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| Hungary’s Leader Grabbed Powers to Fight the Virus. Some Fear Other Motives. | Hungary’s Leader Grabbed Powers to Fight the Virus. Some Fear Other Motives. |
| (1 day later) | |
| BUDAPEST — In the days since the Hungarian Parliament gave Prime Minister Viktor Orban the right to rule indefinitely by decree, nominally in the name of combating the coronavirus pandemic, his government has been energized by much other than the disease. | BUDAPEST — In the days since the Hungarian Parliament gave Prime Minister Viktor Orban the right to rule indefinitely by decree, nominally in the name of combating the coronavirus pandemic, his government has been energized by much other than the disease. |
| First, his deputy briefly toyed with a plan to strip powers from city mayors, many of whom represent opposition parties. Then he threw a cloak of secrecy over one of Hungary’s most expensive infrastructure projects, announcing a bill that would classify key information about a Chinese-funded railway for a decade. Next, he slashed bureaucratic obstacles to expedite a contentious construction project opposed by the opposition. Finally, he announced plans to scrap state recognition of gender transition. | First, his deputy briefly toyed with a plan to strip powers from city mayors, many of whom represent opposition parties. Then he threw a cloak of secrecy over one of Hungary’s most expensive infrastructure projects, announcing a bill that would classify key information about a Chinese-funded railway for a decade. Next, he slashed bureaucratic obstacles to expedite a contentious construction project opposed by the opposition. Finally, he announced plans to scrap state recognition of gender transition. |
| By comparison, Mr. Orban took a gentler approach to testing for the coronavirus. | By comparison, Mr. Orban took a gentler approach to testing for the coronavirus. |
| By Saturday, Hungarian officials had detected fewer than 700 cases, one of the lowest tallies in the European Union. The chief medical officer, Cecilia Muller, also said that the disease was still spreading only within clusters of people, rather than through the general population at large. On Sunday, reported cases grew to 733. | By Saturday, Hungarian officials had detected fewer than 700 cases, one of the lowest tallies in the European Union. The chief medical officer, Cecilia Muller, also said that the disease was still spreading only within clusters of people, rather than through the general population at large. On Sunday, reported cases grew to 733. |
| But some doctors fear that the numbers are so low only because the government has tested so few people. By Saturday, officials had conducted fewer than 20,000 tests — also one of the lowest totals, as a proportion of the national population, in the European Union. | But some doctors fear that the numbers are so low only because the government has tested so few people. By Saturday, officials had conducted fewer than 20,000 tests — also one of the lowest totals, as a proportion of the national population, in the European Union. |
| “We do not have enough tests, so we do not know the realistic data,” said Balazs Rekassy, a former manager of a state health clinic who advises the Budapest mayor, an opponent of Mr. Orban, on medical matters. | “We do not have enough tests, so we do not know the realistic data,” said Balazs Rekassy, a former manager of a state health clinic who advises the Budapest mayor, an opponent of Mr. Orban, on medical matters. |
| “Mr. Orban is very smart — he’s taking this special situation to his advantage,” said Dr. Rekassy. “He’s trying to strengthen his power and create long-term political advantages.” | “Mr. Orban is very smart — he’s taking this special situation to his advantage,” said Dr. Rekassy. “He’s trying to strengthen his power and create long-term political advantages.” |
| New restrictions on journalism that the government deems fake and harmful to the coronavirus response have made it harder to research the scale of the pandemic in Hungary. Many doctors are now reluctant to speak out publicly about specific problems, individual hospitals have been barred from releasing information and journalists are warier of publishing it. | New restrictions on journalism that the government deems fake and harmful to the coronavirus response have made it harder to research the scale of the pandemic in Hungary. Many doctors are now reluctant to speak out publicly about specific problems, individual hospitals have been barred from releasing information and journalists are warier of publishing it. |
| But beneath the veil of silence, there are indications that the situation may be graver than records show. | But beneath the veil of silence, there are indications that the situation may be graver than records show. |
| The coronavirus may have begun to spread through the Hungarian population nearly a month ago, in a process technically known as community transmission, according to a secret readout written by a foreign diplomat who had been briefed in early March by the country director for the World Health Organization, Dr. Ledia Lazeri. The readout was later obtained by The New York Times. | The coronavirus may have begun to spread through the Hungarian population nearly a month ago, in a process technically known as community transmission, according to a secret readout written by a foreign diplomat who had been briefed in early March by the country director for the World Health Organization, Dr. Ledia Lazeri. The readout was later obtained by The New York Times. |
| Dr. Muller, the chief medical officer, said on Friday that Hungary was still in the cluster-spreading phase. She hinted that the country was on the threshold of community transmission. | Dr. Muller, the chief medical officer, said on Friday that Hungary was still in the cluster-spreading phase. She hinted that the country was on the threshold of community transmission. |
| But according to the diplomat’s secret readout, the W.H.O. privately believed that community transmission had begun by the second week of March, since the disease’s first known victims in Hungary moved freely through the country before being diagnosed and one even left for Serbia. | But according to the diplomat’s secret readout, the W.H.O. privately believed that community transmission had begun by the second week of March, since the disease’s first known victims in Hungary moved freely through the country before being diagnosed and one even left for Serbia. |
| The main facility used for testing at that time, St. Laszlo Hospital in Budapest, was also helping to spread the disease rather than contain it, because infected people were unwittingly mingling there with those yet to catch the disease, the readout stated. | The main facility used for testing at that time, St. Laszlo Hospital in Budapest, was also helping to spread the disease rather than contain it, because infected people were unwittingly mingling there with those yet to catch the disease, the readout stated. |
| The W.H.O. also concluded that the Hungarian government’s data was unreliable, since so few people were being tested, the readout said.Asked to comment on the readout, Dr. Lazeri denied making these assessments. An independent epidemiologist currently advising the government, Gergely Roth, also said the country had not yet entered the community transmission phase, and said the term had a contested definition.But diplomats from other missions said they had heard troubling information from a W.H.O. official. | The W.H.O. also concluded that the Hungarian government’s data was unreliable, since so few people were being tested, the readout said.Asked to comment on the readout, Dr. Lazeri denied making these assessments. An independent epidemiologist currently advising the government, Gergely Roth, also said the country had not yet entered the community transmission phase, and said the term had a contested definition.But diplomats from other missions said they had heard troubling information from a W.H.O. official. |
| The W.H.O. did not comment when asked three times whether the organization believed Hungary had entered the community transmission phase. But a spokesperson said on Saturday night that the W.H.O. was “working with countries to define their transmission status according to a new ranking system,” and noted that as of Saturday night the Hungarian government considered the country to be “entering community transmission.” | The W.H.O. did not comment when asked three times whether the organization believed Hungary had entered the community transmission phase. But a spokesperson said on Saturday night that the W.H.O. was “working with countries to define their transmission status according to a new ranking system,” and noted that as of Saturday night the Hungarian government considered the country to be “entering community transmission.” |
| As of Sunday, only 34 people are reported to have died from the virus in Hungary, but doctors worry that some deaths may have been attributed to other causes. A 99-year-old woman who died on March 11 in Budapest was reported to have died of pneumonia, even though her daughter, who visited her regularly and fell ill with similar symptoms at the same time, later tested positive for the virus. | As of Sunday, only 34 people are reported to have died from the virus in Hungary, but doctors worry that some deaths may have been attributed to other causes. A 99-year-old woman who died on March 11 in Budapest was reported to have died of pneumonia, even though her daughter, who visited her regularly and fell ill with similar symptoms at the same time, later tested positive for the virus. |
| The government has also quietly closed parts of the St. Imre Hospital in Budapest, after the disease spread among staff, two senior state doctors said on condition of anonymity. The hospital declined to comment, referring reporters to a government spokesman, who did not reply to two requests. | The government has also quietly closed parts of the St. Imre Hospital in Budapest, after the disease spread among staff, two senior state doctors said on condition of anonymity. The hospital declined to comment, referring reporters to a government spokesman, who did not reply to two requests. |
| Some critics said the government had been slow to use the test facilities it already had at its disposal. Officials did not start testing at laboratories at the Semmelweis Medical School, which alone has the capacity to process at least 400 tests per day, until mid-March. | Some critics said the government had been slow to use the test facilities it already had at its disposal. Officials did not start testing at laboratories at the Semmelweis Medical School, which alone has the capacity to process at least 400 tests per day, until mid-March. |
| Like many other countries, “Hungary did not respond in time,” said Andras Falus, a professor emeritus at the school. | Like many other countries, “Hungary did not respond in time,” said Andras Falus, a professor emeritus at the school. |
| But other doctors praised the government as doing a good job in tough circumstances, at a time of profound economic upheaval in which no country has tested enough people, let alone perfected its response to the pandemic. | But other doctors praised the government as doing a good job in tough circumstances, at a time of profound economic upheaval in which no country has tested enough people, let alone perfected its response to the pandemic. |
| “I do not see right now, for the time being, that there is a big turd in the crepe,” said Gabor Zacher, an emergency doctor with the Hungarian ambulance service. Dr. Zacher has criticized the government’s health measures in the past, but praised its recent social distancing measures. | “I do not see right now, for the time being, that there is a big turd in the crepe,” said Gabor Zacher, an emergency doctor with the Hungarian ambulance service. Dr. Zacher has criticized the government’s health measures in the past, but praised its recent social distancing measures. |
| Hungary implemented social distancing measures earlier than several other European countries, said Gergely Rost, an epidemiologist whom the government recently enlisted to advise Mr. Orban on the likely spread of the virus. | Hungary implemented social distancing measures earlier than several other European countries, said Gergely Rost, an epidemiologist whom the government recently enlisted to advise Mr. Orban on the likely spread of the virus. |
| “As a consequence, we still don’t have too many,” said Dr. Rost, a lecturer at the University of Szeged, a college in southeastern Hungary. “At the moment, the epidemic is pretty much suppressed.” | “As a consequence, we still don’t have too many,” said Dr. Rost, a lecturer at the University of Szeged, a college in southeastern Hungary. “At the moment, the epidemic is pretty much suppressed.” |
| Because of a lack of tests, the real number of cases is likely to be up to nine times higher than the current tally of infections, Dr. Rost said. But “numbers are underestimated in every country, even those who have tested more.” | Because of a lack of tests, the real number of cases is likely to be up to nine times higher than the current tally of infections, Dr. Rost said. But “numbers are underestimated in every country, even those who have tested more.” |
| Updated June 5, 2020 | Updated June 5, 2020 |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| For some, the problems with Mr. Orban’s response to the pandemic stem less from his actions since the start of the crisis, and more from his systemic neglect of Hungarian health care since re-entering office in 2010. | For some, the problems with Mr. Orban’s response to the pandemic stem less from his actions since the start of the crisis, and more from his systemic neglect of Hungarian health care since re-entering office in 2010. |
| Under Mr. Orban, his government’s health care budget dropped as a proportion of national economic output, even as state spending rose in other sectors. He also abolished the Health Ministry, assigning its responsibilities to a larger department. | Under Mr. Orban, his government’s health care budget dropped as a proportion of national economic output, even as state spending rose in other sectors. He also abolished the Health Ministry, assigning its responsibilities to a larger department. |
| Around 10 percent of Hungarian doctors left the country in the first seven years of Mr. Orban’s current tenure in search of better-paid work, senior doctors estimated. The salary of a Hungarian general practitioner, as a proportion of the average national wage, is one of the lowest in Europe. | Around 10 percent of Hungarian doctors left the country in the first seven years of Mr. Orban’s current tenure in search of better-paid work, senior doctors estimated. The salary of a Hungarian general practitioner, as a proportion of the average national wage, is one of the lowest in Europe. |
| Under Mr. Orban, the cancer death rate rose and is tied for the worst in the European Union. Even before the coronavirus outbreak, the government refused to disclose the number of infections contracted in state hospitals for fear of alarming the public. | Under Mr. Orban, the cancer death rate rose and is tied for the worst in the European Union. Even before the coronavirus outbreak, the government refused to disclose the number of infections contracted in state hospitals for fear of alarming the public. |
| In the context of the coronavirus, his government’s most unhelpful action was the dismantling in 2017 of a state-run health authority that included a dedicated team of epidemiologists. Following the authority’s closing, these experts on pandemics either left government or were dispersed to other parts of the health system, undermining the government’s ability to react to a disease like the coronavirus. | In the context of the coronavirus, his government’s most unhelpful action was the dismantling in 2017 of a state-run health authority that included a dedicated team of epidemiologists. Following the authority’s closing, these experts on pandemics either left government or were dispersed to other parts of the health system, undermining the government’s ability to react to a disease like the coronavirus. |
| “The extremely well-functioning pandemic defense network was weakened in recent years,” says Erzsebet Pusztai, a health care expert. “The previous unified organization was taken apart and distributed under government offices, and many experts left. And this serious pandemic found it in a very weakened condition.” | “The extremely well-functioning pandemic defense network was weakened in recent years,” says Erzsebet Pusztai, a health care expert. “The previous unified organization was taken apart and distributed under government offices, and many experts left. And this serious pandemic found it in a very weakened condition.” |
| Years of low funding have left health facilities under-resourced, and contributed to a recent row about whether the government or health care workers should pay for their masks and visors. | Years of low funding have left health facilities under-resourced, and contributed to a recent row about whether the government or health care workers should pay for their masks and visors. |
| “Health care workers are going unarmed into battle — we hardly have any protective masks,” said Dr. Peter Lehoczky, the director of outpatient care in a district of Budapest. “The feeling is that we are trying to shoot down a rocket with a slingshot.” | “Health care workers are going unarmed into battle — we hardly have any protective masks,” said Dr. Peter Lehoczky, the director of outpatient care in a district of Budapest. “The feeling is that we are trying to shoot down a rocket with a slingshot.” |
| Benjamin Novak reported from Budapest, and Patrick Kingsley from Berlin. | Benjamin Novak reported from Budapest, and Patrick Kingsley from Berlin. |