Fresh coronavirus outbreaks are testing public health networks and the resolve of planners to reopen from pandemic shutdowns.

Japan has pushed ahead with relaxing its state of emergency in most regions, not including Tokyo, Osaka and a few other districts.

In the Philippines, fears of spreading the virus complicated efforts to evacuate tens of thousands of people ahead of a typhoon that swept through overnight without causing major damage.

There was good news from China, where the virus first appeared and where no deaths have been reported in a month. The country confirmed four new cases linked to previous ones in Jilin, in the northeast.

Increasingly opening up from widespread shutdowns in February and March, China has maintained social distancing precautions and bans on foreigners entering the country. Its leaders have signalled their confidence with plans to hold the annual session of the communist-ruled country’s ceremonial legislature later this month.

Elsewhere, the trends were more troubling.

Mexico reported its largest one-day rise so far in coronavirus cases, with 2,409 confirmed, as health officials said the country was facing “the most difficult” moment in the pandemic.

It was the first time in Mexico that the number of new cases has exceeded 2,000 in one day. The country has recorded 4,477 deaths.

The increase in cases Thursday came just four days before key industries such as mining, construction and car assembly were due to reopen.

Coronavirus deaths and cases

Colombian President Ivan Duque has ordered all residents of the Amazonas Department, near the border with Brazil, to stay inside except to buy food or get medical care. Local hospitals are being overwhelmed as cases rise in a vulnerable part of the Amazon, home to many indigenous groups.

“The Amazon rainforest needs your help,” teenage climate activist Greta Thunberg said in an online video seeking assistance for Manaus, Brazil’s biggest city in the vast region.

According to official data, 809 people have died so far in Manaus and 9,410 have contracted the virus. But experts and people on the ground say the numbers are likely to be much higher and that people are dying at home, often buried in mass graves without having been tested and not making it into the official count.

In the US, protests and debate persist over how quickly to end shutdowns.

Two weeks into a reopening in Texas, where stay-at-home orders expired on May 1, single-day highs of 58 deaths and 1,458 new cases were reported on Thursday. With more restrictions due to end on Monday, including reopening gyms, confrontations were brewing between big cities trying to keep some precautions in place and state officials who want to push ahead.

In Virginia, two cities were asking governor Ralph Northam to delay the reopening planned for Friday, saying it is still too soon to ease restrictions. Kansas’ Democratic governor Laura Kelly hit the brakes on reopening her state’s economy, ordering bars and bowling alleys to stay closed through to the end of the month instead of reopening Monday. She is also keeping some coronavirus-inspired restrictions in place until near the end of June.

A key factor behind the fits-and-starts reopenings is pressure on overtaxed health systems facing crushing patient loads and struggling to obtain vital supplies of masks and other protective gear.

The head of a hospital system in Maryland’s Prince George’s County said the area’s intensive care units “are bursting at the seams”.

“I would say we are the epicentre of the epicentre,” said Dr Joseph Wright, interim CEO of University of Maryland Capital Region Health. He said the three emergency departments his medical system operates are steadily seeing upwards of 70 new Covid-19 confirmed and suspected patients every day.

“We are certainly still very much in a very busy phase of this surge,” Dr Wright said.

With more than 1.4 million infections and nearly 85,000 deaths, the US has the largest outbreak in the world by far, according to a tally by Johns Hopkins University. Worldwide, the virus has infected more than 4.4 million and killed over 300,000. Experts say the actual numbers are probably far higher.

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