April 16, 2020

Testing Is Biggest Obstacle to Reopening States, Experts Say. UPDATES

Worldwide Confirmed Coronavirus Cases Top 2 Million
As bleak a milestone in the pandemic as the new figures are, unconfirmed cases are believed to be far higher. More than 130,000 people have died from Covid-19.



Health, business and political leaders warn against a rush to lift restrictions. New Yorkers will have to wear face coverings in public, and California will extend aid to undocumented workers.

As President Trump pushes to reopen the economy, most of the country is not conducting nearly enough testing to track the path and penetration of the coronavirus in a way that would allow Americans to safely return to work, public health officials and political leaders say.

Although capacity has improved in recent weeks, supply shortages remain crippling, and many regions are still restricting tests to people who meet specific criteria. Antibody tests, which reveal whether someone has ever been infected with the coronavirus, are just starting to be rolled out, and most have not been vetted by the Food and Drug Administration.

Concerns intensified on Wednesday as Senate Democrats released a $30 billion plan for building up what they called “fast, free testing in every community,” saying they would push to include it in the next pandemic relief package. Business leaders, who participated in the first conference call of Mr. Trump’s advisory council on restarting the economy, warned that it would not rebound until people felt safe to re-emerge, which would require more screening.

In his daily briefing, Gov. Andrew M. Cuomo of New York reiterated his call for federal assistance to ramp up testing, both for the virus and for antibodies. Hours later, Mr. Trump boasted at his own briefing of having “the most expansive testing system anywhere in the world” and said that some states could even reopen before May 1, the date his task force had tentatively set.


From the beginning of the coronavirus crisis, lapses by the federal government have compromised efforts to detect the pathogen in patients and communities. A diagnostic test developed by the Centers for Disease Control and Prevention proved to be flawed. The F.D.A. failed to speed approval for commercial labs to make tests widely available. All of that meant that the United States has been far behind in combating the virus.



Coronavirus in the U.S.: Latest Map and Case Count
A detailed county map shows the extent of the coronavirus outbreak, with tables of the number of cases by county.

Dr. Deborah L. Birx, the coronavirus response coordinator for the White House, offered a road map on Wednesday on which states could be the first to ease stay-at-home orders and reopen businesses — a target date that President Trump said could be before May 1.

“We do have nine states that have less than 1,000 cases and less than 30 new cases per day,” Dr. Birx said during the daily news briefing in the Rose Garden.

She did not list the states, but data compiled by The New York Times suggested that they were Alaska, Hawaii, Maine, Montana, Nebraska, North Dakota, Vermont, West Virginia and Wyoming.

Governors and mayors would make the call on lifting restrictions after receiving guidance from the federal government, which would be announced Thursday, Dr. Birx said.


Moments earlier, Mr. Trump said that governors, whom he did not name, were “chomping at the bit to get going.” But Dr. Birx warned that it was no time for Americans to become complacent about social distancing.

An empty mall in Honolulu in March.
A retail report shows the biggest decline in sales in three decades.

Retail sales plunged in March as businesses shuttered from coast to coast and wary shoppers restricted their spending, a drop that was by far the largest in the nearly three decades the government has tracked the data.

Total sales, which include retail purchases in stores and online as well as auto and gasoline sales and money spent at bars and restaurants, fell 8.7 percent from the previous month, the Commerce Department said Wednesday.


The situation has almost certainly worsened since then. Most states didn’t shut down nonessential businesses until late March or early April.
What happens to retail matters to the broader economy. The sector accounts for more than one in 10 U.S. jobs; only health care employs more. Its stores generate billions of dollars in rent for commercial landlords, ad sales for local media outlets, and sales-tax receipts for state and local governments.

If retailers survive and can quickly reopen and rehire workers, then the eventual economic recovery could be relatively swift. But the failure of a large share of businesses would lead to prolonged unemployment and a much slower rebound.

President Trump’s signature. His name will appear on the “memo” section of stimulus checks.

Trump’s name will be printed on stimulus checks.

Some of the relief payments authorized as part of a $2 trillion stimulus package have started showing up in Americans’ bank accounts. Here’s a page where you can check on the status of your payment.

Most adults will get $1,200, although some will get less, depending on their income. For every qualifying child age 16 or under, the payment will be an additional $500.

At the president’s suggestion, his name will appear on the checks that will be mailed to millions of Americans beginning next month, the Treasury Department said on Tuesday. Adding Mr. Trump’s name is a break from protocol, and it will appear on the “memo” section of the check because Mr. Trump is not legally authorized to sign such disbursements.

Coronavirus: New Yorkers ordered to wear face coverings in busy ...

Cuomo will require New Yorkers to wear facial coverings in public.

Gov. Andrew M. Cuomo of New York said Wednesday that he would order people statewide to don facial coverings while in public if they were unable to stay six feet away from others. The measure will take effect on Saturday.

“If you’re going to be in public and you cannot maintain social distancing, then have a mask and put the mask on,” said Mr. Cuomo, who held out the possibility of civil penalties for violations.

“You’re walking down the street alone? Great,” he said. “You’re now at an intersection and there are people at the intersection and you’re going to be in proximity to other people? Put the mask on.”

He added: “You don’t have the right to infect me.”

The Metropolitan Transportation Authority said in a statement on Wednesday that all subway riders in New York City would be required to wear face coverings when using public transit beginning Friday.

Mr. Cuomo’s announcement came soon after he said that the virus had killed at least 752 people in New York on Tuesday, swelling the state’s official death toll to at least 11,586. The tally does not include the more than 3,700 people in New York City who died without being tested and are now presumed to have died of the virus.

The three-day average of the number of virus patients in hospitals, considered one of the most reliable measures of the virus’s impact, fell for the first time since the outbreak began, down 0.7 percent since Tuesday.

The 752 new deaths made Tuesday the eighth day of the last nine with a death toll over 700, suggesting that the death rate has stabilized, after weeks of increasing.

Health officials have urged people to combine face coverings with adhering to social-distancing rules, suggesting that one tactic did not replace the need for the other. Further complicating the matter is that while scientists agree six feet is a sensible and useful minimum distance for people to separate when possible, some say that farther away would be better.
A sign on the Coney Island boardwalk in Brooklyn advised visitors to keep a distance of at least six feet from each other, but some experts say that might not be enough.

Stay 6 Feet Apart, We’re Told. But How Far Can Air Carry Coronavirus?
Most of the big droplets travel a mere six feet. The role of tiny aerosols is the “trillion-dollar question.”

Six feet has never been a magic number that guarantees complete protection. The Centers for Disease Control and Prevention, one of the organizations using that measure, bases its recommendation on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet.

But some scientists, having looked at studies of air flow and being concerned about smaller particles called aerosols, suggest that people consider a number of factors, including their own vulnerability and whether they are outdoors or in an enclosed room, when deciding whether six feet is enough distance.

Sneezes, for instance, can launch droplets a lot farther than six feet according to a recent study.

Even without the launching power of a sneeze, air currents could carry a flow of aerosol sized virus particles exhaled by an infected person 20 feet or more away.

One complicating factor is that aerosols, smaller droplets that can be emitted when people are breathing and talking, play some role in spreading the new coronavirus. Studies have shown that aerosols can be created during certain hospital or laboratory procedures like when using nebulizers to help patients inhale medication, which makes such procedures risky for doctors who do them.

If the aerosols that people exhale in other settings are significant in spreading the disease, the six-foot distance would not be completely protective because those are carried more easily by air currents.It is also unclear how many virus particles it takes to start an infection, how long the viral particles remain viable.

“Maybe all it takes is an aerosol. You don’t need any droplets at all.” If that’s the case, he said, then someone who is at high risk would not want to be in the same room with someone who is infected or might be infected. Current guidelines already suggest that anyone at high risk should stay home and not be out in public in the first place.

Aerosols are generally considered to be particles under 5 microns in diameter, about the size of a red blood cell, and can be spread in the environment by talking and breathing. But some researchers argue that this is a false dichotomy. Infectious droplets can’t easily be divided into those that are big enough to fall to the ground quickly and those that stay aloft because so much depends on environmental conditions and how deeply they penetrate into the respiratory tract.

People still need to shop and take care of necessities, Dr. Osterholm said, but reducing the risk of exposure to all possible modes of transmission — infected surfaces, droplets and smaller aerosols — is important.

“Your job is to limit it as much as you can.”


A Bronx food pantry on Tuesday.

N.Y.C. will spend $170 million on emergency meals.

“I pledge to you, and I’m very confident making this pledge: We will not allow any New Yorker to go hungry,” Mr. de Blasio said at a news briefing.

The effort will include purchasing 18 million ready-to-eat meals, signing up entire public housing buildings for home meal delivery and hiring more than 11,000 drivers licensed by the Taxi and Limousine Commission to deliver meals.

Even before the crisis, hunger was already widespread in the city and 1.2 million people in the city were classified as food insecure, Mr. de Blasio said.

Hundreds of vehicles lined up around the Capitol in Lansing, Mich., during a protest on Wednesday.

Protesters have taken to the streets in several states to urge governors to reopen businesses and relax rules that health officials have said are necessary to save lives.

In Lansing, Mich., on Wednesday, thousands of demonstrators honked from their cars and some waved flags on the State Capitol grounds at a protest called “Operation Gridlock.” In Frankfort, Ky., dozens of people shouted through a Capitol building window as Gov. Andy Beshear held a virus briefing. And in Raleigh, N.C., a woman was arrested after violating the governor’s stay-at-home order at a protest that drew at least 100 people on Tuesday, The News & Observer reported.

More protests are planned in other states, including Texas, Oregon and Washington, as the economic and health effects of the coronavirus continue to worsen, with more than 28,000 people dead and at least 16 million out of work. The demonstrations are a sign that despite the rising death toll and pleas of public health experts, some workers are growing agitated about lost wages, emergency orders and the tightening restrictions that governors have placed on their movements.

A shuttered restaurant last month at Pike Place Market in Seattle.

A small-business loan program is nearly out of money.

Funding for the Paycheck Protection Program, an initiative created by the $2.2 trillion stimulus law to help small businesses weather the crisis, could run out as early as Wednesday night, amid a standoff in Congress over replenishing it.

congressional leaders and the Trump administration have failed to reach agreement on adding hundreds of billions of dollars to replenish the program, hamstrung by a dispute over whether to enact sweeping changes to how it allocates loans to businesses across the country.

Democrats support additional spending but have insisted on attaching new restrictions to ensure the money flows to minority-owned businesses and other companies that are traditionally disadvantaged in the lending market.

The small-business loan program — which enjoys broad bipartisan support — was among the first to be unveiled, but its introduction has been plagued with problems even as businesses have inundated banks with requests for a piece of the money.

Steven Mnuchin, the Treasury secretary, and aides to Senator Chuck Schumer of New York and Speaker Nancy Pelosi conferred later in the day and were expected to continue discussions on Thursday.

Testing Is Biggest Obstacle to Reopening States, Experts Say - The ...

Trump’s move to freeze aid to the W.H.O. draws condemnation.

President Trump’s public campaign against the World Health Organization — and his order to freeze all money to the group in the middle of a pandemic — is the culmination of mounting anger among his White House advisers, Republican lawmakers and conservative news media about the organization’s lavish praise of China’s response to the coronavirus.

Mr. Trump’s decision to attack the W.H.O., a unit of the United Nations, comes as he is under intense fire at home for his administration’s failure to respond aggressively to the virus, which as of Wednesday had claimed more than 25,000 lives in the United States and infected at least 600,000 people. There are cases in all 50 states.

The director general of the organization, Dr. Tedros Adhanom Ghebreyesus, on Wednesday expressed dismay that Mr. Trump was calling to halt funding as the W.H.O. fights the pandemic.

“W.H.O. is not only fighting Covid-19,” Dr. Ghebreyesus said. “We’re also working to address polio, measles, malaria, Ebola, H.I.V., tuberculosis, malnutrition, cancer, diabetes, mental health and many other diseases and conditions.”

Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, praised the organization on Wednesday in tones at odds with the president’s harsh criticism. He told “CBS This Morning” that questions about the W.H.O.’s pandemic response should be left until “after we get through this.”

The president’s decision came amid concerns about the W.H.O.’s approach to China. Inside the West Wing, officials said, there was near-unanimous agreement among the president’s advisers that the W.H.O. was heavily influenced by the Chinese government and too slow to sound the alarm because it trusted China’s assurances that the virus was under control and did not pose a global threat.