZERIA HAILED: New Jersey pizzeria takes out a loan to pay workers' salaries, then finds more people eager to help.