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Companies Sell the Blood of Recovered Coronavirus Patients for Exorbitant Prices

The W.H.O. extends the global health emergency as deaths near 240,000, and our New Delhi correspondent paints a portrait of a fearful city.

This briefing has ended. Read the latest developments in the coronavirus pandemic here.

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A Berlin laboratory testing samples sent by hospitals. Blood samples are critical in developing vaccines, cures, treatments and tests.Credit...Emile Ducke for The New York Times

Some biotech companies are cashing in on the race to produce coronavirus antibody tests, taking blood samples from people who have been infected and selling them at exorbitant prices.

And the people who give their blood to help the fight against Covid-19 may not realize that it is making such profits for the companies.

Documents, emails and price lists obtained by The New York Times show that several companies around the world are offering to sell Covid-19 blood samples to labs and test manufacturers at elevated prices.

One is Cantor BioConnect in California, which has charged $350 to $40,000 for just a milliliter of blood — less than a quarter of a teaspoon — of blood. Another, the Indian company Advy Chemical, has charged up to $50,000. The more antibodies in the sample, the higher the price.

The companies insist they are not profiteering, but doctors call the practice unethical.

“I’ve never seen these prices before,” said Dr. Joe Fitchett, the medical director of Mologic, a British test manufacturer that was offered high-priced samples. “It’s money being made from people’s suffering.”

Researchers who are trying to develop antibody tests need samples taken from people who caught the virus, and whose immune systems learned to make antibodies to fight it off. Competition for the samples has produced shortages.

That’s particularly true in Britain, where researchers usually rely on the centralized public health system, not the commercial market, to provide samples. For-profit companies are advertising for donors and paying them — $100 in Cantor BioConnect’s case — while British scientists are relying on word of mouth or personal connections to find volunteers.

Aleacia Jenkins, a Covid-19 survivor in Washington State, had planned to provide her blood to Cantor BioConnect. But when she learned of the prices it would charge from a reporter, she changed her mind.

“Anyone trying to take advantage of a pandemic,” she said, “I think that’s really sad and wrong.”

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Vials of remdesivir capped at a Gilead Sciences facility in California.Credit...Gilead Sciences, via Reuters

The U.S. Food and Drug Administration has issued an emergency approval for the antiviral drug remdesivir as a treatment for patients with Covid-19, President Trump announced on Friday.

The approval, formally called an emergency use authorization, had been expected following modestly encouraging results from a federal trial whose results were announced on Wednesday.

The trial found that patients receiving remdesivir recovered more quickly: in 11 days, versus 15 in a group receiving a placebo. But the drug, made by Gilead Sciences, did not significantly reduce fatality rates.

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Wednesday that the results were “a very important proof of concept” but not a “knockout.”

Gilead has said that it is prepared to give away the first 1.5 million doses of remdesivir.

Remdesivir is approved only for severely ill patients and only temporarily; formal approval must come later. Still, some doctors laboring in intensive care units embraced the drug as an important new weapon against a virus that is killing patients worldwide.

But a study in China, published this week in Lancet, found the drug offered no benefit to severely ill patients. And many experts want to see the data from the National Institute of Allergy and Infectious Diseases trial; so far, there have been only announcements about the results from administration officials.

In other science news on the pandemic:

  • Drugs that are widely prescribed to treat high blood pressure do not put patients at greater risk from the coronavirus, researchers are reporting. That’s good news for millions of people who take two classes of drugs, known as ACE inhibitors and ARBs.

  • It may be time to add another strange symptom to the list of coronavirus signs, “Covid toe.” Doctors around the world report that some of their infected patients are developing chillblains — painful, swollen red or purple lesions — on their toes. Ordinarily people get chillblains in the winter, from exposure to cold.

  • Without testing enormous numbers of people, how can we know when the disease has abated enough to resume normal life? The answer, scientists say, may be in the sewers. The virus is in the feces of infected people, so checking the sewers can provide an idea of how many people have it.

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A line outside a bank in New Delhi on Thursday.Credit...Rebecca Conway for The New York Times

Jeffrey Gettleman, The Times’s South Asia bureau chief, moved to New Delhi with his family nearly three years ago. We asked him to paint a picture of how life has changed under India’s coronavirus lockdown, one of the world’s strictest.

The first thing that disappeared was the annoying sound of a power drill up the street, from a house under construction.

Then the newspapers.

Then the fruit sellers, the taxis, the rickshaws, and chicken.

Day by day, life under coronavirus lockdown in India took away something else, usually something good. And nearly six weeks into it, much of this country is still frozen.

In many cities like New Delhi, practically nothing is moving on the roads. People stay indoors, as instructed, emerging only to collect the basic necessities. One friend who gets his food delivered told me he hasn’t left his house for a month.

All the airlines are grounded. Schools and offices are closed. The only businesses that I’ve seen operating are food shops, pharmacies and banks. The banks have lines running out the door and down the sidewalk where red circles have been spray-painted for people to stand in, six feet apart, like little islands.

The other day, I drove to Delhi’s outskirts. India is a place rightly known for teeming crowds and riotous traffic. There seems to be a national aversion to sticking to your lane, so I felt almost guilty blazing down an empty highway, past miles of shuttered shops, with no one to cut me off.

Whenever we turned off the highway, every village, no matter how small, was barricaded — some with oil drums, others with rope. Behind the barricades stood villagers carrying sticks to keep strangers out and wearing fraying bandannas over their faces, the virus vigilantes.

Even the sky above us is different these days. New Delhi is usually one of the world’s most polluted cities; its ceiling is invariably smudge gray. But now with so few cars and factories running, the air here is cleaner than it has been in decades.

The weather that first weekend under lockdown, in late March, was especially lovely: mid 80s, breezy, clear skies. So on the following Monday when I saw The Times’s driver, Jag Singh, one of the few Indians I now see on a regular basis because of our isolation, I asked if he had managed to get outside.

“No.” Did his neighbors? Again, “no.”

Having seen the photos of some Americans rushing to beaches as soon as they were allowed, I asked why he thought Indians felt so constrained.

His answer came quickly: “Everyone’s scared. People are saying if they get sick, where will they go?” Tap here to read the rest of Jeffrey Gettleman’s essay.

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Jared Kushner, President Trump’s son-in-law and senior adviser, recently decided to support a tougher line on China.Credit...Doug Mills/The New York Times

The Trump administration is moving to take a more aggressive stand against China on economic, diplomatic and scientific issues at the heart of the relationship between the world’s two superpowers, further fraying ties that have reached their lowest point in decades.

White House aides this week have prodded President Trump to issue an executive order that would block a government pension fund from investing in Chinese companies, officials said — a move that could upend capital flows across the Pacific. Mr. Trump announced on Friday that he was restricting the use of electrical equipment in the domestic grid system with links to “a foreign adversary” — an unspoken reference to China.

The administration is cutting off grants that would help support virology laboratories in Wuhan, China, the city where the coronavirus outbreak began, and is looking into scientific collaborations undertaken there by the University of Texas.

Senior aides, led by Secretary of State Mike Pompeo, have asked intelligence agencies to continue looking for any evidence to support an unsubstantiated theory that the pandemic might be the result of an accidental lab leak, even though analysts have said they most likely will not find proof.

The open rivalry between the two nations has taken on a harder and much darker shading in the months since the new coronavirus spread from a metropolis on the Yangtze River across the globe, speeding up efforts by hard-liners in both Washington and Beijing to execute a so-called decoupling of important elements of the relationship.

The bitter information war over the virus has become a core part of the competition, but the Trump administration’s efforts to counter China have sharpened across the board. That is partly in response to what administration officials say are China’s own aggressive moves, including the pushing of anti-America disinformation worldwide, increased military activity in the South China Sea and clampdowns on freedoms in the semiautonomous global financial city of Hong Kong.

Mr. Trump’s campaign aides and Republican lawmakers also aim to amplify criticism of China partly to deflect from the administration’s own record on the pandemic, especially as the general election in November approaches.

China is likely to emerge from the recession caused by the pandemic faster than other nations. The United States — still reeling from the virus, with more than one million infected and more than 64,000 dead — will probably rely on economic activity in Asia to help prop up its own economy. Part of that involves getting Beijing to comply with a trade agreement signed in January.

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‘The Pandemic Remains a Public Health Emergency,’ W.H.O. Says

The World Health Organization extended its declaration of a global health emergency as the coronavirus pandemic continues to grow.

The Covid-19 crisis has illustrated that even the most sophisticated health systems have struggled to cope with a pandemic. W.H.O. has grave concerns about the potential impact the virus could have as it starts to accelerate in countries with weaker health systems. Of course, the pandemic remains a public health emergency of international concern. We will continue working with countries and partners to enable essential travel needed for pandemic response, humanitarian relief and cargo operations, and for countries to gradually resume normal passenger travel.

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The World Health Organization extended its declaration of a global health emergency as the coronavirus pandemic continues to grow.CreditCredit...Sarah Blesener for The New York Times

The World Health Organization extended its declaration of a global health emergency on Friday, amid increasing criticism from the Trump Administration about its handling of the coronavirus pandemic.

The move comes three months after the organization’s original decision to announce a “public health emergency of international concern” on Jan. 30. At the time, only 98 of the nearly 10,000 cases confirmed had occurred outside China’s borders.

But the pandemic continues to grow. More than 3.2 million people around the world are known to have been infected and nearly 240,000 have died, according to official counts. There is evidence on six continents of sustained transmission.

All of this led experts on the W.H.O.’s emergency committee to reassess the evolution of the pandemic, and to advise on updated recommendations, officials said.

There has been a rapid rise in new cases in Africa and South America, where many countries have weak health care systems that could easily be overwhelmed, even as the spread of the virus has appeared to slow in many countries in Asia and Europe.

[Read: Hidden toll: Mexico ignores wave of coronavirus deaths in capital.]

“The Covid-19 crisis has illustrated that even the most sophisticated health systems are struggling to cope with the pandemic,” said Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general.

Although people are slowly starting to return to work in China after weeks of lockdowns, nonessential stores are still shuttered in most parts of the world and the virus has badly damaged the global economy.

Across the United States, governors are struggling to square demands to restart businesses with the possible health consequences of loosening social distancing rules.

As the W.H.O. tries to manage the worldwide crisis, it is also fending off intense criticism, some of it unfounded. The Trump administration has cut off funding for the W.H.O., claiming without evidence that it colluded with China to obscure the extent of the epidemic in its early days. Critics say the administration is trying to deflect attention from its own handling of the epidemic.

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Air Europa employees disinfected a plane in Spain on Thursday.Credit...Jaime Reina/Agence France-Presse — Getty Images

After flight attendants and pilots criticized them for not doing more to protect employees, large airlines in the United States and around the world announced this week that they would require their crews to wear masks. Some went even further and said passengers would have to do so, too.

American Airlines and Delta Air Lines said on Thursday that they would start requiring all passengers to wear a face covering in the coming weeks, a policy that will apply to their flight attendants, too. They join Lufthansa Group — which owns its namesake airline, Swiss International Air Lines and Austrian Airlines — as well as JetBlue and Frontier Airlines, all of which made similar announcements this week.

Southwest Airlines said this week that its flight attendants would soon be wearing masks, joining United Airlines, which announced a similar policy late last week. Both airlines said they would “strongly” encourage customers to do the same.

As some places begin to relax or lift stay-at-home orders, lawmakers and unions representing flight attendants and pilots have stepped up calls for industrywide rules on masks to protect flight crews from passengers — and passengers from one another.

Airports have begun to weigh in as well, with the head of Heathrow Airport in London, one of Europe’s biggest transport hubs, noting that it would be nearly impossible to enforce social distancing at airports.

Speaking to the BBC, John Holland-Kaye, Heathrow’s chief executive, said a “better solution” was needed to ensure the safety of air travel, starting with airports.

“Social distancing does not work in any form of public transport, let alone aviation,” he said. “The constraint is not about how many people you can fit on a plane, it will be how many people you can get through an airport safely.”

But even as flight safety measures become the focus, many airlines are struggling to simply stay solvent. Michael O’Leary, the chief executive of the budget airline Ryanair, on Friday told Sky News that the company plans to slash around 3,000 jobs amid the crisis.

Takuo Aoyagi, a Japanese engineer whose pioneering work in the 1970s led to the modern pulse oximeter, a lifesaving device that clips on a finger and shows the level of oxygen in the blood and that has become a critical tool in the fight against the novel coronavirus, died on April 18 in Tokyo. He was 84.

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Takuo Aoyagi.Credit...Engineering and Technology History

His death, in a hospital, was announced by his employer, Nihon Khoden, a Tokyo-based company that makes medical equipment. A niece, Kyoko Aoyagi, confirmed the death but said she did not know the cause.

The pulse oximeter has become “an indispensable addition to medicine,” said V. Courtney Broaddus, a professor emeritus of medicine at the University of California, San Francisco. Historically, patients were measured by four vital signs: temperature, blood pressure, pulse and respiratory rate. “It has become the fifth vital sign,” she said of oxygen level.

While many coronavirus patients do feel chest pain, fever and other symptoms, Dr. Broaddus said, the pulse oximeter “has become especially important because humans do not sense a low oxygen saturation alone.”

Moreover, some Covid patients seem not to have other symptoms. As a result, when moderately or mildly ill patients test positive for the coronavirus, they may be sent home with a pulse oximeter so that they can track their oxygen level and return to the hospital if it drops.

Read the full obituary.

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On Friday, Britain announced it had exceeded its testing target, carrying out 122,347 tests on the last day of the month.Credit...Andrew Testa for The New York Times

Britain, which was slower than other Western European countries to do widespread coronavirus testing, hit a promised milestone, conducting more than 100,000 tests for the virus in a single day, the government said on Friday.

But as expected, the increased testing has helped illustrate how far behind its neighbors Britain is in controlling the epidemic, adding more confirmed infections per day than any country in Europe except Russia.

Britain now has the highest official daily death toll in Europe from Covid-19, by far, though there are big discrepancies in testing and counting from country to country. Britain remains near its peak death rate, averaging about 700 per day this week, more than Italy and France combined.

On Friday, the British government reported 27,501 fatalities so far, keeping it on a pace to overtake Italy, with 28,236, as the country in Europe with the highest official toll.

Prime Minister Boris Johnson’s government has been roundly criticized for taking a more relaxed approach than most of Europe — it waited longer to order businesses to close and people to stay at home, and even now, its lockdown is less stringent than those in many other countries.

The government at first decided against widespread testing, then reversed itself but had difficulty ramping up. In early April, it vowed to reach 100,000 a day by the end of the month, but it did not surpass 50,000 for the first time until Tuesday.

But Matt Hancock, the health secretary, announced on Friday that more than 122,000 tests were conducted on Thursday, the last day of April. Even so, experts say the virus is now so widespread that the rate of testing is still insufficient to allow rigorous contact tracing or to safely allow the economy to reopen.

Mr. Johnson, who had been hospitalized with Covid-19, said on Thursday that the country was not yet ready to ease its restrictions.

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This week, after Dr. Monahan warned Democratic leaders that it might be risky for lawmakers to come back on Monday as scheduled, Speaker Nancy Pelosi abandoned plans to do so.Credit...Anna Moneymaker/The New York Times

Dr. Brian P. Monahan, the tight-lipped doctor who attends to Congress, sent on Thursday what some have construed as a warning: His office, he told senior Republican officials on a private conference call, cannot screen all 100 senators for the coronavirus when they return to work on Monday.

Two miles down Pennsylvania Avenue at the White House, the story is very different. President Trump and Vice President Mike Pence are tested frequently, aides who come into close contact with them are tested weekly and the list of people who need to be tested daily keeps expanding, according to officials familiar with the process.

The stark contrast between the testing haves at the White House and the have-nots on Capitol Hill makes clear that Mr. Trump’s pronouncement that “anybody that wants a test can get a test,” as he said on March 6 at the Centers for Disease Control and Prevention in Atlanta, is far from true. Although the rich and powerful are clearly favored, not even all the powerful have equal access.

In other U.S. news:

  • Texas pushed its way out of a statewide coronavirus lockdown on Friday, with a wide-ranging reopening of restaurants, businesses and beaches in the midst of an ongoing outbreak. Only a day earlier, the state reported its highest single-day death toll from the coronavirus, with 50 new fatalities. Dallas County reported 179 new cases, its highest so far, and for the first time exceeded 100 deaths.

  • Hundreds of protesters converged on the Illinois state capitol in Springfield and in downtown Chicago on Friday, demanding that Gov. J.B. Pritzker lift the stay-at-home order that he extended until May 29. The protest came on the heels of a similar demonstration in Michigan on Thursday: Hundreds of people, some of them armed, converged on the State Capitol in Lansing to protest the stay-at-home orders put in place by Gov. Gretchen Whitmer.

  • The White House is preventing Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, from testifying before the House next week, a spokesman for the House Appropriations Committee said on Friday. Democrats had wanted Dr. Fauci to testify as part of a hearing on health, labor and education agencies and programs.

  • U.S. stocks fell on Friday as investors reacted to signs of growing tensions between China and the United States as well as earnings reports by Apple and Amazon that showed the depth of the pandemic’s impact on big business. Both the S&P 500 and the tech-heavy Nasdaq composite fell about 3 percent. Amazon shares dropped by more than 7 percent.

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Gado in his office in downtown Nairobi.Credit...Khadija Farah for The New York Times

For someone who makes his living skewering hypocrisy, incompetence and corruption, the coronavirus pandemic presents what the military might call a target-rich environment.

That makes this tragedy a time of immense importance to the editorial cartoonist known as Gado, one of Africa’s leading political satirists. He sees it as not just an opportunity but an obligation.

“This is the time when satirists and writers need to be at their utmost vigilance,” said Gado, a native Tanzanian who lives in Kenya. “We should not let our foot off the gas because it’s very important that we ask tough questions.”

For decades, his drawings have addressed official malfeasance of all kinds, as well as terrorism, migration, religion and climate change, and now, of course, he is focused on the disease sweeping the world.

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A cartoon by Godfrey Mwampembwa, popularly known as Gado. 

Gado has lampooned not only the corporate chieftains and government officials mismanaging or profiting from the pandemic, but also ordinary people who believe and spread an array of unfounded claims and conspiracy theories about the origin of the contagion, how it spreads and how to treat it.

His work has become instructive, showing how to sanitize hands and practice social distancing. In a series titled “Myth Busters,” he notes that the coronavirus does not spread through 5G data networks, that taking hot baths will not stop the virus and that drinking alcohol — promoted by Nairobi’s governor — is not a treatment or cure.

He knows that his cartoons can make powerful enemies, but he is used to that.

“I don’t draw in a vacuum,” he said. “And I never avoid any topics.”

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Coronavirus screening and testing in Alexandra township in Johannesburg, on Monday.Credit...Marco Longari/Agence France-Presse — Getty Images

South Africa said it would lift a nationwide lockdown on Friday, but continue to implement strict social distancing and face mask rules, as the nation, already under siege from H.I.V., prepares for a new threat from the seasonal flu.

South Africa implemented one of the world’s most stringent lockdowns after recording its first coronavirus-related death in March. The regulations banned jogging and dog-walking, shuttered parks and banned the sale of alcohol and cigarettes.

Even with the eased restrictions, masks and social distancing will be mandatory and an overnight curfew will be implemented. Employees must still work from home, and gyms and restaurants will remain closed. Schools will not reopen until June 1.

The country quickly sprung into action in March over fears that its population, heavily affected by H.IV. and AIDS, would be particularly susceptible to the new coronavirus.

Beginning on Friday, miners will return to work underground — a move crucial to the economy — in an industry already overwhelmed by high rates of H.I.V. and tuberculosis infection. More than 13 percent of the South African population is H.I.V. positive, meaning nearly eight million people have compromised immune systems.

With 5,350 confirmed coronavirus cases and just over 100 deaths, officials say the phased reopening is essential to curbing the pandemic in a country with a vulnerable population and poor health system.

The economic toll of fighting Covid-19 also necessitated a $26.16 billion stimulus plan, with money borrowed from the International Monetary Fund, the African Development Bank and others.

An unfamiliar sight since the end of apartheid, tanks carrying soldiers rolled into neighborhoods to assist police with enforcing the lockdown. As in other nations, officers were accused of heavy handedness, with six people killed by police in the first week, many in communities of color. This is also where testing and screening drives, led by volunteers wearing protective gear, have been focused.

“Community transmission is there, we see cases, but it’s not spreading like that wildfire that we had expected and that’s what’s leading to this funny turn in the epidemic and the shape of our curve,” said Professor Salim Abdool Karim, head of the country’s Covid-19 task force, presenting a plateaued infection rate.

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CreditCredit...Scott Gelber

In late January, researchers at BenevolentAI, an artificial intelligence start-up in central London, turned their attention to the coronavirus.

Within two days, using technologies that can scour scientific literature related to the virus, they pinpointed a possible treatment with a speed that surprised both the company that makes the drug and many doctors who had spent years exploring its effect on other viruses.

Called baricitinib, the drug was designed to treat rheumatoid arthritis. Though many questions hang over its potential use as a coronavirus treatment, it will soon be tested in an accelerated clinical trial with the United States’ National Institutes of Health. It is also being studied in Canada, Italy and other countries.

The specialists at BenevolentAI are among many A.I. researchers and data scientists around the world who have turned their attention to the coronavirus, hoping they can accelerate efforts to understand how it is spreading, treat people who have it and find a vaccine.

BenevolentAI quickly joined a race to identify drugs that can block the virus from entering the body’s cells. Researchers at the University of California, San Francisco, and many other labs are looking into similar treatments.

Over two days, a small team used the company’s tools to plumb millions of scientific documents in search of information related to the virus. The tools relied on one of the newest developments in artificial intelligence — “universal language models” that can teach themselves to understand written and spoken language by analyzing thousands of old books, Wikipedia articles and other digital text.

Through their software, they found that baricitinib might prevent the viral infection itself, blocking the way it enters cells. The company said it had no expectations for making money from the research and had no prior relationship with Eli Lilly, the company that makes baricitinib.

Dr. Dan Skovronsky, chief scientific officer at Eli Lilly, warned that it was still unclear what effect the drug would have on coronavirus patients. Even after the clinical trial, he said, it may not be clear whether the antiviral properties pinpointed by BenevolentAI are as effective as they might seem to be.

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The Forbidden City in Beijing on Friday. Roughly 70 percent of China’s tourist attractions have reopened.Credit...Tingshu Wang/Reuters

When Zeng Yanqi, a 26-year-old Beijing resident, learned this week that travelers returning to the capital would no longer have to quarantine, she pulled up flight options on her phone. Half an hour later, she had purchased a ticket to visit her parents in Sichuan Province.

Friday kicks off Labor Day, a long weekend in China and the biggest extended holiday since the country began loosening up nationwide restrictions first implemented in January.

After months of lockdown, quarantines and fear, people are rushing to take advantage. Moments after Beijing announced on Thursday that it would lift its quarantine requirements, airline ticket bookings shot up 15 times higher than recent levels, according to Qunar, an online travel service provider. The number of tourists who booked trips in April increased by 300 percent over March, according to Xinhua, the state news agency, citing data from Trip.com, a travel agency.

Roughly 70 percent of the country’s tourist attractions have reopened, and many are offering free entry or other promotions, Luo Shugang, China’s minister of culture, said at a news conference on Thursday.

While encouraging tourism as a means of economic revival, officials reminded travelers that life had not yet returned to normal. Tourist attractions would be limited to 30 percent of their usual capacity, Mr. Luo said, and many would require online reservations. Temperature checks would be widespread. “We are still in the middle of the epidemic control period,” he said.

Still, such warnings could not dampen Ms. Zeng’s spirits. Her parents had immediately rearranged their schedules after hearing of her surprise visit, she said in a phone call from Daxing International Airport in Beijing on Thursday. She had not seen them since October. “Even when I was in college, I didn’t go that long without going home,” she said.

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Migrant workers arrived at a train station at Aluva, in southern India, on Friday to begin their odyssey home. Credit...Arun Chandrabose/Agence France-Presse — Getty Images

At a soup kitchen in Ernakulam, in the south Indian state of Kerala, Sinjith Valluvan broke down when he learned that a train was taking migrant workers to his hometown in the neighboring state of Odisha.

Mr. Valluvan, a 36-year-old construction worker, has been stranded for six weeks in Kerala, since Prime Minister Narendra Modi abruptly ordered a lockdown of the nation of 1.3 billion citizens to fight the spread of coronavirus. At least 10 million migrant workers were suddenly stranded without food or jobs far from home in different parts of the country.

“I can’t tell you how happy I feel about uniting with my children,” Mr. Valluvan said as he was preparing to board a train on Friday evening. But he vowed not to leave his village for work again, saying he never imagined that he would have to beg for food to survive.

His journey was part of a handful of special trains the Indian government on Friday allowed to run to take migrant workers, pilgrims, tourists and students stranded across the country to their home states.

The lockdown has led to one of the biggest internal migrations in India’s modern history as hundreds of thousands of poor people and their children embarked on grueling journeys on foot to escape imminent starvation. In many places, they were stopped and beaten by officers who ordered them to return to where they had come from to stay in line with the lockdown.

At least two dozen deaths of migrant workers trying to return home have been reported across India since the lockdown came into effect. But on Friday morning, the first special train chugged out of the platform at Lingampalli station in Telangana, bound for the eastern state of Jharkhand with 1,200 passengers on board. Government officials clapped for the returnees.

The passengers were ordered to maintain social distancing, and only 54 people were allowed to sit in a compartment that usually seats 72. The train departed in the early morning hours to avoid chaos. The authorities sought to avoid a repeat of a recent incident near Mumbai, India’s financial capital, when thousands of migrant workers defied the lockdown and began assembling at railway stations in hopes of reaching their homes.

India has reported 35,043 infections and 1,154 deaths from the coronavirus, a relatively low number for a country with such a huge and booming population. But restrictions on movement will continue, with the national lockdown extended on Friday until May 17, the Ministry of Home Affairs said in a statement.

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Protesters in an exchange with police officers in central Berlin on Friday.Credit...Emile Ducke for The New York Times

In a world largely under pandemic lockdown, the traditional May 1 mass labor rallies have had to be reimagined, or in some cases called off.

But at a time when working people are bearing the brunt of the coronavirus recession, some saw it as more important than ever to show solidarity on International Workers’ Day, also known as Labor Day.

In Athens, hundreds of Greeks wearing masks and gloves and standing six feet apart gathered outside Parliament on Friday, holding the red, white and blue flags of the labor alliance PAME. Some wore masks with the slogan “Even covered mouths have a voice,” and held banners denouncing the economic suffering of ordinary people.

In Spain, labor unions planned to hold only online events, after courts struck down proposals to gather outdoors. In the city of Vigo, unions wanted to hold a drive-by demonstration, with one person per vehicle, but even that, a court ruled, violated lockdown rules.

Many events also moved online in Germany, with unions broadcasting speeches and music online or on radio. In Berlin, an anonymous message circulated online, calling on people to assemble in the Kreuzberg neighborhood on Friday evening, defying a ban on gatherings of more than 20 people. The police were out in force to prevent such assemblies.

In France, some unions asked would-be protesters to post videos and pictures on social media, and bang pots and pans at midday, rather than attend rallies.

The national lockdown also disrupted the French tradition of buying lilies of the valley from shops and sidewalk vendors, to give to family and friends as symbols of good fortune.

This May 1 was “like no other,” President Emmanuel Macron said in a video posted on social media, but “this spirit of solidarity between workers, has perhaps never been as powerful.”

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Police officers outside a shopping mall in the Causeway Bay commercial district in Hong Kong on Friday.Credit...Lam Yik Fei for The New York Times

The police in Hong Kong deployed thousands of additional officers on Friday after antigovernment activists vowed to return to the streets as the city’s coronavirus outbreak has stabilized.

About 3,000 officers in riot gear were deployed on Friday, the Labor Day holiday in the semiautonomous Chinese city, to conduct high-profile patrols, the local news media reported. The police said in a statement that they would “nimbly deploy manpower to maintain public safety and public order” in response to calls for action that “disregard the government’s laws.”

Protesters, organizing online, called for spontaneous demonstrations on Friday and for a four-day campaign to show support for small businesses that support the pro-democracy movement.

The coronavirus pandemic has helped to quiet the antigovernment movement that roiled Hong Kong last year. But the city had recorded no new coronavirus infections for five consecutive days this week and protesters have recently staged small rallies. Those gatherings were broken up by the police, who cited social distancing rules.

Two new confirmed cases of the coronavirus were recorded on Friday, both of which were imported, health officials said.

Groups of police officers wearing masks and holding shields were seen on Friday across the city. Elsewhere, officers conducted spot checks on residents.

The Labor Day rallies that are traditionally held on May 1 in Hong Kong were denied permits because of public health risks. One pro-democracy labor group instead set up dozens of street booths. In the busy commercial areas of Mong Kok and Sha Tin, activists and bystanders shouted protest slogans. Later in the evening, riot police advanced into a shopping mall where a singing protest had been planned, firing pepper spray and setting up cordons to disperse the crowds.

“The epidemic hasn’t even ended, and the Chinese Communist Party is already eager to settle the score with Hong Kongers,” said Carol Ng, the chairwoman of the Hong Kong Confederation of Trade Unions.

“We must prepare to use more enterprising methods in response to tyranny,” said Ms. Ng as she urged residents to join pro-democracy labor unions on Friday. She also warned against possible mass arrests, citing speculation that some calls for disruptions were intentionally created to help the police round up more activists.

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The Kunduz Regional Hospital, shown in 2016, is the main health facility for several restive provinces in northern Afghanistan.Credit...Najim Rahim for The New York Times

Even when their city was repeatedly overrun by the Taliban and fighting reached their doorsteps, the doctors and nurses in the northern Afghan city of Kunduz kept working. They dressed wounds and saved lives at the main government hospital even as a nearby trauma center was bombed, killing more than 40 people.

Now, about 70 doctors and nurses out of a staff 361 at Kunduz Regional Hospital — the main health facility for several restive provinces in northeastern Afghanistan — are either infected with the coronavirus or in quarantine on suspicion of infection. But there is no choice but to keep the doors open, said Dr. Naeem Mangal, the hospital director. The doctors cannot reject the dozens of war wounded who continue to arrive each day.

“The hospital needs to be quarantined, but what alternative do we have?” said Dr. Mangal. “It has made us so concerned that we are all scared of each other at the hospital because we don’t know who is infected and who isn’t.”

Afghanistan’s feeble health system has been tested by the spread of the pandemic at a time when the war with the Taliban continues to rage nationwide.

Testing remains extremely limited here, but as of Friday, the country had recorded just over 2,300 cases, with at least 228 among medical workers, and 68 recorded deaths.

Dr. Mangal said his hospital in Kunduz, where 23 of 37 confirmed cases are medical workers, has pleaded with people to only visit the hospital for severe emergencies.

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The Robert Capa Contemporary Photography Center in Budapest, Hungary.Credit...Zoltan Balogh/MTI, via AP

The Charles Dickens Museum in London has fallen on hard times. For 95 years, the collection, in the home of the “Oliver Twist” and “Great Expectations” author, has been financed by ticket sales and other earned income. But with no visitors since March, its director fears that its temporary closure could become permanent.

“We have funds to get us through the end of April, and we’ve got a little bit of savings after that,” Cindy Sughrue, who leads the museum, said by phone from her office in the empty building. “I can see that we can eke out until September. But, if the social distancing measures continue beyond that, then there’s a real danger that we will not survive.”

All but about 5 to 7 percent of the world’s museums are currently shuttered because of the coronavirus pandemic, said Peter Keller, the general director of the International Council of Museums. According to the council’s research, one in 10 may not reopen, he added.

More than 30 respondents to a 41-country survey, by the Network of European Museum Organizations, said they feared they would have to close permanently, among them the Museo de La Rioja and Museum of the Americas in Spain; Kornberg Castle in Austria, the Robert Capa Contemporary Photography Center in Hungary, and the National Historical Museum of Albania.

The gravity of the situation varies by country, depending on how much museums rely on ticket sales and tourism, and how much government funding they receive. Museums in the United States which survive from earned income and philanthropy are more vulnerable than government-subsidized European institutions.

Reporting and research was contributed by Jane Bradley, Jeffrey Gettleman, Abdi Latif Dahir, Sameer Yasir, Christopher F. Schuetze, Niki Kitsantonis, Mark Landler, Stephen Castle, Aurelien Breeden, Raphael Minder, Megan Specia, Elaine Yu, Vivian Wang, Mujib Mashal, Fahim Abed, Farah Mohamed, Lynsey Chutel, Matt Apuzzo, Niraj Chokshi, Cade Metz, Nina Siegal, Claire Fu, Ed Wong, Ana Swanson, Sheryl Gay Stolberg, Nicholas Fandos, Katie Rogers, Gina Kolata and Victoria Gomelsky.

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