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ImageDr. Anthony Fauci, Director at the National Institute Of Allergy and Infectious Diseases and President Donald Trump at a news with the Coronavirus task force in Washington DC, on Sunday.
Credit…Anna Moneymaker/The New York Times

Debate roils White House over an untested drug the president insists on promoting.

President Trump doubled down Sunday on his push for the use of an anti-malarial drug against the coronavirus, issuing medical advice that goes well beyond scant evidence of the drug’s effectiveness as well as the advice of doctors and public health experts.

Mr. Trump’s recommendation of hydroxychloroquine, for the second day in a row at a White House briefing, was a striking example of his brazen willingness to distort and outright defy expert opinion and scientific evidence when it does not suit his agenda.

Mr. Trump suggested he was speaking on gut instinct, and acknowledged he had no expertise on the subject.

“But what do I know? I’m not a doctor,” Mr. Trump said, after recommending the anti-malaria drug’s use for coronavirus patients as well as medical personnel at high risk of infection.

“If it does work, it would be a shame we did not do it early,” Mr. Trump said, noting again that the federal government has purchased and stockpiled 29 million doses of the drug.

“What do you have to lose?” Mr. Trump asked, for the second day in a row.

When a reporter asked Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, to weigh in on the question of using hydroxychloroquine, Mr. Trump stopped him from answering. As the reporter noted that Dr. Fauci was the president’s medical expert, Mr. Trump made it clear he did not want the doctor to answer.

“He’s answered the question 15 times,” the president said, stepping toward the lectern where Mr. Fauci was standing.

On Saturday, Dr. Fauci had privately challenged rising optimism about the drug’s efficacy during a meeting of the coronavirus task force in the White House’s Situation Room, according to two people familiar with the events. The argument was first reported by the website Axios.

Peter Navarro, the president’s trade adviser who is overseeing supply chain issues related to the coronavirus, plopped a sheaf of folders on the table and said he had seen several studies from various countries, as well as information culled from C.D.C. officials, showing the “clear” efficacy of chloroquines in treating the coronavirus.

Dr. Fauci pushed back, echoing remarks he has made in a series of interviews in the last week that rigorous study is still necessary. Mr. Navarro, an economist by training, shot back that the information he had collected was “science,” according to the people familiar with what took place.

Dr. Megan L. Ranney, an emergency physician at Brown University in Rhode Island, said in an interview on Sunday night that she had never seen an elected official advertise a miracle cure the way Mr. Trump has done.

“There are side effects to hydroxychloroquine,” Dr. Ranney said. “It causes psychiatric symptoms, cardiac problems and a host of other bad side effects.”

Dr. Ranney said hydroxychloroquine could be effective for some patients, but there wasn’t nearly enough scientific evidence to support Mr. Trump’s claims.

“There may be a role for it for some people,” she said, “but to tell Americans ‘you don’t have anything to lose,’ that’s not true. People certainly have something to lose by taking it indiscriminately.”

As many as half of those with the coronavirus could be asymptomatic, Fauci says.

The nation’s leading infectious disease specialist said Sunday night that as many as half the people infected with the virus may not have any symptoms, a much larger estimate than the director of the Centers for Disease Control and Prevention gave last week.

“It’s somewhere between 25 and 50 percent,” said the specialist, Dr. Anthony S. Fauci, during a briefing by President Trump and members of his coronavirus task force on Sunday. He cautioned, however, that it was only an estimate, adding that even the scientists helping lead the nation’s fight against the virus, “the friends that we are, we differ about that.”

In an interview with National Public Radio last week, Dr. Robert Redfield, the director of the C.D.C., said as many as 25 percent of people with the virus exhibit no symptoms. The large number of symptom-free cases — and scientists’ changing understanding of just how common such cases are — helps explain why the C.D.C. last week changed its guidance, recommending that all Americans wear a cloth face covering in public settings like grocery stores and pharmacies where they cannot ensure keeping a safe distance from others.

It also underscores the extraordinary challenge of controlling the virus’s spread. Dr. Fauci emphasized that for now his estimate was only a guess and that more testing was needed to figure out exactly how many Americans are carrying the virus without realizing it.

“Then we can answer the question in a scientifically sound way,” he said. “Right now, we’re just guessing.”

Queen Elizabeth II urges Britain to display resolve, as Prime Minister Boris Johnson enters the hospital.

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Queen Elizabeth II rallied Britons in the midst of the coronavirus pandemic, which has infected at least 40,000 in the country. Her remarks were pre-recorded from Windsor Castle, where she is sequestering herself.CreditCredit…Paul Ellis/Agence France-Presse — Getty Images

Queen Elizabeth II, in a rare televised address on Sunday, tried to rally her fellow Britons to confront the coronavirus pandemic with the resolve and self-discipline that have seen the nation through its greatest trials.

“I am speaking to you at what I know is an increasingly challenging time,” the queen said in taped remarks from Windsor Castle. The virus has infected at least 40,000 people in Britain, including her eldest son and heir, Prince Charles, and Prime Minister Boris Johnson.

Mr. Johnson was admitted to the hospital for tests, the government said later on Sunday evening, underscoring how the virus has threatened the country’s political establishment.

A spokesman for Mr. Johnson, 55, said on Sunday that the prime minister was still dealing with symptoms of the virus and went to the hospital as a precautionary measure. Downing Street said Mr. Johnson, who was running a high temperature, remained at the helm of the government.

“On the advice of his doctor, the prime minister has tonight been admitted to hospital for tests,” a spokesman said Sunday. “This is a precautionary step, as the prime minister continues to have persistent symptoms of coronavirus 10 days after testing positive for the virus.”

The queen called it “a time of disruption in the life of our country: a disruption that has brought grief to some, financial difficulties to many, and enormous changes to the daily lives of us all.”

The appearance was only the fourth time in her 66-year reign that the queen has addressed the British people, apart from her annual Christmas greeting — and it carries a distinct echo of the celebrated radio address her father, George VI, delivered in September 1939, as Britain stood on the brink of war with Germany.

“I hope in the years to come, everyone will be able to take pride in how they responded to this challenge,” the queen said, “and those who come after us will say that the Britons of this generation were as strong as any. That the attributes of self-discipline, of quiet good-humored resolve and of fellow-feeling still characterize this country.”

Mr. Johnson had been in isolation in his residence next door to 10 Downing Street.

On Saturday, his 32-year-old girlfriend, Carrie Symonds, disclosed that she, too, is suffering symptoms. Ms. Symonds is pregnant.

The British foreign secretary, Dominic Raab, is expected to lead the daily cabinet meeting on the pandemic on Monday. Under the government’s succession plan, Mr. Raab would take up Mr. Johnson’s duties if he is incapacitated.

While the queen fully adopted social distancing early in the pandemic, the British government came late to the need for such measures, with Mr. Johnson initially balking at ordering pubs and restaurants to close. He is now an ardent convert and recorded a video from his quarantine urging people — without much success — not to flock to London parks during a sun-kissed spring weekend.

Britain’s response to the pandemic has improved since that shaky start. The government has vowed to conduct 100,000 virus tests a week by the end of April, a tenfold increase over the current rate.

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A tiger at the Bronx Zoo tests positive for the coronavirus, and other big cats there appear ill.

A tiger at the Bronx zoo has been confirmed to be infected with Covid-19, in what is believed to be a case of what one official called “human-to-cat transmission.”

“This is the first instance of a tiger being infected with Covid-19,” according to the U.S. Department of Agriculture, which noted that although only one tiger was tested, the virus appeared to have infected other animals as well.

“Several lions and tigers at the zoo showed symptoms of respiratory illness,” according to a statement by the Agriculture Department.

Public health officials believe that the large cats caught the virus from a zoo employee. The tiger appeared visibly sick by March 27.

In a statement, the Agriculture Department suggested that those infected with the virus should, “out of an abundance of caution,” avoid contact with their pets and other animals.

The Centers for Disease Control and Prevention has said that it is “aware of a very small number of pets outside the United States reported to be infected,” but that it does not have evidence that pets can spread the coronavirus.

The U.S. is undercounting the number of people who have died in the pandemic, experts say.

Hospital officials, public health experts and medical examiners say that official tallies of Americans said to have died in the pandemic do not capture the overall number of virus-related deaths, leaving the public with a limited understanding of the outbreak’s true toll.

Limited resources and a patchwork of decision making from one state or county to the next have contributed to the undercount. With no uniform system for reporting coronavirus-related deaths in the United States, and a continuing shortage of tests, some states and counties have improvised, obfuscated and, at times, backtracked in counting the dead.

Adding to the complications, different jurisdictions are using distinct standards for attributing a death to the coronavirus and, in some cases, relying on techniques that would lower the overall count of fatalities.

A coroner in Indiana wanted to know if the coronavirus had killed a man in early March, but said that her health department denied a test. Paramedics in New York City say that many patients who died at home were never tested for the coronavirus, even if they showed telltale signs of infection.

In Virginia, a funeral director prepared the remains of three people after health workers cautioned her that they each had tested positive. But only one of the three had the virus noted on the death certificate.

Doctors now believe that some deaths in February and early March were likely misidentified as influenza or only described as pneumonia.

Even under typical circumstances, public health experts say that it takes months or years to compile data that is as accurate as possible on deaths in infectious outbreaks.

But they also say that an accurate count of deaths is an essential tool to understand a disease outbreak as it unfolds: The more deadly a disease, the more aggressively the authorities are willing to disrupt normal life. Precise death counts can also inform the federal government on how to target resources, like ventilators from the national stockpile, to the areas of the country with the most desperate need.

Reporting was contributed by Michael Crowley, Katie Thomas, Maggie Haberman, Roni Rabin, Mark Landler and Stephen Castle.

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