The tension is palpable. There is no non-essential talking. An orchestra of medical monitors marks the tempo with an endless series of soft, distinct beeps.
Never have so many people been inside the library of the Germans Trias i Pujol hospital in northeastern Spain. But the health care workers in improvised protective gear aren't consulting medical books. Instead, they're treating patients in critical condition suffering from pneumonia caused by the coronavirus.
From the outside, this makeshift intensive-care unit in Badalona, near Barcelona, looks nothing like a library. The bookshelves have been removed to make room for up to 20 hospital beds, breathing machines and an array of medical equipment after the longstanding ICU and other areas of the hospital flooded with COVID-19 patients.
With the scarcity of full-body protective suits across Spain, doctors and nurses are employing what they can find, reusing masks, layering oversized surgical gowns with plastic aprons and running through an infinite number of latex gloves.
Like scuba divers, they apply a small dose of detergent to their goggles just before stepping into the sweltering, virus-laden room in the hopes of mitigating the inevitable fogging of their eye protection caused by their own breathing. They'll be at it for hours, racing from patient to patient, sweating under all the layers.
A team of Associated Press journalists enters the room to document the work, but their presence is barely noticed. Health workers remain focused on their essential tasks -- monitoring vitals, administering medication, manipulating the tubes and cords connecting the patients to a plethora of machines.
Most patients are intubated and hooked up to ventilators; about half have been flipped onto their stomachs to ease pressure on their lungs and help their breathing. Nurses acknowledge this is not a hopeful sign.
As Spain sees the rate of infections slowly stabilize, it continues logging a daily record number of deaths – Thursday set a new mark, with 950 deaths in 24 hours. More than 10,000 people have died in Spain thus far.
The patients in this alternate ICU will likely spend weeks in the hospital before their battle with the virus is won or lost. They fight for life without their loved ones, who are unable to visit them.
Nurses on the other side of the glass observe their movements, typing away on computers. Communicating on walkie-talkies, those inside give them the latest developments: "37.8C." One of the patients has a fever again. Medication is then injected into the IV bag.
Time floats, and not just because the nurses are unable to see their watches from behind their foggy goggles.
As one person's shift ends, the laborious process of leaving the ICU begins. Nurses exit via a designated door and remove their now-contaminated armor, one piece at a time. Goggles go into one bucket, gowns in another. The outer layer of gloves and aprons are thrown into the trash.
A weight is lifted off their shoulders as they leave the ICU behind. But another weight takes its place in the form of a haunting question: Will the virus follow them home?
Speaker Nancy Pelosi said Thursday she will establish a special House committee with subpoena power to oversee the government's spending of the more than $2.2 trillion approved to bolster the economy hard hit by the coronavirus pandemic.
Pelosi, D-Calif., described her plans during a conference call with reporters, even as she said that the day's report of a staggering 6.6 million more people filing for unemployment benefits had increased the urgency for a federal response.
Pelosi and President Donald Trump have both suggested fresh legislation spending $2 trillion for new infrastructure projects, but even under the coronavirus crisis its prospects seemed unclear.
Pelosi said the new bipartisan panel would be headed by No. 3 House Democratic leader James Clyburn of South Carolina. It would seek to ensure there is waste, profiteering, price gouging or political favoritism as Washington pumps huge sums into the economy to pay unemployment, protect jobs and businesses and fortify the health care system.
""The committee will be empowered to examine all aspects of the federal response to the coronavirus, and to assure that the taxpayers' dollars are being wisely and efficiently spent to save lives, deliver relief and benefit our economy," she said.
For years, both parties have said they favor job-creating infrastructure spending but have been deadlocked over how to finance it. That's led to jokes about "infrastructure week" — shorthand for Trump plans to roll out proposals that never materialize.
This time, talk of a massive infrastructure effort comes as leaders of the mostly locked-down country desperately try averting the worst economic collapse since the Depression.
Yet even with both sides agreeing that infrastructure can be a reliable way of creating jobs and modernizing systems that themselves add muscle to the economy, it's unclear they can reach an election-year compromise.
"A lot of this is theater, staking out the high ground for the fight that's coming,'' said Liam Donovan, a lobbyist who's specialized in infrastructure work.
Pelosi and other top Democrats sketched out their own evolving infrastructure plan on Wednesday.
Its anchor would be a $760 billion package for roads, mass transit, water systems and high-speed internet networks, with more money coming for education, housing and community health centers. Democrats offered no apologies that their plan included clean energy and other environmental proposals.
"If you're going to rebuild it, it's rebuild it the right way," said Rep. Peter DeFazio, D-Ore., chairman of the House Transportation and Infrastructure Committee.
Trump made his proposal by tweet on Tuesday, saying the plan should be "VERY BIG & BOLD, Two Trillion Dollars." He elaborated later to reporters.
"We redo our roads, our highways, our bridges. We fix up our tunnels, which are, many of them, in bad shape," he said.
Congress' top Republicans have been guarded about the idea but have stopped short of ruling it out.
Senate Majority Leader Mitch McConnell, R-Ky., said he'll oppose any Democratic effort to use a fresh economic recovery bill to advance environmental restrictions or other policy preferences. "We need to make certain that any further actions we take are directly related to this public health crisis." McConnell told told Fox News Radio's Guy Benson on Tuesday.
"This isn't a time to attempt to reshape American life through the eyes of one political party," said House Minority Leader Kevin McCarthy, R-Calif.
Other Republicans are also tapping the brakes, saying any decision should await a fresh view of the economy when Congress returns to Washington. With lawmakers scattered around the country, that won't be until late April, at the earliest.
"If we find ourselves where the economy needs a stimulus, to me a highway infrastructure bill would be a key component of that," Sen. John Barrasso, R-Wyo., chairman of his chamber's Energy and Public Works Committee, said in an interview.
Underscoring the range of support for infrastructure, groups praising the effor included the nonpartisan Environmental Working Group, five steel industry trade organizations and the National Association of Counties.
Other prominent players were less enthusiastic.
The U.S. Chamber of Commerce said it favors increased infrastructure spending but prefers financing it by gradually raising federal fuel taxes. Those levies have been stuck at 18.4 cents per gallon for gasoline and 24.4 cents for diesel since 1993 and are not adjusted for inflation.
The Committee for a Responsible Federal Budget, a bipartisan anti-deficit group, rejected Trump's argument that today's near-zero interest rates made infrastructure spending appealing.
"Just because borrowing is cheap right now doesn't mean it's free," said Maya MacGuineas, the committee's president.
Trump promised a $1 trillion plan during his presidential run, paid for largely by private investments. Democrats opposed that approach.
Last spring, Pelosi and Senate Minority Leader Chuck Schumer, D-N.Y., emerged from a White House meeting to say they'd tentatively agreed with Trump to work on a $2 trillion infrastructure package. That blew up days later during a White House meeting that disintegrated after Trump exploded over Congress' investigation into Russia's aid to his presidential campaign.
The Republican-led Senate and Democratic-controlled House each have plans that have stopped short of final approval.
Barrasso's Senate Environment and Public Works Committee unanimously approved a bipartisan bill last summer mapping $287 billion for roads and bridges. In January, DeFazio's House panel outlined a broader $760 billion plan for roads, broadband and other projects that is now embodied in Pelosi's package.
Prospective Democratic presidential nominee Joe Biden said he thinks his party's nominating convention will have to be pushed back from July into August because of the coronavirus threat. "It's going to depend on what kind of action is taken between now and the middle of the summer to change this curve," Biden said in a Wednesday interview with NBC late-night comedian Jimmy Fallon.
"I doubt whether the Democratic convention is going to be able to be held in early July, mid-July. I think it's going to have move into August. … You just have to be prepared for the alternative, and the alternative — we don't know what it's going to be." Those comments are the furthest Biden has gone in predicting a delay for the convention, which would mark the start of the general election campaign. The coronavirus pandemic is forcing Democrats and Republicans to take a close look at whether they'll be able to move forward as planned with their summer conventions. Democrats are scheduled to convene July 13-16 in Milwaukee. Republicans plan to gather Aug. 24-27 in Charlotte, North Carolina.
In an interview earlier this week with MSNBC, Biden said it's "hard to envision" a normal convention on that schedule. But the former vice president also noted on "The 11th Hour with Brian Williams" that Democrats "have more time" to figure things out as party officials consider contingencies that could range from an outright delay to making parts of the proceedings virtual so that not as many people attend.
"We were able to do it in the middle of a Civil War all the way through to World War II, have Democratic and Republican conventions and primaries and elections and still have public safety," Biden said on MSNBC. "We're able to do both."
Republicans, meanwhile, are expressing confidence they can pull off their convention as scheduled, but party Chairwoman Ronna McDaniel still allows for the possibility that the pandemic could upend GOP plans.
Neither Democratic nor Republican leaders want to sacrifice the boost that can result from an enthusiastic convention gathering. President Donald Trump thrives on big rallies and has obviously missed that part of his routine amid the coronavirus outbreak, reluctantly turning the Rose Garden and the White House briefing room into substitutes. A traditional convention, with a nationally televised nomination acceptance speech, could be even more critical for Biden, who has been relegated recently to remote television interviews from his Delaware home, unable to draw the kind of spotlight that a sitting president commands.
Democratic National Committee authorities based in Milwaukee are exploring various options should social distancing recommendations still be in effect in the summer months. Convention CEO Joe Solmonese hasn't publicly detailed any specifics, promising only that "we will balance protecting the health and well-being of convention attendees and our host city with our responsibility to deliver this historic and critical occasion."
Democrats originally scheduled their convention ahead of the Summer Olympics. But the international games have been postponed until 2021, opening several weeks on the summer television calendar if they could logistically manage a delay. Tradition dictates that Democrats, as the party out of power, hold their convention first.
Solmonese and his aides are expected in the coming weeks to present party Chairman Tom Perez with options. But Democrats' lingering nominating contest could complicate what happens next. Biden holds a prohibitive delegate lead that makes him the prospective nominee, but Vermont Sen. Bernie Sanders remains in the race and insists he has a "narrow" path to the nomination.
With many states pushing back their primaries, Sanders potentially could block Biden from accruing the required delegate majority until late June, just weeks before the current convention dates.
In a typical election, a convention effectively belongs to the nominee, so Perez would be reluctant to make substantial changes to the model without the candidate's approval. But he's also cognizant of Sanders supporters who still distrust DNC leadership after the bitter 2016 nominating fight that Sanders lost to Hillary Clinton.
The bottom line, Biden said, is that "we should listen to the scientists" and that the 2020 election, from conventions to voting methods, "may have to be different."
Republicans don't face the internal party uncertainty, though they still must weigh the same public health scenarios.
McDaniel, the RNC chairwoman, said she thinks "we should be out of this" by the end of August. In an interview, she said Republicans already have raised the money necessary for the convention and have the staff hired and in place.
"We're ready to go," she said. "This isn't something that's going to stop us."
Still, she added a caveat: "Obviously, science will dictate that."
Other aspects of the presidential campaign, meanwhile, continue unabated by the pandemic.
America First Action PAC, a Republican super political action committee backing Trump's reelection, announced a $10 million ad buy that will start in mid-April and continue throughout May in Michigan, Wisconsin and Pennsylvania. The digital, television and direct mail investment is the PAC's first spending against Biden, and it comes in key markets in the three states that provided Trump with his Electoral College margin in 2016.
Priorities USA, the largest Democratic super PAC, responded by adding $1 million to existing ad buys in that crucial trio of states.
Some African countries will have more than 10,000 coronavirus cases by the end of April, health officials projected Thursday, as the continent least equipped to treat serious infections has an "enormous gap" in the number of ventilators and other critical items.
While cases across Africa are now above 6,000 at what has been called the dawn of the outbreak, the continent is "very, very close" to where Europe was after a 40-day period, the head of the Africa Centers for Disease Control and Prevention, Dr. John Nkengasong, told reporters.
The virus "is an existential threat to our continent," he said. All but five of Africa's 54 countries have cases, and local transmission has begun in many of those with the virus.
Nkengasong said authorities are "aggressively" looking into procuring equipment such as ventilators that most African countries desperately need, and local manufacturing and repurposing are being explored.
"We've seen a lot of goodwill expressed to supporting Africa from bilateral and multilateral partners," but "we still have to see that translate into concrete action," he said.
The World Health Organization doesn't know how many ventilators are available across Africa to help those in respiratory distress, regional director Dr. Matshidiso Moeti told reporters. "We are trying to find out this information from country-based colleagues. ... What we can say without a doubt is there is an enormous gap."
Some countries have only a few ventilators. Central African Republic has just three.
A small percentage of people who are infected will need ventilators and about 15% may need intensive care, said WHO official Dr. Zabulon Yoti.
The health officials pleaded for global solidarity at a time when even some of the world's richest countries are scrambling for basic medical needs, including face masks.
"Countries like Cameroon just reached out yesterday, Ivory Coast, Burkina Faso, asking, 'Look, we need tents because we're running out of hospital beds already,'" Nkengasong said.
Even if equipment is obtained, getting them to countries is a growing challenge with Africa's widespread travel restrictions, though countries have made exceptions for cargo or emergency humanitarian flights.
Simply gauging the number of coronavirus cases in Africa is a challenge, even in South Africa, the most developed country on the continent, where authorities have acknowledged a testing backlog.
Other countries suffer from the widespread shortage of testing kits or swabs, though 43 countries in the WHO Africa sub-Saharan region now have testing capability, up from two in early February.
As more African countries impose lockdowns, both the WHO and Africa CDC expressed concern for the millions of low-income people who need to go out daily to earn their living. That's a "huge challenge," Moeti said, noting that hundreds of thousands of children are now out of school as well.
It is too soon to tell how the lockdown in places like South Africa has affected the number of cases, she added.
The lockdowns are causing unease. Police herded several hundred homeless people into a stadium in South Africa's capital, Pretoria, where tents were erected for shelter and methadone was provided for many. There were complaints about the lack of sanitizer or soap.
The first sub-Saharan African nation to impose a lockdown, Rwanda, has now extended it by two weeks, a sign of what might be to come for other nations.
"Don't lock down the whole country," Nkengasong said. "Lock down cities or communities where there's extensive community transmission so .. social harm is minimized. But if infection is spreading across the entire country, you have no choice."
Health experts in Africa are rushing to understand whether factors such as Africa's youthful population — some 70% of the continent's people are under age 30 — will be a benefit in fighting off the virus and how the widespread problems of malnutrition, HIV, tuberculosis and malaria might affect people's ability to fight off infection.
"Our greatest fear" is that programs tackling those perennial issues will be sapped by the current crisis, Nkengasong said. "The time to advocate for those programs is not when COVID is over. The time is now."
Dr. Meredith McMorrow, Medical Officer in the U.S. Centers for Disease Control and Prevention's influenza division, acknowledged to reporters that the U.S. is "suffering right now" and that limits the U.S. ability to respond with overseas aid. But she said the U.S. is helping African nations procure overseas equipment "as rapidly as possible."
The latest African nation to report its first virus death was Zambia.
Iran's parliament speaker Ali Larijani has contracted the coronavirus, the highest-ranking official among several senior government figures to catch the disease, as several top Israeli officials entered quarantine after Israel's health minister tested positive on Thursday.
The parliament in Iran, the regional epicenter of the coronavirus, announced Larijani's illness on its website, saying he was receiving treatment in quarantine.
Meanwhile Israel was rattled by the diagnosis of its health minister, who had frequent contact with Prime Minister Benjamin Netanyahu.
The Middle East has over 82,000 confirmed cases of the virus and over 3,600 deaths, most of them in Iran. Iran's Health Ministry said Thursday that the new coronavirus killed another 124 people, pushing the country's death toll to 3,160.
In a rare acknowledgment of the severity of the outbreak by a senior Iranian official, President Hassan Rouhani said the new coronavirus may remain through the end of the Iranian year, which just began late last month, state TV reported Thursday.
"We always have to follow the health protocols provided by the health ministry," Rouhani added.
In Lebanon, the Philippines ambassador, Bernardita Catalla, died of complications from the coronavirus Thursday, the Philippines said. Lebanon has recorded 494 cases, including 16 deaths.
Israel said Health Minister Yaakov Litzman and his wife, who also contracted the virus, are in isolation, feel well and are being treated.
Shortly after the announcement, Netanyahu's office said he returned to self-quarantine because of contact with Litzman. Netanyahu, who has tested negative, had previously been in isolation after a top aide tested positive for the virus.
Hebrew language media reported that the head of Israel's Mossad spy agency and the National Security Council were asked to self-quarantine because of their interactions with Litzman.
Israel has gone into near-lockdown to try to contain the outbreak. It has reported over 6,200 confirmed cases and 29 deaths of COVID-19, the illness caused by the virus.
Israel's large, insular ultra-Orthodox community, of which Litzman is a member, has been particularly hard hit. In the early phases of the outbreak, some rabbis had pushed back or ignored government-mandated movement restrictions, but resistance appears to have diminished.
For most people, the virus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, it can cause severe symptoms like pneumonia that can be fatal.
In Syria, the government extended the closures of mosques until April 16, nearly a week before the start of the holy month of Ramadan when Muslims spend more time in prayers and worship. It also extended indefinitely a ban on visits to prison and detention facilities, citing concerns over the spread of the virus, and expanded curfew times over weekend days.
Rights groups have called on Mideast governments to release thousands of political detainees held in crammed and unhygienic jails. In government-controlled Syria, 10 cases of infection and two deaths were reported, amid concerns the virus may be more widespread.
The World Health Organization said it was increasing preparedness in the rebel-controlled, northwestern region of Syria that is home to nearly 4 million people, most of them displaced by the war and repeated government offensives. Only half of the health facilities are functioning in rebel-held territory, where displaced camps are crowded and the virus' transmission would be fast once it reaches the area.
Meanwhile, the pandemic is expected to wipe out $23 billion in passenger revenue from airlines across the Middle East and Africa this year, according to an assessment Thursday by the aviation industry's largest trade association.
The International Air Transport Association said Mideast airlines will see a $19 billion drop in revenue this year, compared to 2019. Airlines in Africa, which include EgyptAir, are expected to see a $4 billion drop. Hundreds of thousands of job in the aviation sector are also at risk across both regions.
Saudi Arabia's revenue loss could exceed $5.6 billion this year, as all pilgrimage flights are currently halted in addition to commercial flights to and from the kingdom. The United Arab Emirates, home to world's busiest airport for international travel in Dubai, is projected to lose $5.4 billion in revenue.
Egypt and Qatar could also see more than $1 billion each in revenue loss, while the aviation sector in South Africa is expected to lose $2.3 billion in potential revenue.
IATA said projections are based on assumptions that travel restrictions will continue through the second quarter of 2020. Even if travel recovers partially in the second half of the year, it will be slow and impacted by an overall slump in the global economy and weakened passenger demand.