As the United States led the world with confirmed coronavirus cases, cities such as Detroit, Chicago and New Orleans grew as hotspots Saturday, while the virus continued to pummel New York City and made its way into rural America.

Elsewhere, Russia said its borders would be fully closed as of Monday, 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 approached 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 with more than 115,000, but five countries exceed its roughly 1,700 deaths: Italy, Spain, China, Iran and France. Italy alone now has 10,023 deaths, the most of any country.

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.

But Cuomo said he knew nothing of President Donald Trump’s suggestion of 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. Trump made the comments on his way to Norfolk, Virginia, to see off a U.S. Navy medical ship en route to New York City to help with the response there.

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.

“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.

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.

Officials urged residents and businesses to donate protective gear such as masks, gloves and face shields at New Orleans’ fire stations.

Worried that people would flee New Orleans, Florida Gov. Ron DeSantis ordered anyone arriving from Louisiana to self-quarantine. He said the Florida Highway Patrol and sheriff’s deputies will set up checkpoints to screen cars from Louisiana.

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.

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

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.

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 still closed nonessential shops and banned public gatherings of more than two people until April 20. But 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.

Spain, where stay-at-home restrictions have been in place for nearly two weeks, reported 832 more deaths Saturday, its highest daily count yet, bringing its total to 5,690.

Another 8,000 confirmed infections pushed that count above 72,000. 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 EU 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 had its virus risk evaluation reduced from high to medium. Five districts of the city of 11 million people had other travel restrictions loosened after their risk factor was reduced to low.

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, ordered by Prime Minister Narendra Modi on Wednesday that effectively put millions out of work.

Russian Prime Minister Mikhail Mishustin has ordered his country’s borders fully closed as of Monday. International passenger flights were halted Friday. The order exempts diplomats as well as residents of the Kaliningrad region who must cross through another country to enter the rest of Russia.

Trump invoked the Defense Production Act on Friday, ordering General Motors to begin manufacturing ventilators. He also signed a $2.2 trillion stimulus package approved by Congress that will send checks to millions of Americans, boost unemployment benefits, help businesses and toss a life preserver to an overwhelmed health care system.

Dr. John Brooks of the U.S. Centers for Disease Control and Prevention warned that Americans remained “in the acceleration phase” of the pandemic.

“There is no geographic part of the United States that is spared from this,” he said.

The first death was reported Friday in the rural Michigan town of Cadillac, while numbers grew in Detroit, a four-hour drive to the south. Detroit’s homeless population is especially vulnerable, officials said.

“If any of these individuals got infected, it would be very easy to transmit it to other people without knowing,” said Chad Audi, executive director of the Detroit Rescue Mission Ministries, adding he has since opened two new facilities to accommodate an increase in clients and implemented new safety precautions. “But in no circumstances will we close our doors because these individuals don’t have any place to go. It’s very important to us.”

(AP)