Sars-CoV-2 shares between 80% and 90% of its genetic material with the virus that caused Sars – hence its name. Both consist of a strip of ribonucleic acid (RNA) inside a spherical protein capsule that is covered in spikes. The spikes lock on to receptors on the surface of cells lining the human lung – the same type of receptor in both cases – allowing the virus to break into the cell. Once inside, it hijacks the cell’s reproductive machinery to produce more copies of itself, before breaking out of the cell again and killing it in the process.

Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained.

Though nobody could have predicted that the next infectious disease to threaten the globe would be caused by a coronavirus – flu is generally considered to pose the greatest pandemic risk – vaccinologists had hedged their bets by working on “prototype” pathogens.

Cepi’s original portfolio of four funded Covid-19 vaccine projects was heavily skewed towards these more innovative technologies, and last week it announced $4.4m (£3.4m) of partnership funding with Novavax and with a University of Oxford vectored vaccine project.

Some of the Covid-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology.

All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.

Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. But there’s a high level of attrition as experimental vaccines pass through these phases.

There are good reasons for that. Either the candidates are unsafe, or they’re ineffective, or both. Screening out duds is essential, which is why clinical trials can’t be skipped or hurried. Approval can be accelerated if regulators have approved similar products before.

No vaccine made from genetic material – RNA or DNA – has been approved to date, for example. So the Covid-19 vaccine candidates have to be treated as brand new vaccines, and as Gellin says: “While there is a push to do things as fast as possible, it’s really important not to take shortcuts.”

It’s for these reasons that taking a vaccine candidate all the way to regulatory approval typically takes a decade or more, and why President Trump sowed confusion when, at a meeting at the White House on 2 March, he pressed for a vaccine to be ready by the US elections in November – an impossible deadline.

In the meantime, there is another potential problem. As soon as a vaccine is approved, it’s going to be needed in vast quantities – and many of the organisations in the Covid-19 vaccine race simply don’t have the necessary production capacity. Vaccine development is already a risky affair, in business terms, because so few candidates get anywhere near the clinic. Production facilities tend to be tailored to specific vaccines, and scaling these up when you don’t yet know if your product will succeed is not commercially feasible. Cepi and similar organisations exist to shoulder some of the risk, keeping companies incentivised to develop much-needed vaccines. Cepi plans to invest in developing a Covid-19 vaccine and boosting manufacturing capacity in parallel, and earlier this month it put out a call for $2bn to allow it to do so.

The problem is making sure the vaccine gets to all those who need it. This is a challenge even within countries, and some have worked out guidelines. In the scenario of a flu pandemic, for example, the UK would prioritise vaccinating healthcare and social care workers, along with those considered at highest medical risk – including children and pregnant women – with the overall goal of keeping sickness and death rates as low as possible. But in a pandemic, countries also have to compete with each other for medicines.

Because pandemics tend to hit hardest those countries that have the most fragile and underfunded healthcare systems, there is an inherent imbalance between need and purchasing power when it comes to vaccines.

Outside of pandemics, the WHO brings governments, charitable foundations and vaccine-makers together to agree an equitable global distribution strategy, and organisations like Gavi, the vaccine alliance, have come up with innovative funding mechanisms to raise money on the markets for ensuring supply to poorer countries. But each pandemic is different, and no country is bound by any arrangement the WHO proposes – leaving many unknowns.

“According to our statistics, 90% of the causes of violence [in this period] are related to the Covid-19 epidemic.”

It is a pattern being repeated globally. In Brazil a state-run drop-in centre has already seen a surge in cases it attributes to coronavirus isolation

“We think there has been a rise of 40% or 50%, and there was already really big demand,”

Those alarming figures log only cases where women are able to seek help; many cannot make calls because they fear being overheard by abusive partners, or are stopped from leaving home.

In Italy activists said calls to helplines had dropped sharply, but instead they were receiving desperate text messages and emails.

“It happens in all crisis situations,” said Marcy Hersh, a senior manager for humanitarian advocacy at Women Deliver. “What we worry about is just as rates of violence are on the rise, the accessibility of services and the ability of women to access these services will decrease. This is a real challenge.”

In Spain – where lockdown rules are extremely strict, and many people are being fined for breaking them – the government has told women they will not be fined if they leave home to report abuse.

But on 19 March, the country saw the first domestic violence fatality since the lockdown began five days earlier, when a woman was murdered by her husband in front of their children in the coastal province of Valencia.

The increased threat to women and children was a predictable side effect of the coronavirus lockdowns, said activists. Increased abuse is a pattern repeated in many emergencies, whether conflict, economic crisis or during disease outbreaks, although the quarantine rules pose a particularly grave challenge.

“For sure there is an overwhelming emergency right now. There is more desperation as women can’t go out.”

A prosecutor in Trento, Italy, has ruled that in situations of domestic violence the abuser must leave the family home and not the victim, a decision hailed as “fundamental” by the trade union CGIL.

In Germany the Green party’s parliamentary leader, Katrin Göring-Eckardt, said this week she feared for the lives of thousands of women trapped with violent partners, and called on the government to free up money for safe houses.

In Greece, officials said they were stepping up a campaign to help women deal with problems clearly emerging from the issue of confinement.

“The garnishment came with no warning. You don’t know until your bank account is locked and your money is gone,” said Walker, who didn’t receive the order of garnishment in the mail until 24 March, after money was taken from his account, and he has already started to fall behind in paying bills.

“Unlike the rest of my bills that I can see, the debt collection agency doesn’t send you one. You can’t arrange to auto-pay and they don’t send anything showing what you paid. It’s like they are set up to make you fail. With the coronavirus they shouldn’t be allowed to harass and garnish bank accounts while Americans are in this crisis.”

“Garnishment is a really important issue, especially for low-income, economically vulnerable families, the exact workers being laid off in the US right now,”

He noted it is still unclear if any federal stimulus checks will be subjected to wage garnishment, but warned courts can freeze bank accounts over debt, making these funds inaccessible if they are deposited.

“It’s $350 to $400 a month. I don’t deny I owe this money because they saved my life, but it is detrimental to my health now because I don’t have the money for what I need. I have no money for groceries – I’m only paying my rent and utilities, there’s no money left over,” Johnson said.

Among the Americans still experiencing wage garnishment through the coronavirus pandemic are those who have defaulted on their federal student loans. About 45 million Americans owe more than $1.7tn in student loan debt. According to an analysis by Student Loan Hero, between July 2015 to September 2018, 18 private student debt collection agencies contracted by the US Department of Education added $171bn to their debt inventory, and collected $2.3bn during the same period through wage garnishments.

“The Department of Education has not decided to do anything, as far as I know, to ease the burden from the coronavirus,” said McKinnon. “They took my tax return also, in the middle of this epidemic. It’s heartless.”

She noted the federal stimulus relief package for the coronavirus pandemic is supposed to increase social security income by $200, but that she will still be receiving less than she would before the garnishment. “Even though I paid for years and I’ve tried to utilize their system to take care of my student loans they still decided to garnish my already-below-poverty-line social security income,” Tavares added.

The third instance, an order compelling GM to begin manufacturing ventilators, was the most far-reaching as Trump came under criticism from state governors, Democrats and doctors for playing down a nationwide shortage of ventilators.

Covid-19 is a respiratory illness. Most who contract it recover but it can be fatal, particularly among older people and those with underlying health problems. Ventilators enable a person with compromised lungs to keep breathing.

After Trump invoked the act, GM said it had been working around the clock for more than a week with Ventec Life Systems, a medical device company, and parts suppliers to build more ventilators. The company’s commitment to build Ventec’s ventilators “has never wavered”, it said.

Trump also announced that the White House trade adviser Peter Navarro would become the national DPA policy coordinator for the federal government. Navarro has been a leading advocate of Trump’s protectionist trade agenda, championing tariffs against China and the European Union.

The House speaker, Nancy Pelosi, welcomed Trump’s use of the DPA as “an important but seriously belated step”. She added in a statement on Friday: “Much more must be done. The president must use the full powers of this law to address the dire, widespread shortage of materials required to fight this pandemic, including diagnostic test supplies, masks and other personal protective equipment.”

Critics say Trump ignored early warnings about the threat of the pandemic and had he acted sooner, mass production of ventilators would now be well under way.

In another bizarre moment, when Trump was asked for a message to schoolchildren forced to stay at home, he said: “You can call it a germ, a flu, a virus, you can call it many things. I’m not sure people know what it is.” Scientists have identified it as coronavirus disease (Covid-19), an infectious disease caused by a newly discovered coronavirus called Sars-CoV-2.

In another sign that Trump is not living up to his appeal for bipartisanship, Trump did not invite Pelosi or any other Democrats to the signing of a $2.2tn emergency relief bill. Pelosi said in a statement on Friday: “We must do more to address the health emergency, mitigate the economic damage, and provide for a strong recovery.”

Within a week of its first confirmed case, South Korea’s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease.

Some 357,896 tests later, the country has more or less won the coronavirus war. On Friday only 91 new cases were reported in a country of more than 50 million.

The US response tells a different story. Two days after the first diagnosis in Washington state, Donald Trump went on air on CNBC and bragged: “We have it totally under control. It’s one person coming from China. It’s going to be just fine.”

Though the decision to allow private and state labs to provide testing has increased the flow of test kits, the US remains starkly behind South Korea, which has conducted more than five times as many tests per capita. That makes predicting where the next hotspot will pop up after New York and New Orleans almost impossible.

Today, 86,012 cases have been confirmed across the US, pushing the nation to the top of the world’s coronavirus league table – above even China.

Most worryingly, the curve of cases continues to rise precipitously, with no sign of the plateau that has spared South Korea.

Jeremy Konyndyk, who led the US government’s response to international disasters at USAid from 2013 to 2017, frames the past six weeks in strikingly similar terms. He told the Guardian: “We are witnessing in the United States one of the greatest failures of basic governance and basic leadership in modern times.”

It was not until 29 February, more than a month after the Journal article and almost six weeks after the first case of coronavirus was confirmed in the country that the Trump administration put that advice into practice. Laboratories and hospitals would finally be allowed to conduct their own Covid-19 tests to speed up the process.

If Trump’s travel ban did nothing else, it staved off to some degree the advent of the virus in the US, buying a little time. Which makes the lack of decisive action all the more curious.

In the absence of sufficient test kits, the US Centers of Disease Control and Prevention (CDC) initially kept a tight rein on testing, creating a bottleneck. “I believe the CDC was caught flat-footed,” was how the governor of New York, Andrew Cuomo, put it on 7 March. “They’re slowing down the state.”The CDC’s botched rollout of testing was the first indication that the Trump administration was faltering as the health emergency gathered pace. Behind the scenes, deep flaws in the way federal agencies had come to operate under Trump were being exposed.

In 2018 the pandemic unit in the national security council – which was tasked to prepare for health emergencies precisely like the current one – was disbanded. “Eliminating the office has contributed to the federal government’s sluggish domestic response,” Beth Cameron, senior director of the office at the time it was broken up, wrote in the Washington Post.

It was hardly a morale-boosting gesture when Trump proposed a 16% cut in CDC funding on 10 February – 11 days after the World Health Organization had declared a public health emergency over Covid-19.

The Food and Drug Administration (FDA), which regulates the diagnostic tests and will control any new treatments for coronavirus, has also shown vulnerabilities. The agency recently indicated that it was looking into the possibility of prescribing the malaria drug chloroquine for coronavirus sufferers, even though there is no evidence it would work and some indication it could have serious side-effects.

As the former senior official put it: “We have the FDA bowing to political pressure and making decisions completely counter to modern science.”

Trump has designated himself a “wartime president”. But if the title bears any validity, his military tactics have been highly unconventional. He has exacerbated the problems encountered by federal agencies by playing musical chairs at the top of the coronavirus force.

The president began by creating on 29 January a special coronavirus taskforce, then gave Vice-President Mike Pence the job, who promptly appointed Deborah Birx “coronavirus response coordinator”, before the federal emergency agency Fema began taking charge of key areas, with Jared Kushner, the president’s son-in-law, creating a shadow team that increasingly appears to be calling the shots.“There’s no point of responsibility,” the former senior official told the Guardian. “It keeps shifting. Nobody owns the problem.”

So it has transpired. In the wake of the testing disaster has come the personal protective equipment (PPE) disaster, the hospital bed disaster, and now the ventilator disaster.Ventilators, literal life preservers, are in dire short supply across the country. When governors begged Trump to unleash the full might of the US government on this critical problem, he gave his answer on 16 March.In a phrase that will stand beside 20 January 2020 as one of the most revelatory moments of the history of coronavirus, he said: “Respirators, ventilators, all of the equipment – try getting it yourselves.”

In the absence of a strong federal response, a patchwork of efforts has sprouted all across the country. State governors are doing their own thing. Cities, even individual hospitals, are coping as best they can.

“Everyone is losing revenue, and many have skyrocketing demand. You do the math,” said Tim Delaney, chief executive of the 25,000-member National Council of Nonprofits.

Relief efforts are underway. Foundations, traditionally not among the spryest of organizations, learned from 9/11 and severe hurricanes that they could move fast. They are quickly retooling to disburse emergency money and relax reporting requirements that are suddenly impossible to meet.

Bloomberg Philanthropies, Carnegie Corporation of New York, the Doris Duke Charitable Foundation and 23 other foundations as well as individual donors have created a $78 million Covid-19 rescue fund for New York City nonprofits. Grants will start going out to small and midsize social services and arts and cultural organizations on Monday. Interest-free loans will follow.

In hard-hit Seattle, the Seattle Foundation is administering a $14.3 million emergency program funded by local businesses, foundations and government. It released more than $10 million to 120 organizations this week.

Nonprofits on the front lines have been forced to be nimble. Meals on Wheels People in Portland, Ore., closed its 22 neighborhood dining locations on March 13 and switched to a no-touch delivery system for its 15,000 clients. To reduce contact even more, deliveries are made only three days a week, although they include more than one meal.

Demand, of course, is soaring — from a typical 10 to 15 new requests per day to as many as 100. But perhaps surprisingly, volunteers are signing up at an equally fast rate.

If there is any redeeming aspect of the crisis for nonprofits, it might be this: When people are allowed to re-emerge into a changed world, there will be renewed enthusiasm for many causes. Parks and wilderness, for example, have never seemed as alluring as they do now, when so many are restricted to a walk around the block.

First, though, things may get dicier. In a 2018 survey by the Nonprofit Finance Fund, a consultant, three-quarters of nonprofits said they would run out of cash in less than six months. Nineteen percent said they had only enough funds to last, at the most, for a month. Nonprofits live on the edge, pouring everything they have into their mission.

Those Democratic grandparents, especially, tend to be more moderate, more swayed by traditional government experience and more keenly focused on the tactics they believe are needed to defeat President Trump, strategists and pollsters said.

“Older voters, after African-American voters, have been the single most important constituency for Joe Biden,” said Celinda Lake, a veteran Democratic pollster and political strategist who works with the Biden team but spoke in her personal capacity.

But politically, the primary results this election season have highlighted the extraordinary, sustained power of older Americans: Exit polls, surveys and interviews with political strategists and demographers show that the concerns and preferences of these voters have played a critical role in defining the trajectory of the Democratic race so far, and are poised to do so in the general election as well.

Mr. Biden, who once faced significant competition for older Americans, emerged in recent weeks as the dominant front-runner among those highly committed Democratic voters who have now helped bring him to the cusp of his party’s presidential nomination.Older voters have punched above their political weight for years, with turnout among those 65 and older often double, or more, that of the youngest voters. As Americans age and become more rooted in their communities, political participation tends to rise with their stake in society.

Even in the midterm elections in 2018, hailed as a high-water mark for youth voting because the share of 18- to 24-year-olds nearly doubled from the previous midterm election, the gap with older voters remained about the same. About 66 percent of eligible older people turned out, compared with about 36 percent of 18- to 24-year-olds, said William Frey, a demographer at the Brookings Institution.

Certainly, Mr. Sanders, the overwhelming favorite with younger voters, is continuing to campaign. And while the Vermont senator has acknowledged that younger voters did not appear to turn out at the rate he had hoped for, polls and exit surveys show that Mr. Biden faces major challenges with that constituency, a liberal slice of the electorate that, his advisers acknowledge, he will need to energize if he is the nominee.

“The irony is that the pattern is about to reverse in the general,” Ms. Lake said, pointing to Mr. Trump’s overall strength with older voters, even as she added that “Donald Trump is despised by younger voters.”

The virus has thrown politics completely, and unpredictably, up in the air. What will happen in Florida’s retirement communities — some of the most vulnerable in the nation to the virus — if Mr. Trump’s push to reopen the country fast comes to pass? It’s a question with potentially partisan implications.

Older people have long leaned Republican. A majority have chosen Republicans in four of the last seven presidential elections, according to Mr. Frey. In recent years they have also become more demographically distinct from the rest of the country: About 78 percent of eligible senior voters are white, compared with just 67 percent of eligible voters in the country as a whole.

This presents a challenge for Mr. Biden, should he win the nomination: how to get younger voters — who did not prefer him to begin with — to turn out for him, while persuading their older counterparts, who tend to choose Republicans, to vote for him over Mr. Trump.

In recent weeks, Mr. Biden has increased his efforts to appeal to younger and more progressive voters, ramping up outreach and embracing portions of proposals from Mr. Sanders and Senator Elizabeth Warren that take aim at the student debt burden.

Older Americans will soon be even more important. Mr. Frey noted that the large “Baby Boom” generation has only just begun entering the older American voting bloc. He has calculated that the number of senior eligible voters will rise to 68 million in 2028 from 47 million in 2016.

But first, there is still a primary contest, and the age gap between Mr. Biden and Mr. Sanders has been on vivid display all year. The senator favored large rallies that attracted devoted young people, while Mr. Biden’s events, even in his strongest states, tended to be smaller, with crowds that tilted older.

Severe economic collapse, something like war, can bring changes so sudden that there is no time to adapt. Melissa Dellapasta, 45, was setting up a meal for executives of the Cleveland Indians on March 12 when everyone seemed to just get up and leave. An announcement had come: Baseball was postponed indefinitely. She has not worked since.

Young parents said they now understood the extreme stress their parents experienced when they had been laid off, a mood they mistook as just another bout of grown-up grumpiness.

He was essentially ordering the company to do something it had already arranged to do: G.M. announced earlier on Friday that it was moving forward with an emergency joint venture with a small manufacturer, Ventec Life Systems, even in the absence of a contract from the Federal Emergency Management Agency.

In a late-afternoon news conference, Mr. Trump said, “Now it turns out we will have to be producing large numbers.” He said that over the next 100 days, “we will either make or get, in some form, over 100,000 additional units,” more than three times the nation’s annual production.

Mr. Trump’s announcement at his coronavirus task force’s daily briefing came on a day of intensive criticism of the administration’s slow response and lack of leadership in a pandemic that has now resulted in over 1,500 deaths in the United States. More than 100,000 people here have been infected with the coronavirus, according to a New York Times database. The United States is the only country so far to hit that milestone.

Much of the criticism has focused on the absence of sufficient stockpiles of basic materials like masks and ventilators, and especially on the lack of urgency in organizing increased production and distribution.

Officials in more than 200 American cities, large and small, report a dire need for face masks, ventilators and other emergency equipment to respond to the coronavirus outbreak, according to a survey released on Friday.

More than 90 percent — or 192 cities — told the conference that they did not have an adequate supply of face masks for police officers, firefighters or emergency workers. In addition, 92 percent of cities reported a shortage of test kits to diagnose who has contracted the virus — a problem Mr. Trump has said in recent days was all but solved — and 85 percent said they did not have a sufficient supply of ventilators available to health facilities.

Roughly two-thirds of the cities said they had not received any emergency equipment or supplies from their state, the report said. And of those that did receive state aid, nearly 85 percent said it was not enough to meet their needs.

In total, the conference tabulated that cities needed 28.5 million face masks, 24.4 million other items of personal protection equipment, 7.9 million test kits and 139,000 ventilators.

In New York, the epicenter of the virus in the United States, doctors and nurses have reported that they were being forced to experiment with putting several patients on a single ventilator — a largely untested, unapproved practice that state authorities are now permitting in an effort to keep alive older adults or immunocompromised patients who could not breathe on their own.

“I don’t believe you need 40,000 or 30,000 ventilators,” Mr. Trump said Thursday night, discussing an urgent request from Gov. Andrew M. Cuomo of New York. “You know, you’re going to major hospitals sometimes, they’ll have two ventilators. And now, all of a sudden, they’re saying, can we order 30,000 ventilators?”

Mr. Trump’s abrupt change on the need for ventilators appeared to be in response to news reports that his administration had decided at the last minute not to announce a $1.5 billion contract with G.M. because of concern about the high cost and slow delivery of the machines.

Because Mr. Trump played down the severity of the coronavirus for much of January and February, and into the beginning of March, the White House got a late start in assessing how much equipment would be needed.

The White House had been preparing to unveil the G.M.-Ventec joint venture this week, and had hoped to announce that upward of 20,000 ventilators would be available in weeks, and that ultimately 80,000 would be produced. But the company complained that FEMA would not commit to spending the $250 million or so it would take to retool the factory.

Multiple times throughout Friday's press briefing, the President claimed the current situation was unprecedented and unforeseen. According to Trump, "nobody was prepared for this," not even past presidents. He added, "In all fairness to all of the former presidents, none of them ever thought a thing like this could happen."

This is false. The US intelligence community and public health experts had warned for years that the country was at risk from a pandemic. Experts had also warned that the country would face shortages of critical medical equipment, such as ventilators, if a pandemic occurred.

Trump said of the coronavirus: "You can call it a germ, you can call it a flu, you can call it a virus, you know you can call it many different names. I'm not sure anybody even knows what it is."

You cannot accurately call the coronavirus "a flu." They are, simply, different viruses with different characteristics, though they share some symptoms the coronavirus has a much higher mortality rate.

it's significantly more serious" -- with a mortality rate approximately 10 times higher than the 0.1% for the flu. It's also obviously untrue that there is not "anybody" who knows what the coronavirus is.

He saved himself from larger losses by selling a big chunk of his Amazon shares in February, before the worldwide scale of the coronavirus crisis was fully acknowledged and before the stock market collapse

Bezos sold $3.4bn worth of Amazon shares in the first week of February, just before the stock price peaked.

his timing was near-perfect. The share sales, which represented about 3% of his total holding, were much greater than Bezos had made in previous months. The stock sold was as much as he had sold in the previous 12 months, according to analysis by the Wall Street Journal.

Other US executives that have been either lucky or smart by selling large chunks of their shareholdings in February include Larry Fink, the chief executive of fund manager BlackRock, who saved potential losses of $9m, and Lance Uggla, CEO of data firm IHS Markit, who sold $47m of shares on 19 February that would have dropped to $19m if he had held on to them.

In total US executives sold about $9.2bn in shares of the companies they run in the five weeks before the start of the stock market rout. Selling before the 30% collapse in the market saved them from paper loses of $1.9bn.

The UN’s general assembly can step in where the security council has failed, and is currently considering a resolution to uphold the organisation’s central role in fighting the pandemic and to ensure that “there is no place for any form of discrimination, racism and xenophobia in the response to the pandemic”.

But some diplomats voiced concern that if the security council becomes less visible at the height of the pandemic, it will lose its centrality as an arena in which the world’s most powerful governments are held to account.

People have to understand that when we overrun our healthcare – our hospitals – that people will still come in with heart attacks, people will still have car accidents. These things that happen every day on top of Covid-19 will make our healthcare system collapse in the same way that you’re seeing that happen in New York and you’re seeing it happen across the globe,”

Until Wednesday morning, Georgia also had the fourth-highest death toll of coronavirus patients, until Louisiana’s cases soared. With over half a dozen Georgia hospitals shutting down during the past decade across rural communities, much of the state’s healthcare has been lacking. In 2017, a study found Georgia had one of the worst healthcare systems in the country, ranking it 49th for access.

It was operating at 125% capacity as of Thursday morning, with dozens more people lined up outside seeking tests and treatment.

In the Elmhurst and the nearby Corona neighborhood, one in four people lack health insurance. One in four live in poverty. Those numbers have probably grown since Covid-19 put a record 3 million Americans out of their jobs, with more expected to file for unemployment next week.

New York City is home to 560,000 undocumented immigrants. There is a gulf between the sort of healthcare an undocumented immigrant and a native-born American can access. A city report found 94% of US-born New Yorkers had health insurance, compared to only 42% of undocumented immigrants, in 2018.

Like so many other hospitals in the US and across the world, Elmhurst has also been struggling with a lack of vital equipment and protective gear for medical workers, to help prevent them contracting the disease.

Under normal circumstances, Elmhurst has a 15-bed intensive care unit. Now, it is full with Covid-19 patients who require invasive intubation to be on ventilators. As of Thursday morning, 45 of the hospital’s now 63 ventilators were in use, a person with knowledge of hospital inventory said.

In the last 48 hours, 50 additional hospital staff have been sent to Elmhurst hospital, and 60 patients transferred elsewhere to try to alleviate the strain on hospital staff. De Blasio said he is transferring another 40 ventilators to the hospital.

That was before more than 68,000 people in the United States tested positive for the coronavirus, grinding the country to a halt, upending lives from coast to coast, and postponing primary elections in many states. The virus has made the stakes, and the differing visions the two parties have for health care in America, that much clearer.

“Sometimes these health care debates can get a bit abstract, but when it’s an immediate threat to the health of you and your family, it becomes a lot more real.”

While the Democrats spent much of their primary fighting about whether to push for “Medicare for all” or build on the Affordable Care Act, the coronavirus crisis may streamline the debate to their advantage: At a time when the issue of health care is as pressing as ever, they can present themselves as the party that wants people to have sufficient coverage while arguing that the Republicans do not.

“A crisis like the coronavirus epidemic highlights the stake that everyone has in the care of the sick,” said Paul Starr, a professor of sociology and public affairs at Princeton who served as a health policy adviser in the Clinton White House. “It really strengthens the Democratic case for expanded health coverage, and that should work, I should think, to Biden’s advantage in a campaign against Trump.”

The virus is also having dire economic consequences, depriving Mr. Trump of a potent re-election argument rooted in stock market gains and low unemployment numbers. It is testing Mr. Trump’s leadership in the face of a national emergency like nothing he has encountered, and if voters give him poor marks, that could inflict lasting damage on his chances in November’s general election.

Four years ago, Mr. Trump ran for president promising to repeal the Affordable Care Act, popularly known as Obamacare. But his campaign pledge quickly turned into a debacle in the first year of his presidency when Republicans struggled and ultimately failed to repeal and replace the health law. In the midterm elections the next year, Democrats emphasized health care, highlighting issues like preserving protections for people with pre-existing conditions, and they won control of the House.

Mr. Trump is particularly vulnerable on the issue of health care. Over the course of his presidency, his administration has repeatedly taken steps to undermine the Affordable Care Act, including by arguing in court that the entire law should be invalidated. The Supreme Court agreed this month to hear an appeal in that case, which is the latest major challenge to the law. The court is not expected to rule until next year, but Democrats point to the Trump administration’s legal position as yet another example of the president’s desire to shred the Affordable Care Act.

In his campaign, Mr. Biden has already put a focus on health care, promising to build on the Affordable Care Act and create a so-called public option, an optional government plan that consumers could purchase. On the campaign trail, he has talked about his own exposure to the health care system

In the Democratic primary race, the health care debate has largely focused on the divide between moderate-leaning Democrats looking to build on the Affordable Care Act and progressives calling for Medicare for all, a government-run health insurance program. Mr. Biden and Mr. Sanders represent the two sides of that argument.

In a poll this month by Morning Consult, four in 10 Americans said the coronavirus outbreak had made them more likely to support universal health care proposals in which everyone would receive their health insurance from the government.

“We usually do about two storage deals a day,” said Mr. Barsamian, who runs a company in Princeton, N.J., called the Tank Tiger, a nod to the local university’s mascot. “We have done about 120 in the last couple of weeks.”

People in the energy industry say they have never seen changes happening at the speed and magnitude that are occurring because of the coronavirus.

The first major downturn in demand occurred in February when China, the world’s largest energy consumer, shut down much of its economy in an effort to stabilize the spread of the coronavirus. Now, the slowdown is rolling across the world, with much of Europe and major parts of the United States in lockdown.

The price war between Saudi Arabia and Russia has exacerbated the situation. The Saudis are slashing prices and threatening to ramp up oil output by about 25 percent to 12 million barrels a day, beginning in April. The surplus, IHS Markit forecasts, could add up to a tank-busting one billion barrels or more.

Not only does oil need a place to go, but the state of the oil market has provided traders with an opportunity to make money. They are taking advantage of a market where prices in the future are much higher than current levels. For instance, a barrel of light, sweet U.S. crude is priced at about $25 a barrel for May, about $6 lower than August. So a trader or an oil company can make easy money by buying oil at today’s depressed prices, selling it on the futures market and pocketing the difference minus storage and other costs — a situation known as contango.

Knowing how much oil is stored around the world is a key metric to “understanding the health of the oil market,” said Hillary Stevenson, an analyst at Genscape, a market intelligence firm. But, she warned, “capacity is finite; the safety net is only so big.”

One sign of a glut: The volume of oil placed on ships to wait for better days has grown by about 25 percent in March. According to Mr. Booth, about 81 loaded tankers — an unusually high number — are loitering off coasts around the globe.

The fact that oil is being put on ships, a more costly proposition than storage on land, implies that the world is running out of room, at least in some places, Mr. Booth said. Chinese buyers, perhaps seeing current prices as a bargain, continue to import at high levels, he said. Mr. Booth estimated that three-quarters of a billion barrels of usable storage capacity remained around the world — not enough room for the buildup in supplies some forecasters are predicting.

In the wake of price-cutting by Saudi Arabia and other countries, oil companies in the United States are being paid less. On Tuesday, Enterprise Products, an Oklahoma company, posted prices for various grades of crude that ranged as low as $7.61 a barrel.

Space is running out in western Canada, whose 40 million barrels of storage is now more than three-quarters full, according to Rystad Energy, which estimates that producers will need to slash production by 11 percent

Earlier in the week, he said he wanted to reopen the country for business by Easter, on April 12, despite widespread warnings from health officials that the worst effects of the virus were still weeks away and prematurely lifting social distancing guidelines would result in unnecessary deaths.

As a practical matter, however, Mr. Trump does not have the power to decide whether the country can reopen. He can issue federal guidelines, but the decision of whether to return to business as usual is up to each state.

But public health experts warned that there needed to be a nationwide approach to fighting the spread of a virus that could easily move around the country just as it has done around the globe. And many expressed horror at the idea of pulling back on mitigation efforts too early.

Ever since President Trump came into office, a record high turnover and unfilled jobs have emptied offices across wide sections of the federal bureaucracy. Now, current and former administration officials and disaster experts say the coronavirus has exposed those failings as never before and left parts of the federal government unprepared and ill equipped for what may be the largest public health crisis in a century.

Some 80 percent of the senior positions in the White House below the cabinet level have turned over during Mr. Trump’s administration, with about 500 people having departed since the inauguration

At the Department of Veterans Affairs, workers are scrambling to order medical supplies on Amazon after its leaders, lacking experience in disaster responses, failed to prepare for the onslaught of patients at its medical centers.

Equally notable may have been the resignation last year of Scott Gottlieb, the commissioner of the Food and Drug Administration, who was an early advocate for broad coronavirus testing and stronger mitigation policies. He was succeeded by Dr. Stephen M. Hahn, a noted oncologist, who has struggled during Senate hearings to explain some of his positions. The agency is largely viewed as slow in engaging the private sector to develop tests for the coronavirus. Many members of Mr. Gottlieb’s team departed with him, leaving the agency with many people new to their jobs.

The Department of Homeland Security, the agency tasked with screening at airports and carrying out the travel restrictions that were Mr. Trump’s first major action to combat the coronavirus, is full of vacancies. Of the 75 senior positions listed on the department’s website, 20 are either vacant or filled by acting officials.

Even National Park Service vacancies have taken a toll. The park service — which has its own police force — in recent days closed some parking lots near the Tidal Basin on the National Mall, where the cherry blossoms attract huge crowds each year, and urged people to stay away. Mayor Muriel Bowser stepped in and limited access to the area and sent police officers and members of the National Guard to enforce the shutdown.

Even the Pentagon, which is broadly viewed as better positioned than many other agencies for the pandemic response, is not immune. More than a third of all Senate-confirmed civilian positions at the Defense Department are vacant or filled by temporary officials, a peak level for the administration outside of the transition period, according to Pentagon statistics. Of 60 senior positions, 21 lack permanent appointees.

Cases in the United States now exceed 80,000, the most of any nation, even China and Italy, according to a New York Times database, and more than 1,000 deaths across the country have been linked to the virus.

President Trump said the federal government planned to designate areas as being at high, medium or low risk for spreading the virus to guide local decisions on imposing or relaxing restrictions on movement and commerce.

The terrifying speed of the U.S. economic collapse from the pandemic has spurred lawmakers to action. Late Wednesday night, senators agreed on a $2 trillion aid package that would provide cash payments to nearly all Americans and would expand the unemployment system, among other changes. Final congressional approval is expected on Friday.

A three-day rally has lifted stocks in the S&P 500 index more than 17 percent, including a rise of 6.2 percent on Thursday, though prices remain far lower than they were a month ago.

Some part-time and low-wage workers don’t qualify for unemployment benefits. Nor do gig workers, independent contractors and the self-employed, although the emergency aid package passed by the Senate would broaden eligibility to include many of them. Others who do qualify may not know it

The congressional relief package is intended to, in effect, press “pause” on the economy, allowing idled workers and shuttered businesses to keep paying their bills so that they can spring back quickly once the health crisis eases. If it works, the recovery could be relatively swift; if it doesn’t, the cascade of layoffs and business failures could stretch on far longer.

Low-wage workers — many of them black, like Ms. Moore-Caraway, or Hispanic — have been hit especially hard by the sudden economic reversal. Many work in the industries most affected by the outbreak, such as restaurants and travel, and few can work from home. They are also less likely to have sick leave or other paid time off, and they have less money saved to help overcome a missed paycheck.

Black and Hispanic workers “always bear the brunt” of economic slowdowns, said Alix Gould-Werth, a researcher at the Washington Center for Equitable Growth, a left-leaning think tank. “Now they’re bearing the brunt of these twin crises, the health crisis and the economic crisis.”

Under the congressional aid package, most families would receive $1,200 per adult and $500 per child in direct payments. The bill would also increase unemployment benefits by $600 a week and extend how long laid-off workers could receive benefits. And it would waive some requirements for receiving jobless benefits, like the requirement that recipients look for work.

An earlier relief bill, passed by Congress last week, provided $1 billion to help state unemployment systems that are breaking under the stress of record call volumes. Departments across the country reported huge spikes in call volumes and online applications.

The current rules, written during the Obama administration, are now up for review, and Trump administration appointees do not want to further tighten controls on the industrial pollutant, which contributes to lung disease. But in a draft analysis of the soot regulations, scientists included data showing that by tightening the existing standard by 25 percent, as many as 12,150 lives could be saved a year. That data may be a powerful weapon for promised legal challenges to the stay-the-course soot rule.

And this winter, as Trump administration officials worked on a rollback of Obama-era fuel economy standards, political appointees found themselves at odds with their career staff, combing through thousands of pages of analysis to find what Thomas J. Pyle, a Trump campaign adviser in 2016, called “trip wires that E.P.A. staffers were setting” in their work. There is no accusation, however, that any data was false or that E.P.A. employees were engaged in scientific misconduct.

Civil servants who have served in the federal government for decades said that the efforts by the Trump Administration to roll back environmental regulations were sharply different from those of previous administrations.“In previous administrations, we did not always agree with the policies, but when we did new rules, we spent years reviewing the data, the science, the economics, as the law says to do,” said Elizabeth Southerland, who joined the E.P.A. during the first George Bush administration and resigned in 2017 from her position as a senior official in the agency’s clean water program. “But what these guys have done is come in and repeal and replace, without relying on data and science and facts.”

But E.P.A. scientists who reviewed the health data concluded the current rule was still killing people and wanted their warnings made public.So on Page 181 of a draft 457-page scientific risk assessment, they placed critical data points. The scientists estimated that the current standard, which allows for 12 micrograms of fine soot per cubic meter of air, is “associated with 45,000 deaths” annually. In a separate paragraph, the scientists wrote that if the rule were tightened to nine micrograms per cubic meter, annual deaths would fall by about 27 percent — or 12,150 people a year.

A final version of the report, published in January to preview the still-unpublished rule, does say the rule as it stands contributes to 45,000 deaths annually, but it also says only that tightening it would reduce “health risks,” not deaths.

Such advice guided dozens of scientists, lawyers and engineers who wrote President Barack Obama’s Clean Power Plan to cut planet-warming carbon dioxide emissions from power plants and give a boost to renewable energy. When the same civil servants were directed to undo it and create a more coal-friendly version, some of those who remained at the E.P.A. made sure the documents accompanying the proposed replacement included the fact that increased coal pollution would cause 1,400 new premature deaths a year.

The scientists have some legal protection. On climate change, the Global Change Research Act of 1990 legally mandates that 13 federal agencies work together to produce a comprehensive report every four years on the impact of planetary warming on the United States. After the 2018 assessment concluded that climate change could knock as much as 10 percent off U.S. economic production by the century’s end, White House officials decided the law mandating the report made suppressing or altering it too legally risky.