DETROIT — The coronavirus continued its unrelenting spread across the United States, with a sharp rise in fatalities and pummeling major cities like New York, Detroit, New Orleans and Chicago, where an infant that tested positive for the virus died Saturday. It made its way, too, into rural America, where hotspots erupted in ski havens in the Rockies and small towns in the Midwest.

Confirmed U.S. coronavirus-related deaths doubled in two days, hitting 2,000 on Saturday evening, based on reporting from state health departments, according to the Washington Post.

It took about a month from the first confirmed death for the United States to record 1,000, but the toll has risen rapidly, and officials say the worst is yet to come. The earliest death was announced in Washington state on Feb. 29.

The sharp rise in fatalities comes as the pandemic’s epicenter has shifted to the United States, where reported infections are approaching 120,000 and where President Trump said the federal government may enforce a quarantine on the hard-hit New York area. Officials and health professionals in New York and around the country have been sounding alarms that hospitals are not prepared for an influx of coronavirus patients.

Elsewhere, Russia announced a full border closure while in parts of Africa, pandemic prevention measures took a violent turn, with Kenyan police firing tear gas and officers elsewhere seen on video hitting people with batons.

Worldwide infections surpassed the 650,000 mark with more than 30,000 deaths as new cases also stacked up quickly in Europe, according to a tally by Johns Hopkins University. The U.S. leads the world in reported cases, but five countries exceed its death toll: Italy, Spain, China, Iran and France. Italy alone now has more than 10,000 deaths, the most of any country.

Illinois Gov. J.B. Pritzker said Saturday that an infant with COVID-19 died and the cause of death is under investigation. Officials didn’t release other information about the infant, who was from Chicago’s Cook County, including whether the child had other health issues.

“If you haven’t been paying attention, maybe this is your wake-up call,” said Illinois Department of Public Health Director Dr. Ngozi Ezike.

New York remained the worst-hit U.S. city. Gov. Andrew Cuomo said defeating the virus will take “weeks and weeks and weeks.” The U.N. donated 250,000 face masks to the city, and Cuomo delayed the state’s presidential primary from April 28 to June 23.

As President Trump made his way to Norfolk, Virginia, to see off a U.S. Navy medical ship sent to New York City to help, he suggested imposing some kind of quarantine for New York and parts of New Jersey and Connecticut, all hit hard by the coronavirus. The federal government generally does not have the power to impose such restrictions on states.

But some states without known widespread infections began to try to limit exposure from visitors from their stricken neighbors.

In Rhode Island, Gov. Gina Raimondo said Friday that the state National Guard would go door to door in coastal communities to find visitors from New York. and advise them about a mandatory 14-day quarantine for people from the state.

Florida Gov. Ron DeSantis, a Republican and close Trump ally, told reporters he had spoken with the president about the possibility of a quarantine for the greater New York City area. DeSantis already ordered anyone arriving from Louisiana to self-quarantine and said law enforcement officers would set up checkpoints to screen cars from Louisiana.

Louisiana has surpassed 3,300 infections, with 137 dead from COVID-19, according to the health department. Gov. John Bel Edwards said the region was on track to run out of ventilators by the first week of April.

Cases also have been rising rapidly in Detroit, where poverty and poor health have been problems for years. The number of infections surged to 1,381, with 31 deaths, as of noon Saturday. The city’s homeless population is especially vulnerable, officials said.

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

“This is off the charts,” she said.

Chopra said many patients have ailments like asthma, heart disease, diabetes and hypertension. She also acknowledged that in Detroit, one of the nation’s largest African American cities, there is a distrust among some in the community of the medical system and government due to systemic racism.

“In Detroit, we are seeing a lot of patients that are presenting to us with severe disease, rather than minor disease,” said Chopra, who worried about a “tsunami” of patients.

Trump approved a major disaster declaration for Michigan, providing money for the outbreak. He has done the same for New York, Louisiana and Illinois.

Cases in Chicago and suburban Cook County accounted for about three-fourths of Illinois’ 3,026 total as of Friday. Chicago Mayor Lori Lightfoot closed popular lakeshore parks after people failed to practice social distancing, despite a statewide shelter-at-home order.

The governor of Kansas also issued a stay-at-home order to begin Monday, as the virus takes hold in more rural areas where doctors worry about the lack of ICU beds.

A cluster of three counties in rural Indiana have surging rates of confirmed cases. One of them, Decatur, population 26,000, has 30 cases with one confirmed death and another suspected, said Sean Durbin, the county’s public health emergency preparedness coordinator. Several cases were traced to large gatherings earlier in the month, including a religious retreat and a high school basketball tournament.

The disease will be particularly devastating in close-knit rural communities where everyone knows everyone, Durbin said, adding that he was a friend of the person believed to have died from the virus as well as others currently in critical condition.

The health department has already run out of personal protective equipment, Durbin said. The last supply from the federal stockpile arrived more than a week ago, and contained just 77 N95 masks and two dozen face shields.

“I wish there was a stronger word for disappointed, I’m calling on them to do better,” he said of the help they’ve gotten from the government.

The virus is straining health systems in Italy, Spain and France. Lockdowns of varying degrees have been introduced across Europe, nearly emptying streets in normally bustling cities.

Germany has fewer deaths than some neighboring countries but has closed nonessential shops and banned public gatherings of more than two people until April 20. It still had its share of grim news, with 12 residents of a nursing home in the northern town of Wolfsburg dying since Monday after being infected, news agency dpa reported.

Italian Premier Giuseppe Conte announced he had signed a decree freeing up 400 million euros ($440 million) for coupons and packages of food aid, to be delivered door-to-door if necessary.

“People are suffering psychologically. They’re not used to staying in their homes. But they are also suffering economically,” Conte said. Italy has almost completed a three-week lockdown, with no end in sight.

In Spain, where stay-at-home restrictions have been in place for nearly two weeks, the death toll rose to 5,812.

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

Spanish Prime Minister Pedro Sánchez called for a more vigorous response from the European Union. Spain, Italy, France and six other members have asked the union to share the burden of European debt, dubbed “coronabonds” in the media, to help fight the virus. But the idea has met resistance from other members, led by Germany and the Netherlands.

“It is the most difficult moment for the EU since its foundation and it has to be ready to rise to the challenge,” Sánchez said. “

As the epicenter has shifted westward, the situation has calmed in China, where some restrictions have been lifted. Some subway service was restored in Wuhan, where the virus first emerged in December, after the city of 11 million had its virus risk evaluation reduced from high to medium.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. But for others, especially older adults and people with existing health problems, the virus can cause more severe illness, including pneumonia, and lead to death.

More than 135,000 people have recovered, according to Johns Hopkins.

Countries are still trying to bring home citizens stranded abroad. On Saturday, 174 foreign tourists and four Nepali nationals in the foothills of Mount Everest were flown out days after being stranded at the only airstrip serving the world’s highest mountain.

Indian authorities sent buses to the outskirts of New Delhi to meet an exodus of migrant workers desperately trying to reach their home villages amid the world’s largest lockdown that effectively put millions out of work.

Russian Prime Minister Mikhail Mishustin ordered his country’s borders fully closed as of Monday, exempting diplomats as well as residents of the exclave of the Kaliningrad region.

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