“We are nowhere near where we need to be with testing supplies,” Gov. Laura Kelly of Kansas said.Credit...John Hanna/Associated Press
In both red and blue states, governors, health departments and hospitals are finding innovative ways to cope, but still lack what experts say they need to track and contain outbreaks.
About a week after the first report of a Covid-19 case at a meatpacking plant in southwest Kansas in early April, the state’s governor, Laura Kelly, issued a pointed warning to President Trump: Without test kits to separate the well from the sick, a fast-moving outbreak could idle facilities that produce roughly one-quarter of the nation’s meat supply.
Within three days, 80 blue-and-white boxes of test kits and testing machines arrived, and two Black Hawk helicopters from the Kansas National Guard whisked them to the afflicted region. As the test results came in last week, the costs of the delay became clear: 250 workers in six plants were already infected.
In Albany, Ga., a hot spot for the disease, a hospital finally figured out a way to run its own coronavirus tests, rather than relying on limited state capacity or outsourcing the work to slow-moving private labs. But it still struggles to run as many tests as it would like because of a shortage of components.
In Ohio, a research institution in Columbus is teaming up with a plastics company to churn out nasal swabs on 3-D printers for use in the state. But when Mysheika W. Roberts, the city’s health commissioner, offered test kits to local health centers, she learned they lacked the protective gear they needed to put them to use.
As governors decide about opening their economies, they continue to be hampered by a shortage of testing capacity, leaving them without the information that public health experts say is needed to track outbreaks and contain them.
It has proved hard to increase production of reagents — sensitive chemical ingredients that detect whether the coronavirus is present — partly because of federal regulations intended to ensure safety and partly because manufacturers, who usually produce them in small batches, have been reluctant to invest in new capacity without assurance that the surge in demand will be sustained.
Some physical components of test kits, like nasal swabs, are largely imported and hard to come by amid global shortages. Health care workers still lack the protective gear they need to administer tests on a wide-scale basis. Labs have been slow to add people and equipment to process the swelling numbers of tests.
On top of all that, the administration has resisted a full-scale national mobilization, instead intervening to allocate scarce equipment on an ad hoc basis and leaving production bottlenecks and shortages largely to market forces. Governors, public health officials and hospital executives say they are still operating in a kind of Wild West economy that has left them scrambling — and competing with one another — to procure the equipment and other materials they need.
As states begin to reopen, the nation is far from being able to conduct the kind of widespread surveillance testing that health experts say would be optimal. Many states are still struggling to conduct much more urgent testing of patients with symptoms, or those in high-risk groups. Few have the money or the personnel to also check on the presence of the virus in the general population or to reach out to people who have been in contact with those confirmed to be ill.
“We are not in a situation where we can say we are exactly where we want to be with regard to testing,” Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said this week in an interview with Time.
“You are using a free-market model in a public health emergency,” Governor Kelly, a Democrat, said an interview, “and I’m not sure those two go together particularly well.”
Politicians and public health experts have sparred for weeks over when, and under what circumstances, to allow businesses to reopen and Americans to emerge from their homes. But another question could prove just as thorny — how?
Because the restart will be gradual, with certain places and industries opening earlier than others, it will by definition be complicated. The U.S. economy is a complex web of supply chains whose dynamics don’t necessarily align neatly with epidemiologists’ recommendations.
Georgia and other states are beginning the reopening process. But even under the most optimistic estimates, it will be months, and possibly years, before Americans again crowd into bars and squeeze onto subway cars the way they did before the pandemic struck.
It isn’t clear what, exactly, it means to gradually restart a system with as many interlocking pieces as the U.S. economy. How can one factory reopen when its suppliers remain shuttered? How can parents return to work when schools are still closed? How can older people return when there is still no effective treatment or vaccine? What is the government’s role in helping private businesses that may initially need to operate at a fraction of their normal capacity?
The openings have elicited passionate criticism, some from residents and business owners and some from higher places. Gov. Brian Kemp’s order for Georgia was criticized as premature this week by President Trump, who has generally expressed eagerness to open the American economy. In Atlanta, Mayor Keisha Lance Bottoms went on national television on Friday morning to urge her constituents to stay home. Many listened.
The relaxed rules, coming as the nation nears a sobering 50,000 deaths from the virus, varied. Alaska allowed limited in-store shopping at retail stores, and some restaurants in Fairbanks reopened their dining rooms over the weekend. Oklahoma reopened its state parks. South Carolina, which was in front of the rest of the country in its effort to draw residents out of their homes, once again allowed access to public beaches. And Georgia officials recommended that salon owners perform temperature checks at their entrances.
In Miami-Dade County, the county hardest hit by the coronavirus in Florida and where a stay-at-home order remains in effect, Mayor Carlos Gimenez said he intended to reopen parks, golf courses and marinas. Beaches would remain closed under the plan.
Mr. Gimenez said the county would still observe new, complicated social distancing rules, and would hire around 400 security workers to enforce them. Basketball games would be banned, for example, but shooting hoops individually would be allowed. Workers would be trained to inform visitors of the rules and ask them to leave the public spaces if they violate them.
In Southern California, where restrictive social distancing measures have remained in place, soaring temperatures tested public discipline as crowds flocked to a subset of beaches that have not been closed to the public. Frustrated officials in Orange and Ventura Counties, which kept beaches open, said on Saturday that they were ramping up their patrols, and were even deploying drones to keep an eye out overhead.
All pharmacies in New York will be able to test for Covid-19, Governor Cuomo says.
New Yorkers anxious to learn if they have the coronavirus will soon be able to get tested at any local pharmacy, Gov. Andrew M. Cuomo announced Saturday.
Mr. Cuomo said he was signing an executive order authorizing all of the state’s roughly 5,000 pharmacies to conduct coronavirus tests as a part of an effort to reach a larger number of people.
“If your local drugstore can now become a collection site, people can go to their local drugstore,” Mr. Cuomo said. “Since we now have more collection sites, more testing capacity, we can open up the eligibility for those tests.”
He also said the state would expand testing criteria to include all first responders, health care workers and essential employees, allowing those individuals to be tested even if they do not have symptoms.
Getting access to a coronavirus test has been a source of anxiety for thousands of New Yorkers since the highly contagious virus upended life in New York, where more than 16,000 people have died of Covid-19, the disease caused by the virus. Some larger pharmacy chains were already offering tests, Mr. Cuomo said, but his order would permit many smaller ones to administer tests, as well.
Mr. Cuomo also announced new antibody testing for front-line health care workers at four city hospitals, including Bellevue Hospital in Manhattan and Elmhurst Hospital in Queens, both of which have handled a surge of coronavirus cases. Antibodies are largely seen as proof that a person had survived the virus and may have developed temporary immunity.
But with the testing announcements came some bad news. A day after reporting the smallest number of deaths since April 1, Mr. Cuomo said the state experienced a slight uptick in casualties linked to the virus. The number of deaths inched upward, to 437. That was 15 more than the number of deaths reported on Friday, which had been the lowest tally since the beginning of the month, Mr. Cuomo said. The state reported Saturday 10,553 new infections, bringing the New York’s total to 282,143.
But he reported 1,184 new hospitalizations, down from 1,296 the previous day.
“We are back where we were 21 days ago — 21 days of hell, back to where we were,” Mr. Cuomo said. “We would like to get back to the days when only 400, 500 people were showing new infections everyday.”
‘Quarantine fatigue’: Researchers find more Americans venturing out against coronavirus stay-at-home orders
By April 17, the researchers found, the share of people presumed to have stayed home — meaning their phones didn’t move at least a mile that day — declined from a national average of 33 percent to 31 percent, compared with the previous Friday. That came after six weeks of the staying-home percentage increasing or holding steady. Because the study’s sample size is so large — more than 100 million cellphones observed monthly — even slight changes are statistically significant.
Dr. Wilbur Chen, an associate professor at the University of Maryland School of Medicine, said it’s too soon to know whether the findings reveal a one-week blip or the start of a trend.
Experts have theories about why the week of April 13, the most recent data available, became a tipping point. Many homebound Americans hit the mental milestone of the fifth week, technically entering a second month, with no clear end in sight. Even with the boom in video calls and virtual cocktail hours, they say, feelings of loneliness and isolation continue to mount. Balmy spring temperatures also probably drew people out, particularly in warmer regions where a hot, sticky summer will soon descend.
It’s also no coincidence, they say, that resolve would begin to wane amid the Trump-supported protests, even as most Americans tell pollsters they support stay-at-home requirements.The nationwide drop in the researchers’ “social distancing index” started April 14. That was one day before thousands of protesters in Michigan received national attention for jamming roads around the state capitol, demanding that the restrictions be eased and people be allowed to return to work.
The social distancing index reflects how much people stay home, as well as how much and how far they travel by plane, car, transit, bicycle and on foot. Phones that didn’t make any stops of 10 minutes or more, such as those on people out for a bike ride or walk with the dog, were counted as staying home.
Many Americans flocked to beaches on Saturday as one Florida county expanded access and California experienced a heat wave, even as new coronavirus cases hit a record high in the United States the day before and deaths topped 53,000.
People attempt to keep their personal distance at Coney Island.
Californians continued to ignore Governor Gavin Newsom's pleas to stay home after flocking to the beaches Friday and Saturday, prompting Newsom on Friday to plead for social distancing during the continued heat wave this weekend.
Trump suggests that the daily briefings are no longer worth his time.
On the first day in weeks that the White House did not hold a press briefing on the coronavirus, President Trump lashed out at the news media for asking “hostile questions” and suggested his daily appearances were no longer worth his time.
“What is the purpose of having White House News Conferences when the Lamestream Media asks nothing but hostile questions, & then refuses to report the truth or facts accurately,” Mr. Trump wrote on Twitter on Saturday night. “They get record ratings, & the American people get nothing but Fake News. Not worth the time & effort!”
The tweet came two days after Mr. Trump suggested at a briefing that an “injection inside” the huma+n body with a disinfectant could help combat the coronavirus. Despite a lack of scientific evidence, Mr. Trump has long trumpeted various ideas against the virus, like sunlight and warmer temperatures as well as an array of drugs, including the malaria drug hydroxychloroquine, which he has promoted as a “what have you got to lose” remedy. Medical experts have since stepped up warnings about the drugs’ possibly dangerous side effects.
Since Thursday’s assertion, Mr. Trump has been angrily tweeting about the unfairness of his coverage after a damaging news cycle his aides have privately admitted is self-inflicted. Officials have also said that they were skeptical that Mr. Trump would fully retreat from a scenario in which he took questions from reporters, even though he said the two-hour format of the briefings was not worth the effort.
The worsening economy and a cascade of ominous public and private polling have Republicans increasingly nervous that they are at risk of losing the presidency and the Senate, and some in the party fear that Mr. Trump’s single best advantage as an incumbent — his access to the bully pulpit — has effectively become a platform for self-sabotage.
The White House considers replacing the Health Secretary.
Officials inside the White House are discussing replacing Alex M. Azar II, the health and human services secretary, after a string of news reports about the administration’s slow response to the coronavirus and a separate controversy about an ousted department official, two senior administration officials said.
Mark Meadows, President Trump’s new chief of staff, is among the aides considering removing Mr. Azar once the height of the coronavirus crisis abates, the officials said. The discussions were first reported by Politico and The Wall Street Journal.
Mr. Trump has become angry with Mr. Azar in recent weeks, after stories in The Washington Post and The New York Times detailed decisions and discussions related to the administration’s response to the coronavirus. Mr. Trump, who has closely followed the coverage, was upset that he was being blamed while Mr. Azar was portrayed in a more favorable light, aides said, adding that the president was also suspicious that Mr. Azar was trying to save his own reputation at the president’s expense. The president told friends that he assumed Mr. Azar was working the news media to try to save his own reputation at the expense of Mr. Trump’s.
Fearing the virus, people with life-threatening emergencies are avoiding hospitals.
Bishnu Virachan was a bicycle deliveryman for a grocery store in Queens. With New York City locked down, he was busier than ever. But in early April, as he was watching television, he said he felt a pain in his heart. It frightened him, but he did not go to the emergency room. Mr. Virachan, 43, was even more afraid of that.
Doctors across the country say that fear of the coronavirus is leading many people in the throes of life-threatening emergencies, like a heart attack or stroke, to stay home when ordinarily they would have rushed to an emergency room. Without prompt treatment, many suffer permanent damage or die. Many hospitals report that heart and stroke units are nearly empty. Some medical experts fear more people are dying from untreated emergencies than from the coronavirus itself.
Mr. Virachan was lucky. After a few days, pain overrode fear and he went to Mount Sinai Hospital in Manhattan. Doctors discovered a nearly complete blockage of his left main coronary artery. A surgeon opened the artery, but now Mr. Virachan is left with a weakened heart. Had he waited much longer, doctors said, he would have died.
U.S. scientists join W.H.O. in calling for better coronavirus antibody tests.
Scientists in the United States and abroad are cautioning leaders against overreliance on coronavirus antibody tests, even as the tests have come to be seen as an essential tool for getting workers back to their jobs.
The World Health Organization warned against using antibody tests as a basis for issuing “immunity passports” to allow people to travel or return to work. Countries like Italy and Chile have proposed the permits as a way to clear people who have recovered from the virus to return to work.
Laboratory tests that detect antibodies to the coronavirus “need further validation to determine their accuracy and reliability,” the global agency said in a statement on Friday. Inaccurate tests may falsely label people who have been infected as negative, or may falsely label people who have not been infected as positive, it noted. Further, it clarified that “there is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection.”