Combined with messaging from the White House minimizing the disease, that fueled a lackluster response that missed chances to slow the spread of the virus, they said.

“There were many, many opportunities not to end up where we are,” Dr. Ashish K. Jha, the director of the Global Health Institute at Harvard, told the AP. “Basically, they took this as business as usual. ... And that’s because the messaging from the White House was ‘this is not a big deal, this is no worse than the flu.’ So that message basically created no sense of urgency within the FDA or the CDC to fix it.”

Trump last week rated his administration’s response to the crisis as a perfect 10. However, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the CDC’s system wasn’t designed to test for and track a widespread outbreak, which he characterized as “a failing.”

In interviews with the AP, two federal health officials with direct knowledge of the situation said CDC experts don’t know why many of the agency’s test kits failed to reliably detect the virus. The officials spoke on condition of anonymity because they were not authorized to speak publicly about what went wrong.

J. Stephen Morrison, a health policy expert at the Center for Strategic and International Studies in Washington, called the testing issues a “debacle,” contributing to what he described as a confused and delayed federal response to the crisis.

As a result, he said, the CDC has now been marginalized within the White House — a worrisome development.

The CDC published the technical details for its COVID-19 test on Jan. 28, 10 days after the WHO. By then, the virus had already been in the U.S. for at least two weeks.

The 35-year-old man who would become the first American to test positive had arrived in Seattle on Jan. 15, following a trip to Wuhan. After swabs from his nose and throat were flown to the CDC lab, federal officials announced the results Jan. 21.

In an interview on CNBC the following day, the president was asked about the risk to the nation.

“We have it totally under control,” he said. “It’s one person coming in from China. ... It’s going to be just fine.”

With limited capacity at the CDC lab in Atlanta, the agency placed strict criteria on who could be tested: people with fevers, coughing or difficulty breathing who had also visited Wuhan within the preceding two weeks or who had close contact with someone already confirmed or under investigation for having the virus.

On Jan. 30, the day WHO declared the outbreak a public health emergency, Trump again assured the American people that the virus was “very well under control.”

Then he departed for a weekend at his Mar-a-Lago club in Florida, where he tweeted a photo of himself playing golf at his club in West Palm Beach.

“Getting a little exercise this morning!” the president wrote.

The following day, the U.S. declared its own emergency. Still, U.S. citizens returning from China who did not have a fever weren’t tested for the virus but were encouraged to self-quarantine at home for 14 days.

At that point, the CDC had confirmed just eight cases of COVID-19 in the U.S. The agency amended its testing criteria to include people with fevers who had traveled to China, rather than specifically just Wuhan.

As more sick people sought to be tested, many states were forced to limit access because of the flawed CDC test. Accounts began to emerge through social media of people with all the symptoms of COVID-19 who either couldn’t get tested or had test results delayed by days or even a week.

“I know of doctor friends of mine who have critically ill patients in the ICU, and we don’t know if they have COVID or not because we can’t get a test,” Jha said last week.

On Feb. 24, exasperated officials at the Association of Public Health Laboratories sent a letter to the FDA, basically asking permission for state labs to develop their own tests. Within days, the FDA reversed its previous position and said both public and private labs could conduct testing.

Trump, for his part, continued to insist the virus would die out on its own. “One day, it’s like a miracle. It will disappear,” he predicted Feb. 27.

By then, experts say, the opportunity to halt the relentless spread of the virus within the U.S. population had been lost.

On Feb. 29, only 472 patients had been tested nationwide, with just 22 cases confirmed, according to CDC data. Of those, nine cases were not related to travel but had spread person-to-person within the U.S.

Trump has also attempted to mislay blame for the testing troubles on the Obama administration. In 2018, Trump disbanded the White House directorate charged with preparing for and responding to global pandemics.

“I don’t take responsibility at all,” Trump replied when asked about the testing shortfall in a March 13 briefing at the White House.

Morrison said Trump appears to see the virus as a political issue rather than a public health threat.

“You can imagine a White House that said, ‘Do whatever it takes to test everybody for the virus,’” he said. “That wasn’t the mentality. It was the opposite mentality, and ultimately the responsibility to protect the American people lies with the White House.”

Only in the last few days has the United States finally begun testing more people each day than far smaller South Korea, according to data complied by Johns Hopkins University.

https://apnews.com/c335958b1f8f6a37b19b421bc7759722

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39848863)

Author: Mr. WuFlu

Each day that the administration debated the travel measures, roughly 14,000 travelers arrived in the United States from China, according to figures cited by the Trump administration. Among them was a traveler who came from Wuhan to Seattle in mid-January, who turned out to be the first confirmed case in the United States.

https://www.reuters.com/article/us-health-coronavirus-nsc/as-trump-administration-debated-travel-restrictions-thousands-streamed-in-from-china-idUSKBN21N0EJ

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39950172)

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39987521)

Okay, maybe XO poasters.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39849058)

Trump is basically what happens when XO wins the WH

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39849055)

And they consider themselves grown men

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39939744)

You libs are really pathetic

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39849174)

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39850415)

To contain the virus, the asian countries had very aggressive case tracing and public alerts (e.g., via texting).

China requires you to leave your name and phone number at every public place you visit. They call everyone who's visited a place with the virus. People also need to be personally responsible and self quarantine.

Seems we dont have the legal framework or culture to allow this type of public alerts.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39911859)

Aggressive screening might have helped contain the coronavirus in the United States. But technical flaws, regulatory hurdles and lapses in leadership let it spread undetected for weeks.

By Michael D. Shear, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas and Noah Weiland

March 28, 2020

Updated 3:45 p.m. ET

WASHINGTON — Early on, the dozen federal officials charged with defending America against the coronavirus gathered day after day in the White House Situation Room, consumed by crises. They grappled with how to evacuate the United States consulate in Wuhan, China, ban Chinese travelers and extract Americans from the Diamond Princess and other cruise ships.

The members of the coronavirus task force typically devoted only five or 10 minutes, often at the end of contentious meetings, to talk about testing, several participants recalled. The Centers for Disease Control and Prevention, its leaders assured the others, had developed a diagnostic model that would be rolled out quickly as a first step.

But as the deadly virus from China spread with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

The absence of robust screening until it was “far too late” revealed failures across the government, said Dr. Thomas Frieden, the former C.D.C. director. Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said the Trump administration had “incredibly limited” views of the pathogen’s potential impact. Dr. Margaret Hamburg, the former commissioner of the Food and Drug Administration, said the lapse enabled “exponential growth of cases.”

And Dr. Anthony S. Fauci, a top government scientist involved in the fight against the virus, told members of Congress that the early inability to test was “a failing” of the administration’s response to a deadly, global pandemic. “Why,” he asked later in a magazine interview, “were we not able to mobilize on a broader scale?”

Across the government, they said, three agencies responsible for detecting and combating threats like the coronavirus failed to prepare quickly enough. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense.

Dr. Robert R. Redfield, 68, a former military doctor and prominent AIDS researcher who directs the C.D.C., trusted his veteran scientists to create the world’s most precise test for the coronavirus and share it with state laboratories. When flaws in the test became apparent in February, he promised a quick fix, though it took weeks to settle on a solution.

Image

Dr. Robert R. Redfield is the head of the C.D.C.. The test his agency developed failed in February.

Dr. Robert R. Redfield is the head of the C.D.C.. The test his agency developed failed in February.Credit...Anna Moneymaker/The New York Times

The C.D.C. also tightly restricted who could get tested and was slow to conduct “community-based surveillance,” a standard screening practice to detect the virus’s reach. Had the United States been able to track its earliest movements and identify hidden hot spots, local quarantines might have confined the disease.

Dr. Stephen Hahn, 60, the commissioner of the Food and Drug Administration, enforced regulations that paradoxically made it tougher for hospitals, private clinics and companies to deploy diagnostic tests in an emergency. Other countries that had mobilized businesses were performing tens of thousands of tests daily, compared with fewer than 100 on average in the United States, frustrating local health officials, lawmakers and desperate Americans.

Image

Regulations at the F.D.A., led by Dr. Stephen Hahn, made it difficult for hospitals to test patients at the same rate as in other countries.

Regulations at the F.D.A., led by Dr. Stephen Hahn, made it difficult for hospitals to test patients at the same rate as in other countries.Credit...Anna Moneymaker/The New York Times

Alex M. Azar II, who led the Department of Health and Human Services, oversaw the two other agencies and coordinated the government’s public health response to the pandemic. While he grew frustrated as public criticism over the testing issues intensified, he was unable to push either agency to speed up or change course.

Mr. Azar, 52, who chaired the coronavirus task force until late February, when Vice President Mike Pence took charge, had been at odds for months with the White House over other issues. The task force’s chief liaison to the president was Mick Mulvaney, the acting White House chief of staff, who was being forced out by Mr. Trump. Without high-level interest — or demands for action — the testing issue festered.

Image

Under Alex M. Azar II, the health secretary, the C.D.C. and F.D.A. failed to break out of their business-as-usual habits.

Under Alex M. Azar II, the health secretary, the C.D.C. and F.D.A. failed to break out of their business-as-usual habits.Credit...Anna Moneymaker/The New York Times

At the start of that crucial lost month, when his government could have rallied, the president was distracted by impeachment and dismissive of the threat to the public’s health or the nation’s economy. By the end of the month, Mr. Trump claimed the virus was about to dissipate in the United States, saying: “It’s going to disappear. One day — it’s like a miracle — it will disappear.”

By early March, after federal officials finally announced changes to allow more expansive testing, it was too late to escape serious harm.

Now, the United States has more than 100,000 coronavirus cases, the most of any country in the world. Yet even with deaths on the rise, cities shuttered, the economy sputtering and everyday life upended, many Americans who come down with symptoms of Covid-19 still cannot get tested.

In a statement, Judd Deere, a White House spokesman, said that “any suggestion that President Trump did not take the threat of Covid-19 seriously or that the United States was not prepared is false.” He added that at Mr. Trump’s direction, the administration had “expanded testing capacities.”

Dr. Bruce Aylward, a senior adviser at the World Health Organization, led an expert team to China last month to research the mysterious new virus. Testing, he said, was “absolutely vital” for understanding how to defeat a disease — what distinguishes it from others, the spectrum of illness and, most important, its path through populations.

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“You want to know whether or not you have it,” Dr. Aylward said. “You want to know whether the people around you have it. Because you know what? Then you could stop it.”

“You can’t stop it,” he warned, “if you can’t see it.”

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Medical workers with a patient in Wuhan, China, in January. The U.S. health secretary would declare a public health emergency at the end of the month.

Medical workers with a patient in Wuhan, China, in January. The U.S. health secretary would declare a public health emergency at the end of the month.Credit...EPA, via Shutterstock

A Startling Setback

The first time Dr. Robert Redfield heard about the severity of the virus from his Chinese counterparts was around New Year’s Day, when he was on vacation with his family. He spent so much time on the phone that they barely saw him. And what he heard rattled him; in one grim conversation about the virus days later, George F. Gao, the director of the Chinese Center for Disease Control and Prevention, burst into tears.

Dr. Redfield, a longtime AIDS researcher, had never run a government agency before his appointment to lead the C.D.C. in 2018. Until then, his biggest priorities had been fighting the opioid epidemic and the spread of H.I.V. Suddenly, a man who preferred treating patients in Haiti or Africa to being in the public glare was facing a new pandemic threat.

At first, Dr. Redfield’s agency moved quickly.

On Jan. 7, the C.D.C. created an “incident management system” for the coronavirus and advised travelers to Wuhan to take precautions. By Jan. 20, just two weeks after Chinese scientists shared the genetic sequence of the virus, the C.D.C. had developed its own test, as usual, and deployed it to detect the country’s first coronavirus case.

“That’s our prime mission,” Dr. Redfield said later in an interview, “to get eyes on this thing.”

Assessing the virus would prove challenging. It was so new that scientists had little information to work with. China provided limited data, and rebuffed an early attempt by Mr. Azar and Dr. Redfield to send C.D.C. experts there to learn more. That the virus could cause no symptoms and still spread — something not initially known — made it all the more difficult to understand.

To identify the virus, the C.D.C. test used three small genetic sequences to match up with portions of a virus’s genome extracted from a swab. A German-developed test that the W.H.O. was distributing to other countries used just two, potentially making it less precise.

But soon after the F.D.A. cleared the C.D.C. to share its test kits with state health department labs, some discovered a problem. The third sequence, or “probe,” gave inconclusive results. While the C.D.C. explored the cause — contamination or a design issue — it told those state labs to stop testing.

The startling setback stalled the C.D.C.’s efforts to track the virus when it mattered most. By mid-February, the nation was testing only about 100 samples per day, according to the C.D.C.’s website.

Dr. Redfield played down the problem in task force meetings and conversations with Mr. Azar, assuring him it would be fixed quickly, several administration officials said.

With capacity so limited, the C.D.C.’s criteria for who was tested remained extremely narrow for weeks to come: only people who had recently traveled to China or had been in contact with someone who had the virus.

A string of critical errors.

The U.S.’s Slow Start to Coronavirus Testing: A TimelineMarch 28, 2020

The lack of tests in the states also meant local public health officials could not use another essential epidemiological tool: surveillance testing. To see where the virus might be hiding, nasal swab samples from people screened for the common flu would also be checked for the coronavirus.

The C.D.C. announced a plan on Feb. 14 to perform the screening in five high-risk cities: New York, Chicago, Los Angeles, San Francisco and Seattle. An agency official said it could provide “an early warning signal to trigger a change in our response strategy.” But most of the cities could not carry it out.

“Had we had done more testing from the very beginning and caught cases earlier,” said Dr. Nuzzo, of Johns Hopkins, “we would be in a far different place.”

The consequences became clear by the end of February. For the first time, someone with no known exposure to the virus or history of travel tested positive, in the Seattle area, where the U.S.’s first case had been detected more than a month earlier. The virus had probably been spreading there and elsewhere for weeks, researchers later concluded. Without a more complete picture of who had been infected, public health workers could not do “contact tracing” — finding all those with whom any contagious people had interacted and then quarantining them to stop further transmission.

The C.D.C. gave little thought to adopting the test being used by the W.H.O. The C.D.C.’s test was working in its own lab — still processing samples from states — which gave agency officials confidence. Dr. Anne Schuchat, the agency’s principal deputy director, would later say that the C.D.C. did not think “we needed somebody else’s test.”

And the German-designed W.H.O. test had not been through the American regulatory approval process, which would take time.

Throughout February, Dr. Redfield shuttled between Atlanta, where the C.D.C. is based, and Washington, holding multiple calls every day with Mr. Azar and participating in the coronavirus task force.

Mr. Azar’s take-charge style contrasted with the more deliberative manner of Dr. Redfield, who lacked the kind of commanding television presence that impressed Mr. Trump. He was “a consensus person,” as one colleague described him, who sought to avoid conflict. He relied heavily on some of the C.D.C.’s career scientists, like Dr. Schuchat and Dr. Nancy Messonnier, the director of the agency’s National Center for Immunization and Respiratory Diseases.

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Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, has taken a public role in the crisis.

Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, has taken a public role in the crisis.Credit...Amanda Voisard/Reuters

Under scrutiny from Congress, Dr. Redfield offered reassurances. Responding on Feb. 24 to a letter from 49 members of Congress about the need for testing in the states, he wrote, “CDC’s aggressive response enables us to identify potential cases early and make sure that they are properly handled.”

Days later, his agency provided a workaround, telling state and local health department labs that they could finally begin testing. Rather than awaiting replacements, they should use their C.D.C. test kits and leave out the problematic third probe.

Meanwhile, the agency’s epidemiologists were growing more concerned as the virus spread in South Korea and Italy. On Feb. 25, Dr. Messonnier gave a briefing with a much blunter warning than usual. “Disruption to everyday life might be severe,” she said.

Mr. Trump, returning from a trip to India, was furious, according to senior administration officials. Later that day, Mr. Azar seemed to be tamping down the level of concern. All Dr. Messonnier had meant, he said at a news conference, was that people should “start thinking about, in their own lives, what that might involve.”

“Might,” Mr. Azar repeated emphatically. “Might involve.”

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The C.D.C.’s flawed testing kit for the new coronavirus.

The C.D.C.’s flawed testing kit for the new coronavirus.Credit...Centers for Disease Control and Prevention

Barriers to Testing

Dr. Stephen Hahn’s first day as F.D.A. commissioner came just six weeks before Mr. Azar declared a public health emergency on Jan. 31. A radiation oncologist and researcher who helped turn around MD Anderson in Houston, one of the nation’s leading cancer centers, Dr. Hahn had come to Washington to oversee a sprawling federal agency that regulates everything from lifesaving therapies to dog food.

But overnight, his mission — to manage 15,000 employees in a culture defined by precision and caution — was upended. A pathogen that Mr. Trump would later call the “invisible enemy” was hurtling toward the United States. It would fall to the newly arrived Dr. Hahn to help build a huge national capacity for testing by academic and private labs.

Instead, under his leadership, the F.D.A. became a significant roadblock, according to current and former officials as well as researchers and doctors at laboratories around the country.

Private-sector tests were supposed to be the next tier after the C.D.C. fulfilled its obligation to jump-start screening at public labs. In other countries hit hard by the coronavirus, governments acted quickly to speed tests to their populations. In South Korea, for example, regulators in early February summoned executives from 20 medical manufacturers, easing rules as they demanded tests.

But Dr. Hahn took a cautious approach. He was not proactive in reaching out to manufacturers, and instead deferred to his scientists, following the F.D.A.’s often cumbersome methods for approving medical screening.

Even the nation’s public health labs were looking for the F.D.A.’s help. “We are now many weeks into the response with still no diagnostic or surveillance test available outside of C.D.C. for the vast majority of our member laboratories,” Scott Becker, chief executive of the Association of Public Health Laboratories, wrote to Mr. Hahn in late February. “We believe a more expeditious route is needed at this time.”

Ironically, it was Mr. Azar’s emergency declaration that established the rules Dr. Hahn insisted on following. Designed to make it easier for drugmakers to pursue vaccines and other therapies during a crisis, such a declaration lets the F.D.A. speed approvals that could otherwise take a year or more.

But the emergency announcement created a new barrier for hospitals and laboratories that wanted to create their own tests to diagnose the coronavirus. Usually, they faced minimal federal regulation. But once Mr. Azar took action, they were subject to an F.D.A. process called an “emergency use authorization.”

Even though researchers around the country quickly began creating tests that could diagnose Covid-19, many said they were hindered by the F.D.A.’s approval process. The new tests sat unused at labs around the country.

Stanford was one of them. Researchers at the world-renowned university had a working test by February, based on protocols published by the W.H.O. The organization had already delivered more than 250,000 of the German-designed tests to 70 laboratories around the world, and doctors at the Stanford lab wanted to be prepared for a pandemic.

“Even if it didn’t come, it would be better to be ready than not to be ready,” said Dr. Benjamin Pinsky, the lab’s medical director.

But in the face of what he called “relatively tight” rules at the F.D.A., Dr. Pinsky and his colleagues decided against even trying to win permission. The Stanford clinical lab would not begin testing coronavirus samples until early March, when Dr. Hahn finally relaxed the rules.

Executives at bioMérieux, a French diagnostics company, had a similar experience. The company makes a countertop testing system, BioFire, that is routinely used to check for the flu and other respiratory illnesses in 1,700 hospitals around the country. It can provide results in about 45 minutes.

“A lot of us said, you know, your typical E.U.A. is just much too demanding,” said Dr. Mark Miller, the company’s chief medical officer, referring to the emergency approval. “It’s going to take much too much time. And can’t you do something to shorten that?”

Officials at the F.D.A. tried to be responsive, Dr. Miller said. But rather than throw out the rules, the agency only modified the regulatory requirements, still requiring weeks of discussions and negotiations.

After conversations with the F.D.A. in mid-February, the company received emergency approval for its BioFire test on March 24. (The company also began talking to the F.D.A. in January about another type of test, but decided not to pursue it in the United States for now.) Dr. Miller said that while he was ultimately satisfied with the F.D.A.’s actions, the overall response by the government was too slow, especially when it came to logistical questions like getting enough testing supplies to those who needed them.

“You’ve got other countries — and I’m sorry, unfortunately, the U.S. is one of those — where they’ve been slow, disorganized,” he said. “There are still not enough tests available there to test everybody who needs it.”

In an emailed statement, Dr. Hahn maintained that his agency had moved as quickly as it safely could to ensure that tests would be accurate. “Since the early days of this pandemic,” he said, “the F.D.A.’s doors have always been and still remain open to test developers.”

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Mr. Azar speaking about the public health response in January after five cases were confirmed in the United States.

Mr. Azar speaking about the public health response in January after five cases were confirmed in the United States.Credit...Samuel Corum/Getty Images

A Lack of Trust

Alex Azar had sounded confident at the end of January. At a news conference in the hulking H.H.S. headquarters in Washington, he said he had the government’s response to the new coronavirus under control, pointing out high-ranking jobs he had held in the department during the 2003 SARS outbreak and other infectious threats.

“I know this playbook well,” he told reporters.

A Yale-trained lawyer who once served as the top attorney at the health department, Mr. Azar had spent a decade as a top executive at Eli Lilly, one of the world’s largest drug companies. But he caught Mr. Trump’s attention in part because of other credentials: After law school, Mr. Azar was a clerk for some of the nation’s most conservative judges, including Justice Antonin Scalia of the Supreme Court. And for two years, he worked as Ken Starr’s deputy on the Clinton Whitewater investigation.

As Mr. Trump’s second health secretary, confirmed at the beginning of 2018, Mr. Azar has been quick to compliment the president and focus on the issues he cares about: lowering drug prices and fighting opioid addiction. On Feb. 6 — even as the W.H.O. announced that there were more than 28,000 coronavirus cases around the globe — Mr. Azar was in the second row in the White House’s East Room, demonstrating his loyalty to the president as Mr. Trump claimed vindication from his impeachment acquittal the day before and lashed out at “evil” lawmakers and the F.B.I.’s “top scum.”

As public attention on the virus threat intensified in January and February, Mr. Azar grew increasingly frustrated about the harsh spotlight on his department and the leaders of agencies who reported to him, according to people familiar with the response to the virus inside the agencies.

Described as a prickly boss by some administration officials, Mr. Azar has had a longstanding feud with Seema Verma, the Medicare and Medicaid chief, who recently became a regular presence at Mr. Trump’s televised briefings on the pandemic. Mr. Azar did not include Dr. Hahn on the virus task force he led, though some of the F.D.A. commissioner’s aides participated in H.H.S. meetings on the subject.

And tensions grew between the secretary and Dr. Redfield as the testing issue persisted. Mr. Azar and Dr. Redfield have been on the phone as often as a half-dozen times a day. But throughout February, as the C.D.C. test faltered, Mr. Azar became convinced that Dr. Redfield’s agency was providing him with inaccurate information about testing that the secretary repeated publicly, according to several administration officials.

In one instance, Mr. Azar appeared on Sunday morning news programs and said that more than 3,600 people had been tested for the virus. In fact, the real number was much smaller because many patients were tested multiple times, an error the C.D.C. had to correct in congressional testimony that week. One health department official said Mr. Azar was repeatedly assured that the C.D.C.’s test would be widely available within a week or 10 days, only to be given the same promise a week later.

Asked about criticism of his agency’s response to the pandemic, Dr. Redfield said: “I’m personally not focused on whether they’re pointing fingers here or there. We’re focused on doing all we can to get through this outbreak as quickly as possible and keep America safe.”

For all Mr. Azar’s complaints, however, he continued to defer to the scientists at the two agencies, according to several administration officials. Mr. Azar’s allies said he was told by Dr. Redfield and Dr. Fauci that the C.D.C. had the resources it needed, that there was no reason to believe the virus was spreading through the country from person to person and that it was important to test only people who met certain criteria.

But even in the face of a crescendo of complaints from doctors and health care researchers around the country, Mr. Azar failed to push those under him to do the one thing that could have helped: broader testing.

In a statement, Caitlin Oakley, Mr. Azar’s spokeswoman, said that the secretary had “empowered and followed the guidance of world-renowned U.S. scientists” on the testing issue. “Any insinuation that Secretary Azar did not respond with needed urgency to the response or testing efforts,” she said, “are just plain wrong and disproven by the facts.”

By Feb. 26, Dr. Fauci was concerned that the stalled testing had become an urgent issue that needed to be addressed. He called Brian Harrison, Mr. Azar’s chief of staff, and asked him to gather the group of officials overseeing screening efforts.

Around noon on Feb. 27, Dr. Hahn, Dr. Redfield and top aides from the F.D.A. and H.H.S. dialed in to a conference call. Mr. Harrison began with an ultimatum: No one leaves until we resolve the lag in testing. We don’t have answers and we need them, one senior administration official recalled him saying. Get it done.

By the end of the day, the group agreed that the F.D.A. should loosen regulations so that hospitals and independent labs could move forward quickly with their own tests.

But the evening before, Mr. Azar had been effectively removed as the leader of the task force when Mr. Trump abruptly put Mr. Pence in charge, a decision so last-minute that even the top health officials in the White House learned of it while watching the announcement.

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President Trump announcing the rollout of additional tests at the C.D.C. in early March.

President Trump announcing the rollout of additional tests at the C.D.C. in early March.Credit...T.J. Kirkpatrick for The New York Times

A Tacit Acknowledgment

Previous presidents have moved quickly to confront disease threats from inside the White House by installing a “czar” to manage the effort.

During an outbreak of the Ebola virus in 2014, President Barack Obama tapped Ron Klain, his vice president’s former chief of staff, to direct the response from the West Wing. Mr. Obama later created an office of global health security inside the National Security Council to coordinate future crises.

“If you look historically in the United States when it is challenged with something like this — whether it’s H.I.V. crises, whether it’s pandemic, whether it’s whatever — man, they pull out all the stops across the system and they make it work,” said Dr. Aylward, the W.H.O. epidemiologist.

But faced with the coronavirus, Mr. Trump chose not to have the White House lead the planning until nearly two months after it began. Mr. Obama’s global health office had been disbanded a year earlier. And until Mr. Pence took charge, the task force lacked a single White House official with the power to compel action.

Since then, testing has ramped up quickly, with nearly 100 labs at hospitals and elsewhere performing it. On Friday, the health care giant Abbott said it had received emergency approval for a portable test that could detect the virus in five minutes.

The president boasted on Tuesday that the United States had “created a new system that now we are doing unbelievably big numbers” of tests for the virus. The U.S., he said, had done more testing for the coronavirus in the last eight days than South Korea had done in eight weeks.

Image

Vice President Mike Pence discussing 15-day federal guidelines this month to “slow the spread” of the pandemic.

Vice President Mike Pence discussing 15-day federal guidelines this month to “slow the spread” of the pandemic.Credit...Doug Mills/The New York Times

Yet hospitals and clinics across the country still must deny tests to those with milder symptoms, trying to save them for the most serious cases, and they often wait a week for results. In tacit acknowledgment of the shortage, Mr. Trump asked South Korea’s president on Monday to send as many test kits as possible from the 100,000 produced there daily, more than the country needs.

Public health experts reacted positively to the increased capacity. But having the ability to diagnose the disease three months after it was first disclosed by China does little to address why the United States was unable to do so sooner, when it might have helped reduce the toll of the pandemic.

“Testing is the crack that split apart the rest of the response, when it should have tied everything together,” said Dr. Nahid Bhadelia, ​the medical director of the Special Pathogens Unit at Boston University School of Medicine.

“It seeps into every other aspect of our response, touches all of us,” she said. “The delay of the testing has impacted the response across the board.”

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39885757)

Magatards?

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39890590)

Atleast there would be some kind of basis for this one

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39912401)

control for shitlib enclaves like NYC metro and Calif., and USA is not that bad at all.

Sorry, shitlib.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39927514)

All that being said, at this date, I don’t see evidence that the US response is materially worse than other large western democracies. Seems like we’re on the fat part of the curve. Germany and maybe Canada doing great but UK, France, Italy, Spain not doing really better than US so far. Sweden even might be fucked.

Sure we can and should kill Trunp for not giving us a top 10% given our resources but it’s doesn’t look like a complete mess (yet) so far. Maybe our federal system giving governors real executive power might make up for many of Trumps deficiencies.

My biggest worry is that he’ll lift the restrictions too early without a plan for mass testing and we’ll have another breakout while the European counties manage things and don’t need a second shutdown.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39930673)

Jfc......

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39938286)

https://www.reuters.com/article/us-health-coronavirus-nsc/as-trump-administration-debated-travel-restrictions-thousands-streamed-in-from-china-idUSKBN21N0EJ

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39950172)

U should take an L but ur too dumb and ideological

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40218429)

Author: Mr. WuFlu

Each day that the administration debated the travel measures, roughly 14,000 travelers arrived in the United States from China, according to figures cited by the Trump administration. Among them was a traveler who came from Wuhan to Seattle in mid-January, who turned out to be the first confirmed case in the United States.

https://www.reuters.com/article/us-health-coronavirus-nsc/as-trump-administration-debated-travel-restrictions-thousands-streamed-in-from-china-idUSKBN21N0EJ

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39950172)

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40218436)

A review of federal purchasing contracts by the Associated Press shows that federal agencies largely waited until mid-March to begin placing bulk orders of N95 respirator masks, mechanical ventilators and other equipment needed by front-line healthcare workers.

https://www.latimes.com/world-nation/story/2020-04-05/u-s-wasted-months-before-preparing-for-virus-pandemic

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39951764)

A memo from Peter Navarro is the most direct warning known to have circulated at a key moment among top administration officials.

A top White House adviser starkly warned Trump administration officials in late January that the coronavirus crisis could cost the United States trillions of dollars and put millions of Americans at risk of illness or death.

The warning, written in a memo by Peter Navarro, President Trump’s trade adviser, is the highest-level alert known to have circulated inside the West Wing as the administration was taking its first substantive steps to confront a crisis that had already consumed China’s leaders and would go on to upend life in Europe and the United States.

“The lack of immune protection or an existing cure or vaccine would leave Americans defenseless in the case of a full-blown coronavirus outbreak on U.S. soil,” Mr. Navarro’s memo said. “This lack of protection elevates the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans.”

Dated Jan. 29, it came during a period when Mr. Trump was playing down the risks to the United States, and he would later go on to say that no one could have predicted such a devastating outcome.

Mr. Navarro said in the memo that the administration faced a choice about how aggressive to be in containing an outbreak, saying the human and economic costs would be relatively low if it turned out to be a problem along the lines of a seasonal flu.

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But he went on to emphasize that the “risk of a worst-case pandemic scenario should not be overlooked” given the information coming from China.

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In one worst-case scenario cited in the memo, more than a half-million Americans could die.

A second memo that Mr. Navarro wrote, dated Feb. 23, warned of an “increasing probability of a full-blown COVID-19 pandemic that could infect as many as 100 million Americans, with a loss of life of as many as 1.2 million souls.”

At that time, Mr. Trump was still downplaying the threat of the virus. The administration was considering asking Congress for more money to address the situation, and the second memo, which circulated around the West Wing and was obtained by The Times, urged an immediate supplemental spending appropriation from Congress of at least $3 billion.

“This is NOT a time for penny-pinching or horse trading on the Hill,” Mr. Navarro wrote in the second memo, which was unsigned but which officials attributed to him. It was unclear whether Mr. Trump saw the second memo, whose contents were first reported by Axios.

The second memo seemed aimed at members of the White House Task Force established by Mr. Trump to manage the crisis, and reflected deep divisions within the administration about how to proceed and persistent feuding between Mr. Navarro and many other top officials about his role and his views.

“Any member of the Task Force who wants to be cautious about appropriating funds for a crisis that could inflict trillions of dollars in economic damage and take millions of lives has come to the wrong administration,” the memo said.

Among other things, the memo called for an increase funding for the government to purchase personal protective equipment for health care workers, estimating they would need “at least a billion face masks” over a four-to-six-month period.

The administration ended up asking for $2.5 billion. Congress then approved $8 billion.

Mr. Navarro is now the administration’s point person for supply chain issues for medical and other equipment needed to deal with the virus.

The January memo written by Mr. Navarro was dated the same day that Mr. Trump named the task force to deal with the threat, and as the administration was weighing whether to bar some travelers from China, an option being pushed by Mr. Navarro.

Mr. Trump would approve the limits on travel from China the next day, though it would be weeks before he began taking more aggressive steps to head off spread of the virus.

Questions about Mr. Trump’s handling of the crisis, especially in its early days when he suggested it was being used by Democrats to undercut his re-election prospects, are likely to define his presidency. Mr. Navarro’s memo is evidence that some in the upper ranks of the administration had at least considered the possibility of the outbreak turning into something far more serious than Mr. Trump was acknowledging publicly at the time.

Neither Mr. Navarro nor spokespeople for the White House responded to requests for comment.

The memo, which was reviewed by The New York Times, was sent from Mr. Navarro to the National Security Council and then distributed to several officials across the administration, people familiar with the events said. It reached a number of top officials as well as aides to Mick Mulvaney, then the acting chief of staff, they said, but it was unclear whether Mr. Trump saw it.

Mr. Navarro is a well-established China hawk who has long been mistrustful of the country’s government and trade practices. Both Mr. Navarro and Matthew Pottinger, the chief deputy at the National Security Council, were among the few officials urging colleagues in January to take a harder line in relation to the growing threat of the coronavirus.

But their warnings were seen by other officials as primarily reflecting their concerns about China’s behavior — and their concerns look more prescient in hindsight than they actually were, other officials argue.

With the subject line “Impose Travel Ban on China?” Mr. Navarro opened the memo by writing, “If the probability of a pandemic is greater than roughly 1%, a game-theoretic analysis of the coronavirus indicates the clear dominant strategy is an immediate travel ban on China.”

Mr. Navarro concluded at one point: “Regardless of whether the coronavirus proves to be a pandemic-level outbreak, there are certain costs associated with engaging in policies to contain and mitigate the spread of the disease. The most readily available option to contain the spread of the outbreak is to issue a travel ban to and from the source of the outbreak, namely, mainland China.”

He suggested that under an “aggressive” containment scenario, a travel ban may need to last as long as 12 months for proper containment, a duration of time that at that point some White House aides saw as unsustainable.

The travel limits subsequently imposed by Mr. Trump did not entirely ban travel from China, and many travelers from the country continued to stream into the United States.

Mr. Navarro was at odds with medical experts like Dr. Anthony S. Fauci, who had argued that such travel bans only delay the eventual spread.

Mr. Navarro alluded to that debate on Saturday during a separate argument with Dr. Fauci in the Situation Room about whether the anti-malaria drug hydroxychloroquine was effective in treating or preventing the virus, according to two people familiar with the events.

In the memo, Mr. Navarro cautioned that it was “unlikely the introduction of the coronavirus into the U.S. population in significant numbers will mimic a ‘seasonal flu’ event with relatively low contagion and mortality rates.”

He noted the history of pandemic flus and suggested the chances were elevated for one after the new pathogen had developed in China.

“This historical precedent alone should be sufficient to prove the need to take aggressive action to contain the outbreak,” he wrote, going on to say the early estimates of how easily the virus was spreading supported the possibility that the risks were even greater than the history of flu pandemics suggested.

Mark Mazzetti contributed reporting.

https://www.nytimes.com/2020/04/06/us/politics/navarro-warning-trump-coronavirus.html

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39960189)

HHS spokeswoman Katie McKeogh said the remaining 10% will be kept in reserve to support federal response efforts.

House Oversight Chairwoman Carolyn B. Maloney, D-N.Y., said in a statement that the Trump administration is leaving states to scour the open market for scarce supplies, often competing with each other and federal agencies in a chaotic bidding war that drives up prices.

“The President failed to bring in FEMA (the Federal Emergency Management Agency) early on, failed to name a national commander for this crisis, and failed to fully utilize the authorities Congress gave him under the Defense Production Act to procure and manage the distribution of critical supplies,” Maloney said. “He must take action now to address these deficiencies.”

For the last month, health care workers across the nation have taken to social media to illustrate the shortages by taking selfies wearing home-sewn masks on their faces and trash bags over their scrubs.

President Donald Trump has faulted the states for not better preparing for the pandemic and has said they should only being relying on the federal stockpile as a last resort.

The AP reported Sunday that the Trump administration squandered nearly two months after the early January warnings that COVID-19 might ignite a global pandemic, waiting until mid-March to place bulk orders of N95 masks and other medical supplies needed to build up the stockpile. By then, hospitals in several states were treating thousands of infected patients without adequate equipment and were pleading for help.

https://apnews.com/a464316e25560d393bd07a021b7e81ba

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39977814)

Jared Kushner

https://www.newyorker.com/news/letter-from-trumps-washington/the-coronavirus-and-how-the-united-states-ended-up-with-nurses-wearing-garbage-bags

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39987312)

https://twitter.com/MarkDice/status/1248697036112723969?s=19

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39988518)

The one where a bunch of nurses in PPE put balloons on their rear ends and danced around in a hallway (near patient rooms, which I'm guessing are empty) is really cute too.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39992192)

President Trump announced plans to roll out "self-isolating" in mid March.

"We look at it from a pure health standpoint," Fauci said. "We make a recommendation, often the recommendation is taken, sometimes it's not.

"But it is what it is."

https://www.the-sun.com/news/672794/fauci-lives-saved-us-shut-down-earlier/

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40000494)

An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response.

https://www.nytimes.com/2020/04/11/us/politics/coronavirus-trump-response.html

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40000513)

https://twitter.com/maggienyt/status/1249384733798170627?s=21

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40002820)

That would have had a 5% chance of containment. And if it did work, it would have required we keep all borders closed for five years.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40002833)

1. Should have closed China much earlier and included Europe in it (http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#39950172)

2. Should have had mass testing ready to go and screened everyone returning from Wuhan by mid-late January when other countries were doing so. There should be no debate they bungled the testing horribly. Least controversial statement I've made. (http://xoxohth.com/thread.php?thread_id=4485407&mc=133&forum_id=2#39885757)

3. If that failed, should have proactively locked down Washington and New York much earlier instead of waiting for governor to do so. Look at how successful California has been, relatively speaking.

4. There are about 20 other failures all listed above if you care to inform.

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40012307)

https://www.rawstory.com/2020/04/kellyanne-conway-buried-in-ridicule-for-scientifically-illiterate-covid-19-rant/

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40023269)

https://news.gallup.com/poll/308675/trump-job-rating-slides-satisfaction-tumbles.aspx

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40037087)

State officials and labs say competition for supplies and questionable results are prolonging the national crisis

https://www.wsj.com/articles/coronavirus-testing-hampered-by-disarray-shortages-backlogs-11587328441

3 months and trumpfags still can’t get their test right

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40049489)

https://news.yahoo.com/trump-let-u-fall-behind-120054883.html

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40049600)

https://washingtonmonthly.com/2020/04/21/how-trump-wasted-the-best-tool-he-had-to-fight-coronavirus/

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40065558)

https://www.dailymail.co.uk/news/article-8255403/Donald-Trump-WALKS-coronavirus-briefing-disinfectant-disaster.html

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40087444)

https://www.nydailynews.com/coronavirus/ny-coronavirus-new-yorkers-household-cleaners-trump-20200425-rnaqio5dyfeaxmthxx2vktqa5m-story.html

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40093505)

A shortfall in masks lays bare the blunders by hospitals, manufacturers and the federal government

https://www.wsj.com/articles/miscalculation-at-every-level-left-u-s-unequipped-to-fight-coronavirus-11588170921

(http://www.autoadmit.com/thread.php?thread_id=4485407&forum_id=2#40121547)