The global COVID-19 death toll passed 200,000 today, with brisk activity continuing in US hot spots and growing in others. In Brazil, hospitals in several major cities are nearing collapse after surges of sick patients.

Today the global case total climbed to 2,887,894 in 185 nations, with fatalities reaching 202,368, according to the Johns Hopkins online dashboard. The US total is at 933,933, with 53,449 deaths.

White House mulls scaling back briefings

In the wake of the fallout over President Trump's recent comments about the potential use of disinfectants and light as medical treatment for COVID-19, the White House is considering scaling back on White House daily briefings, NBC News reported today.

According to other media sources, yesterday's briefing was short, and Trump didn't field any questions from the press. Medical members of the coronavirus task force such as Deborah Birx, MD, and Tony Fauci, MD, did not attend, and no briefings are scheduled for this weekend.

The president's aides and advisors are worried that the long briefings, which have numbered nearly 50 over the past 2 months, are politically damaging.

Meanwhile, in New York, Governor Andrew Cuomo today said about 1,100 people were hospitalized yesterday, which is more than officials want to see, but less than the state has seen in the past 21 days. He also said the state would expand COVID-19 testing criteria to frontline health workers, emergency responders, and essential workers.

"They are our heroes who are risking their health to get us through this crisis. They deserve priority for testing," he said on Twitter.

Cuomo also announced antibody testing for healthcare workers has begun at four hospital sites and signed an executive order allowing pharmacists to test for COVID-19.

Massachusetts cases surge

In Massachusetts, the third-worst-hit state, Governor Charlie Baker said the state is experiencing a case surge, though hospitals are prepared, CNN reported. He said 55% of the state's hospital beds are still available. Baker said the state is waiting to see if hospitalizations and other indicators drop before deciding to scale back stay-at-home orders, which are slated to end on May 4.

Elsewhere, COVID-19 cases are growing in more recently affected areas such as the Midwest and South, according to a study from the Dartmouth Atlas Project published on Apr 23 in Health Affairs. Based on county-level data, the group said cities where outbreak levels are rising fastest include Grand Forks, North Dakota; Sioux City, Iowa; Waterloo, Iowa; Columbus, Ohio; Green Bay, Wisconsin; Amarillo, Texas; Lincoln, Nebraska; Des Moines, Iowa; Wichita, Kansas; and Chattanooga, Tennessee. They also noted that some of the areas in which cases are accelerating, such as some Texas cities, are in states where governors are easing back on distancing orders.

In other US developments, the Centers for Disease Control and Prevention (CDC) has added six more symptoms to its COVID-19 list, according to an update on its website, CBS News reported. Originally, the CDC said fever, cough, and shortness of breath were the main symptoms. Now it has added chills, repeated shaking with chills, muscle pain, headache, sore throat, and recent loss of taste or smell.

Brazil testing lag leads to undercount

Brazil is testing people for COVID-19 at a vastly lower level than the rest of the world, and its global total is likely a big underestimate, the Wall Street Journal reported today. The country is testing 12 times less than Iran and 32 times less than the United States, and groups not getting tested include healthcare workers and people who die at home.

Cemetery workers attest to a surge of deaths in people with respiratory conditions, and researchers at some Brazilian universities estimate that cases could be 8 to 16 times higher than official numbers suggest. Some experts say the artificially low numbers are fueling the president's view that the outbreak isn't bad and is no worse than seasonal flu.

According to the Associated Press, health officials in Rio de Janeiro and four other big cities say their hospitals are near the verge of collapse or are too overwhelmed to take any more cases. An estimate from a group at the University of Sao Paulo said Brazil could already have 587,000 to 1.1 million cases. As of today, the country's official total is 58,616, with 4,016 deaths, according to the Johns Hopkins online dashboard.

Russian deaths rise

Russia today reported its highest 1-day death toll, with 66 confirmed, raising the fatality count to 681, Anadolu Agency news reported. Officials also reported 5,966 more cases, up from 5,849 reported yesterday.

Anna Popova, the country's chief sanitary officer, said 52% of Russia's cases are asymptomatic, a proportion that is growing, a concern that is pushing authorities to increase testing.

In China, the National Health Commission today reported 12 more cases, 11 imported and 1 local infection in Heilongjiang province, which is located in the northeast on the border with Russia and has reported outbreaks sparked by returning travelers.