MADRID — Bells tolled in Madrid’s empty central square and flags were lowered to half-staff in a day of mourning Monday in hard-hit Spain, while the top infectious-disease expert in the United States warned that smaller U.S. cities are about to witness the rapid acceleration in coronavirus cases that New York is seeing.
Dr. Anthony Fauci said on ABC’s “Good Morning America” that New Orleans and Detroit are showing signs that “they’re going to take off,” and other, smaller cities are “percolating.”
“What we’ve learned from painful experience with this outbreak is that it goes along almost on a straight line, then a little acceleration, acceleration, then it goes way up,” he said.
The warning came as virus deaths in New York surpassed 1,000, President Donald Trump extended social-distancing recommendations for a month in an abrupt turnaround, and the outbreak pushed the health systems in Italy and in Spain to the breaking point.
Spain reported more than 800 new deaths, raising its overall toll to more than 7,300.
Spain and Italy make up more than half the world’s death toll of more than 34,800 people from the virus that has upended the lives of billions and devastated world economies. Hospitals are buckling under the weight of caring for so many desperately ill patients at once. Italy has by far the most reported virus deaths, at nearly 11,000.
At least six of Spain’s 17 regions were at their limit of intensive care unit beds, and three more were close to it, authorities said. Crews of workers were frantically building more field hospitals.
Nearly 15 percent of all those infected in Spain, almost 13,000 people, are health care workers, hurting hospitals’ efforts to help the tsunami of people gasping for breath.
In hard-hit Madrid, flags were lowered for an official mourning period. During a minute of silence for the dead, Madrid’s Puerta del Sol square was empty as bells tolled.
In a situation unimaginable only a month ago, Italian officials were cheered when they reported only 756 new deaths in one day. Italy said the number of deaths has dropped about 10 percent a day since Friday.
”We are saving lives by staying at home, by maintaining social distance, by traveling less and by closing schools,” said Dr. Luca Richeldi, a lung specialist.
In a stark reversal, Trump extended federal guidelines recommending that Americans stay home for another 30 days until the end of April. The turnabout came after Fauci said up to 200,000 Americans could die and millions become infected if lockdowns and social distancing did not continue.
“We want to make sure that we don’t prematurely think we’re doing so great,” Fauci said.
The U.S. now has more than 143,000 infections and 2,500 deaths, according to Johns Hopkins University, while around the world more than 735,000 people are infected.
Moscow went on its own lockdown Monday as all of Russia braced for sweeping nationwide restrictions. The Russian capital of 13 million accounts for more than 1,200 of the country’s more than 1,800 coronavirus cases.
“The extremely negative turn of events we are seeing in the largest European and U.S. cities causes extreme concern about the life and health of our citizens,” Moscow Mayor Sergei Sobyanin said.
Experts say the critical situations seen in hospitals in Italy and Spain will be soon heading toward the United States.
In Italy, coronavirus patient Andrea Napoli, 33, said he didn’t remotely expect that he would be hospitalized, struggling for his life, since he was young and fit. But what he saw shocked him.
While he was being treated in Rome, three patients died in his ward. He saw doctors stressed and exhausted from the long hours, out of breath from pushing equipment around, dressed in protective masks, suits and gloves.
”What I saw was a lot, a lot of pain. It was very hard,” Napoli said. ”I heard screams from the other rooms, constant coughing from the other rooms.”
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms like pneumonia and be fatal. More than 150,000 people have recovered, according to Johns Hopkins.
China on Monday reported 31 new COVID-19 cases, among them just one domestic infection. At the peak of China’s restrictions, some 700 million people were ordered to stay home, but those rules are easing.
Cases across Africa rose close to 5,000 in 46 countries. Zimbabwe began a three-week lockdown Monday and more cities across the continent were shut down.
Japanese automaker Toyota halted production at its auto plants in Europe, though all its factories in China resumed production Monday.
Associated Press writers around the world contributed to this report.