Giroir, Trump’s testing czar, said most virus test results were coming back quickly. Public health experts disagree.
As schools, universities and businesses struggle to reopen without the coronavirus testing they need to curb outbreaks, the Trump administration’s testing czar testified to Congress Friday that it was currently impossible to get all tests back within three days.
The testing czar, Adm. Brett P. Giroir, told lawmakers that getting all coronavirus tests back between 48 and 72 hours, which many health officials have said is critical, “is not a possible benchmark we can achieve today, given the demand and the supply.”
Admiral Giroir said that it would be “absolutely” achievable in the future, and that half of all test results were being processed within 24 hours. While not all tests can be turned around within three days, he said, the average wait time for the rest was around that time or less — an assessment that is sharply at odds with what patients and health professionals around the country say they are experiencing.
He told lawmakers that the nation was now averaging about 820,000 tests each day, and that roughly half were “done in either point-of-care technologies with results in 15 minutes or less or at local hospitals for which the turnaround time is generally within 24 hours.”
And he said that three-quarters of tests from commercial labs were coming back within five days.
The remainder, he said, are processed by commercial labs like Quest Diagnostics and LabCorp. Three-quarters of those tests were coming back within five days, he said.
Admiral Giroir spoke alongside Dr. Anthony S. Fauci, the nation’s top infectious disease expert, and Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, during a hearing of the House Select Subcommittee on the Coronavirus Crisis, a special panel created by Speaker Nancy Pelosi to oversee the Trump administration’s coronavirus response.
His comments on testing turnaround times were met with puzzlement by public health experts, who say that even if the figures are accurate, they do not reflect the reality on the ground. Reporting test results and wait times in aggregate, these experts say, does not indicate things are getting better. Testing shortages persist. And in some places, tests cannot be processed at all because of a lack of reagents — the chemicals needed to detect whether the virus is present — or lab capacity.
“Across the board, the supply chain is still fragile and fragmented,” said Amanda Harrington, director of the Clinical Microbiology Laboratory at Loyola University Medical Center in Maywood, Ill. “We have assays we don’t know if we can run tomorrow.
Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the administration needed a “national dashboard for testing” where data is collected and made publicly available.
Later Friday in an evening briefing in Florida with President Trump, Gov. Ron DeSantis of Florida noted: “We’re doing so many tests, sometimes it takes seven to ten days to get the results back, ”He said that the state was trying to speed tests for symptomatic people, and that new point-of-care tests from the federal government should help the state get faster results.
In Alabama, the average wait time for coronavirus test results is currently seven days — significantly longer than the two or three-day turnaround window advised by public health officials for making quarantine and care decisions.
In a statement released by the state’s department of public health on Friday, officials asked health care providers to limit testing to “the elderly, those in congregate living settings, health care personnel, those with symptoms consistent with COVID-19 and those with underlying medical conditions that place them most at risk.”
Democrats on the House panel wasted little time in pointing out that the caseload is much lower in Europe and Asia than in the United States. Dr. Fauci said countries in those parts of the world were more aggressive about shutting down as the pandemic raged.
“When they shut down, they shut down to the tune of about 95 percent, getting their baseline down to tens or hundreds of cases a day,” Dr. Fauci said. By contrast, he said, only about 50 percent of the United States shut down, and the baseline of daily cases was much higher — as many as 20,000 new cases a day — even at its lowest. More recently, the United States has recorded as many as 70,000 new cases a day.
Dr. Fauci also cast doubt on a study promoted by Mr. Trump and other conservatives. Conducted by Henry Ford Hospital in Detroit, it showed an apparent benefit for hydroxychloroquine, the anti-malaria drug that President Trump has touted as a Covid-19 treatment. “That study is a flawed study,” Mr. Fauci said. (Read more about the most-talked-about treatments for the coronavirus.)
Considered a cornerstone of the public health arsenal to suppress the virus, contact tracing has largely failed in the United States, as the virus’s pervasiveness and major lags in testing have rendered the system almost pointless.
The goal of contact tracing is to reach people who have spent more than 15 minutes within six feet of an infected person and ask them to voluntarily quarantine at home for two weeks, even if they test negative, monitoring themselves for symptoms during that time. On Friday, Dr. Fauci said that if someone gets tested, “they should assume that it might be positive and should essentially isolate themselves before they go back and get the result of the test.”
In some of the hardest-hit regions, contact-tracing efforts seem futile, as many people have refused to participate or cannot even be located, further hampering health care workers.
In Arizona’s most populated region, for example, the virus is so ubiquitous that contact tracers have been unable to reach a fraction of those infected. In Austin, Texas, the story is much the same. Cities in Florida, which has been seeing an average of more than 10,000 new cases a day in the past week, have largely given up on contact tracing. Things are equally dismal in California. And in New York City’s tracing program, workers have complained of crippling communication and training problems.
From the very beginning, states and cities have struggled to detect the prevalence of the virus because of spotty and sometimes rationed diagnostic testing and long delays in getting results. For the tests currently available and in high demand, there is not a consensus on who should get them. Some experts say everyone should get tested, even those without symptoms. Others say the tests should be reserved for the people who have symptoms or are more vulnerable to infection.
There is broad consensus, however, that more tests are needed.
On Friday, the National Institutes of Health announced that seven companies have received $248.7 million to ramp up test production and deliver millions more weekly tests as early as September.
The tests, which include three simple “point of care” tests that don’t need to be shipped to laboratories, were selected as promising candidates to address the serious shortages that have plagued testing efforts since March.
White House officials and Democrats blamed each other on Friday for the looming expiration by day’s end of a $600 weekly jobless aid payment that has become a critical lifeline for tens of millions of Americans, as they remained at an impasse on passing another round of federal pandemic relief.
At a news conference at the White House, Mark Meadows, the chief of staff, accused Democrats of playing “politics as usual” on Capitol Hill. At the other end of Pennsylvania at the Capitol, Speaker Nancy Pelosi of California declared that administration officials “do not understand the gravity of the situation.”
Both said they planned to continue discussions on Friday, and potentially into the weekend to find a compromise. But the talks will come too late to help laid-off workers set to lose their aid. Many state unemployment systems have already stopped sending payments.
Economist have said the faltering economy is likely to face further devastation without the security of additional payments.
Grasping for more time to reach an agreement, Republicans on Thursday at first proposed extending the benefit at a much lower rate through the end of the year, and then proposed continuing the $600-per-week benefit for one week. But Democrats, who want to extend the $600 weekly payments through the end of the year, rejected those alternatives. Ms. Pelosi said on Friday that they would do nothing to address the magnitude of the problem or bridge the deep divides separating her party’s $3 trillion aid proposal with at $1 trillion plan endorsed by Republicans.
“When you have a six-day, one-week extension on a provision, it is usually — has always been — to accommodate a legislative topic if you’re on the verge of having an agreement,” Ms. Pelosi said. “Why don’t we just get the job done? Why don’t we just get the job done?”
Representative Steny H. Hoyer of Maryland, the majority leader, said on Friday that lawmakers who were to begin their annual August recess would be on call to return to Washington for potential votes on the recovery package, should lawmakers and the White House reached an agreement.
A large outbreak at a Georgia summer camp adds to the evidence that children are susceptible to the virus.
As schools and universities plan for the new academic year, and administrators grapple with complex questions about how to keep young people safe, a new report about a coronavirus outbreak at a sleepaway camp in Georgia provides fresh reasons for concern.
The camp implemented several precautionary measures against the virus, but stopped short of requiring campers to wear masks. The virus blazed through the community of about 600 campers and counselors, the Centers for Disease Control and Prevention reported on Friday.
The study is notable because few outbreaks in schools or child care settings have been described to date, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
“The study affirms that group settings can lead to large outbreaks, even when they are primarily attended by children,” she said.
“The fact that so many children at this camp were infected after just a few days together underscores the importance of mitigation measures in schools that do reopen for in person learning,” Dr. Rivers added.
While the role children play in the spread of the virus has been questioned, the authors of the report said the research adds to evidence that children of all ages are not only susceptible to infection, but may play an important role in transmission.
Of the 344 campers and staff for whom test results were available, 260 tested positive, meaning at least 43 percent were infected, though the figure may well be higher, the C.D.C. said.
Of children ages 6 to 10, over half were infected; 44 percent of those ages 11 to 17 were infected, as were one-third of those ages 18 to 21. Only seven staffers were older than 22, and two of them tested positive.
Those who had been at the camp longest had the highest rate of infection; overall, more than half of the staff, who had arrived before the campers, were infected.
Fitch Ratings downgrades its outlook on U.S. debt. as deficit soars.
The credit rating firm Fitch left the United States’ AAA rating untouched, but downgraded its outlook on what’s effectively the national credit score, suggesting the country’s status as one of the world’s most trustworthy borrowers could be put at risk by the enormous deficits the federal government is running to combat fallout from the pandemic.
“The outlook has been revised to negative to reflect the ongoing deterioration in the U.S. public finances and the absence of a credible fiscal consolidation plan,” Fitch analysts wrote on Friday in a report announcing the decision.
Cratering tax revenues and surging expenditures have driven record levels of red ink for the federal government in recent months. The United States budget deficit hit a record $864 billion in June as the government continued pumping money into the economy to support workers and businesses slammed by the pandemic. Some analysts expect monthly deficits to soon top $1 trillion.
Ballooning deficits have led to an explosion of new borrowing. Fitch noted that the Treasury Department borrowed just under $3 trillion dollars from the end of February to the end of June.
Much of the supply of new government bonds was, essentially, purchased by the Federal Reserve, which has bought $2.6 trillion in financial assets since the middle of March, Fitch noted.
The presence of the Federal Reserve, which can essentially create whatever money it wants and use it to buy assets, such as U.S. government debt, has depressed yields on government bonds even as its debts and deficits rise sharply.
On Friday, the yield on the 10-year note fell to 0.53 percent, one of the lowest levels in recorded history, suggesting there is virtually no concern among investors about the country’s ability to service its growing debts.
When the virus erupted in the West, Italy was the nightmarish epicenter, a place to avoid at all costs and a shorthand in the United States and much of Europe for uncontrolled contagion.
Fast forward a few months, and the United States has had tens of thousands more deaths than any other country in the world. European states that once looked smugly at Italy are facing new flare-ups.
And Italy? Its hospitals are basically empty of Covid-19 patients. Daily deaths attributed to the virus in Lombardy, the region that bore the brunt of the pandemic, hover around zero. The number of new daily cases has plummeted to “one of the lowest in Europe and the world,” said Giovanni Rezza, director of the infective illness department at the National Institute of Health.
How Italy has gone from being a global pariah to a model — however imperfect — of viral containment holds fresh lessons for the rest of the world, including the United States.
Italy has consolidated, or at least maintained, the rewards of a tough nationwide lockdown through a mix of vigilance and painfully gained medical expertise.
Its government has been guided by scientific and technical committees.
The country set aside economic pressures and only began easing its exceptionally tight lockdown based on case counts.
Italy continues to limit travel from elsewhere.
Local doctors, hospitals and health officials collect more than 20 indicators on the virus daily and send them to regional authorities, who then forward them to the National Institute of Health.
The result is a weekly X-ray of the country’s health upon which policy decisions are based.
Here are other developments from around the globe:
Across Europe, the economy tumbled into its worst recession on record in the second quarter. From April to June, gross domestic product fell by 11.9 percent from the first quarter in the European Union, and by 12.1 percent in the core group of countries that use the euro currency. On an annualized basis, European Union economies shrank by 14.4 percent, and eurozone economies by 15 percent, the sharpest contractions since statistics started being kept in 1995.
Britain has barred millions of people in northern England from meeting other members of other households at their homes, paused reopenings set for Aug. 1 and moved to make face masks mandatory in more places, after a day on which it reported 38 new coronavirus deaths and nearly 900 known new infections, its highest case numbers in a month.
As the virus surged this spring, health care workers in the United States and the United Kingdom scrambled to make do with scarce personal protective equipment. The consequences to their own health were stark.
According to a new study, these workers were 3.4 times more likely to report a positive coronavirus test than the general population. Workers who described their equipment — including masks, gloves and gowns — as insufficient were 1.3 times more likely to report positive tests than their colleagues who deemed their equipment appropriate.
Using self-reported data collected through a Covid-symptom monitoring app, researchers at Harvard Medical School and Massachusetts General Hospital surveyed 99,795 front-line health care workers and two million other people from March 24 through April 23. Health care workers who were Black, Asian or other races were 1.81 times more likely to report a positive test result than non-Hispanic white health care workers, the study found.
“Minority front-line health care workers tend to be in higher-risk settings and have less access to protective equipment,” said Dr. Erica T. Warner, a co-author of the study and an assistant professor of medicine at Harvard Medical School. “This is a microcosm of the larger disparity we see in health care in general.”
Even though protective gear is now more readily available, shortages are still common.
SPORTS AND CULTURE ROUNDUP
Baseball grapples with more outbreaks as it adjusts to cardboard fans and piped-in crowd noise.
The Cardinals-Brewers game is the third postponement on baseball’s Friday night schedule, following earlier ones involving the Miami Marlins, who were to play the Washington Nationals, and the Philadelphia Phillies, who were to host Toronto. The Marlins have had 18 players (including another on Friday) and two staff members test positive this week; those cases have already upended baseball’s revised schedule.
One of the biggest adjustments for major leaguers during this 60-game season will be playing in empty, cavernous stadiums, at least for the time being. While baseball has attempted to fill the void with cardboard fans, artificial noise and even virtual “crowds” on broadcasts, there is no denying that games are being held in an atmosphere that is far from normal.
“I think it’s going to affect things in weird ways that we can’t even fully anticipate right now,” Russell Carleton, a psychologist and analyst who has consulted with the Cleveland Indians and the Mets, said of 2020’s empty stadiums. “And it’s going to vary from guy to guy.”
Other developments related to sports and culture:
The Salzburg Festival is still going on but its centennial season is abbreviated and has come with an elaborate protection plan.
The Barrington Stage Company in Massachusetts was planning to become the first theater in the U.S. to stage an indoor show featuring an Actors’ Equity performer since the outbreak closed theaters. The company removed many seats in its theater, reconfigured its air-conditioning system, and redesigned bathrooms. But the state of Massachusetts decided not to permit indoor theater, so the show, “Harry Clarke,” is moving outdoors.
Bryan Cranston, the star of “Breaking Bad,” has posted a video of himself donating plasma following his recovery from Covid-19. The actor called plasma “liquid gold” and said it could be rich in antibodies and could benefit others in their recovery.
New York City public schools, the nation’s largest school system, will be able to reopen its school buildings in September only if the city maintains a test positivity rate below 3 percent, Mayor Bill de Blasio announced on Friday. That conservative threshold is even lower than the 5 percent test positivity rate which has been set by Gov. Andrew M. Cuomo as a cut-off for school reopening and recommended by public health experts.
The average positivity rate for New York City has generally remained lower even than the new city threshold, according to city and state figures. But even a modest uptick in cases over the next few weeks could nudge that rate higher, which raises fresh questions about whether city schools will open part-time on Sept. 10 as planned. On Friday, the school system submitted its reopening plan to the state.
New York is one of the only large districts in the country that is currently planning to reopen its buildings at all: Children will report to school one to three days a week to allow for social distancing. All staff members will be asked to take tests before the start of school, with expedited results. Education officials in the city laid out a plan on Thursday for what would happen in the seemingly inevitable event that cases are confirmed in a classroom.
The protocol means it is likely that at many of the city’s 1,800 schools, individual classrooms or even entire buildings will be closed at points during the school year.
Officials said confirmed infections among students, teachers and staff members would be treated the same. One or two cases in a single classroom would require those classes to close for 14 days; all students and staff members in that classroom would be ordered to self-quarantine, and students would learn remotely. The rest of the school would continue to operate.
But if two or more people in different classrooms in the same school tested positive, the entire building would close while city disease detectives were brought in to investigate the cases, which could take several days. Depending on the results of the investigation, the building could reopen, but the classrooms with positive cases would remain closed for 14 days.
Elsewhere in the U.S.:
Cases in New Jersey, which just a week ago had plunged to their lowest levels since the pandemic began, are rising again, fueled in part by outbreaks among young adults along the Jersey Shore. As of Thursday, the state had recorded an average of 434 cases per day over the last week, an increase of 35 percent from the average two weeks earlier, according to a Times database. On Friday, there were 699 new cases, the governor said.
The French drug maker Sanofi said on Friday that it had secured an agreement of up to $2.1 billion to supply the U.S. federal government with 100 million doses of its experimental coronavirus vaccine, the largest such deal announced to date. The arrangement with Sanofi and its partner, the British pharmaceutical company GlaxoSmithKline, brings the Trump administration’s investment in coronavirus vaccine projects to more than $8 billion. This effort, known as Operation Warp Speed, is placing bets on multiple vaccines and is paying companies to manufacture millions of doses before clinical trials have been completed.
The Trump administration wasted around $500 million by overpaying for ventilators through negotiations that were “inept,” a panel of the House Oversight and Reform Committee said in a report released Friday. It faulted Peter Navarro, Mr. Trump’s top trade adviser, and Jared Kushner, his son-in-law and senior adviser, for negotiating a deal in which the panel said they paid almost five times the price per device than under a previous contract with the same vendor.
Florida broke a record — the most deaths the state reported in a single day — for the fourth day in a row: On Friday, the state announced 257 additional fatalities. Mississippi reported its most deaths in a single day from the virus, 52, and North Dakota reported a new single-day case record, 164.
Even with significant gaps in the available data, there are strong indications that Native American people have been disproportionately affected by the virus. The rate of known cases in the eight counties with the largest populations of Native Americans is nearly double the national average, a Times analysis has found.
Greenwich, Conn., one of the wealthiest suburbs in the country, is experiencing what health officials have called a “mini surge” of infections, an outbreak that has cascaded through the community and underscored how social gatherings among young people are posing fresh challenges to containing the virus. More than 20 people between the ages 16 and 21 have tested positive for the virus, with more cases expected as testing continues, according to Greenwich health officials.
Black youth detained in juvenile justice facilities have been released at a far slower rate than their white peers in response to the coronavirus, according to a new report that also found that the gap in release rates between the two groups had nearly doubled over the course of the pandemic. The report, released this month by the Annie E. Casey Foundation, illustrates one more disparity the coronavirus has exacerbated for Black children, who are disproportionately funneled into the juvenile justice system.
Reporting was contributed by Liz Alderman, Ian Austen, Luke Broadwater, Julia Calderone, Emily Cochrane, Kate Conger, Michael Cooper, Michael Crowley, Robert Gebeloff, Erica L. Green, Jan Hoffman, Rebecca Halleck, Michael Levenson, Giulia McDonnell Nieto del Rio, Eshe Nelson, Richard A. Oppel Jr., Richard C. Paddock, Elian Peltier, Matt Phillips, Austin Ramzy, Motoko Rich, Amanda Rosa, Eliza Shapiro, Megan Specia, Sheryl Gay Stolberg, Eileen Sullivan, Katie Thomas, Tracey Tulley, Neil Vigdor, Katherine J. Wu and Mihir Zaveri.