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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. (AP Photo/Kathy Willens)
KAT STAFFORD and MARTHA IRVINE Associated Press
Published: 28 March 2020

DETROIT (AP) — As confirmed coronavirus cases in the United States led the world — with more than 105,000 infections — cities such as Detroit, Chicago and New Orleans grew as hotspots Saturday, while the virus continued to pummel New York City and also made its way into rural America. 

In parts of Africa, meanwhile, virus prevention measures took a violent turn as countries imposed lockdowns and curfews or sealed off major cities, with police in Kenya firing tear gas and officers elsewhere captured on video hitting people with batons. Russia said its borders would be fully closed as of Monday.

The number of worldwide infections surpassed 620,000 with more than 28,000 deaths as new cases also stacked up quickly in Europe, according to a tally by John Hopkins University. While the U.S. now leads the world in reported cases, five countries exceed its roughly 1,700 deaths: Italy, Spain, China, Iran and France.

New York remained the worst-hit U.S. city. Gov. Andrew Cuomo said defeating the virus will take “weeks and weeks and weeks.” 

Detroit sees 31 deaths

Cases also have been rising rapidly in cities such as Detroit, where poverty and poor health have been problems for years. The number of infections surged to 1,381, with 31 deaths recorded, as of noon Saturday.

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

“This is off the charts.”

Chopra, who has worked in Detroit for more than 15 years, 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 it will be hit with a “tsunami” of patients.

President Donald Trump approved a major disaster declaration for Michigan, providing additional money to address the outbreak. He also has done the same for such states as New York, Louisiana and Illinois.

Locked down and quarantined

The virus already is straining health systems in Italy, Spain and France. Lockdowns of varying severity have been introduced across Europe, nearly emptying streets in normally bustling cities, including Paris where drone photos showed landmarks eerily deserted.

German Chancellor Angela Merkel appealed to her country, which has experienced fewer deaths compared with some neighboring countries, to “be patient.” Her chief of staff said Germany — where authorities closed nonessential shops and banned public gatherings of more than two — won't relax its restrictions before April 20.

Spain, where stay-at-home restrictions have been in place for nearly two weeks, reported 832 more deaths Saturday, its highest daily count yet, bringing its total to 5,690. 

Another 8,000 confirmed infections pushed that count above 72,000. But Spain's director of emergencies, Fernando Simón, saw hope in that the rate of infection is slowing and figures “indicate that the outbreak is stabilizing and may be reaching its peak in some areas.”

Spain sees health workers at high risk

Doctors, nurses and ambulance drivers in Spain's worst-hit regions are working nonstop and falling ill at an alarming rate. More than 9,000 health workers in the country have been infected.

“We are completely overwhelmed,” said paramedic Pablo Rojo at Barcelona’s Dos de Maig hospital. “Seven or eight (patients transported today) and all with COVID-19. ... And the average age is decreasing. They’re not 80 years old anymore, they are now 30 and 40 years old.”

Spain has struggled to get coronavirus tests and protective gear for health workers. The government has started flights to transport the supplies directly from China to reduce waiting times. 

China edging back to a new normal

As the epicenter has shifted westward, the situation has calmed in China, where some restrictions have been lifted. Six subway lines restored limited service in Wuhan, where the virus first emerged in December, after the city had its virus risk evaluation downgraded from high to medium. Five districts of the city of 11 million people had other travel restrictions loosened after their risk factor was reduced to low.

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.

UK cases rising fast— including Prime Minister

The effects of the outbreak have been felt by the powerful and the poor alike.

As British Prime Minister Boris Johnson became the first leader of a major country to test positive for the virus, another member of his cabinet also developed symptoms, as the number of people in the U.K. who have died for the illness passed the 1,000 mark.

Johnson is being accused of failing to follow his own self-distancing rules, though he says he is in self-quarantine now.

Millions in India on lockdown

Countries are still scrambling bring home some citizens stranded abroad by border closures and a near-shutdown of flights.

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.

In neighboring India, authorities sent buses to the outskirts of the capital to meet an exodus of migrant workers desperately trying to reach their home villages amid the world's largest lockdown. Thousands had fled their New Delhi homes after Prime Minister Narendra Modi announced a 21-day lockdown that began Wednesday and effectively put millions out of work.

Russian Prime Minister Mikhail Mishustin has ordered his country's borders fully closed as of Monday, following increasingly stringent restrictions imposed recently. International passenger flights were halted Friday. The order excepts diplomats as well as residents of the Kaliningrad exclave who must cross through another country to enter the rest of Russia.

Cases still rising

Trump invoked the Defense Production Act on Friday, ordering General Motors to begin manufacturing ventilators. 

Trump signed a $2.2 trillion stimulus package, after the House approved the sweeping measure by voice vote. It will send checks to millions of Americans, boost unemployment benefits, help businesses and toss a life preserver to an overwhelmed health care system.

Dr. John Brooks of the U.S. Centers for Disease Control and Prevention warned that Americans remained “in the acceleration phase” of the pandemic and that all corners of the country are at risk.

"There is no geographic part of the United States that is spared from this," he said.

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

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