Trump Suggests Daily Briefings No Longer Worth His Time as White House Considers Replacing Health Secretary

Trump Suggests Daily Briefings No Longer Worth His Time as White House Considers Replacing Health Secretary

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As governors weigh reopening 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. And while the United States has made strides over the past month in expanding testing, its capacity is nowhere near the level President Trump suggests it is.

There are numerous reasons. 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.

The United States conducted about 1.2 million tests from April 16 to April 22, up from about 200,000 tests from March 16 to March 22, according to data from the Covid Tracking Project. In both conservative and liberal states, governors, health departments and hospitals are finding innovative ways to cope, but the nation is far from being able to conduct the kind of widespread surveillance testing that health experts say would be optimal.

“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.

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.

“What can I do? What can I do?” he asked. “Everywhere, the coronavirus.”

Mr. Virachan’s hesitancy almost cost him his life. And he is not the only patient taking grave chances.

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.

A recent paper by cardiologists at nine large medical centers estimated a 38 percent reduction since March 1 in the number of patients with serious heart attacks coming in to have urgently needed procedures to open their arteries.

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.

When college campuses shut down around the country, many students moved back in with their parents, bemoaning the loss of independence, social connections and academic networking that are so much a part of the college experience.

But for many of the estimated one million international students attending college in the United States, the situation was much more drastic.

A lot of them came from well-off families who could secure temporary accommodations for them, or fly them home.

But others got here after their families saved, borrowed and sacrificed to pay their tuition and board, which typically is set at top-dollar rates and is an important cash-earner for colleges. For those students, continuing their college careers has become a big “if.”

The few temporary dorms set up by universities can cost more than what they were paying before. Many are couch surfing with friends, and hitting up food banks to eat. Some flew home, though their ability to return, amid visa restrictions and flight bans, is open to question.

One student started getting up at 3 a.m. to continue her linear algebra class online from Tanzania, with a seven-hour time difference.

My world is shattering,” said Elina Mariutsa, a Russian student studying international affairs and political science at Northeastern University.

Americans abroad have their own dilemma.

Those who had assumed they could stay overseas, and wait for the pandemic to ebb, now face an unnerving choice: Either stick it out, and prepare for the possibility they will be infected with the virus and treated in foreign hospitals, or chance catching it on the way back home.

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.”

A recent survey from the Pew Research Center found that the pandemic has had a devastating impact on minorities and lower-income families: More than half of lower-income adults have had someone in their household lose their job, or seen their pay cut. Among Hispanic adults surveyed, that figure climbs to over 60 percent. More than half of lower-income respondents also said they would struggle to pay their bills this month, the survey found.

A separate analysis from Pew, released on Friday, found that, while the number of new unemployment claims has surged to record highs, many unemployed people will not receive benefit payments.

The rules vary widely by state, according to the analysis. In March, just over 65 percent of unemployed residents of Massachusetts received benefit payments; in Florida, which has been struggling with an unemployment website that Gov. Ron DeSantis calls “a jalopy,” about 8 percent of jobless residents received the aid. (That number has since gone up slightly.)

But as some states start to reopen businesses and revive their economies, researchers have found that many of the jobs that are restored are lower-income positions. That raises a set of challenges for workers: Heightened odds of coming in contact with the virus, while also having limited access to health care compared with other economic groups.

“We know people rely on these jobs,” said Oleta Garrett Fitzgerald, who is part of the Southern Rural Black Women’s Initiative. She notes that, in many places, “folks are subject to lose these jobs at the drop of a hat.”

Experts said it was critical for more widespread testing to be conducted in order to help protect these workers. “Otherwise, we are sending our people into a roaring furnace to get burned up,” said Dr. Camara Phyllis Jones, a professor of community health and preventive medicine at the Morehouse School of Medicine. “Our people are not disposable.”

The Metropolitan Opera’s At-Home Gala — a worldwide relay of live streamed performances that, in contrast to opera’s usual grandeur, was filmed using only household devices — was presented at and will remain available until Sunday evening Eastern time.

It has an only-in-opera level of aspiration and difficulty: a roster of more than 40 of the company’s starriest singers, plus members of the orchestra and chorus, performing live across nine time zones. Among them are Lisette Oropesa, in Baton Rouge, La.; Anna Netrebko, in Vienna; and Piotr Beczala, in what he described to Peter Gelb, the Met’s general manager, as a village at the end of the earth in Poland.

The Met halted performances on March 12 in response to the coronavirus pandemic — and eventually canceled the remainder of its season.

Mr. Gelb — who hosted from New York along with Yannick Nézet-Séguin, the Met’s music director, who is in Montreal — said that the idea came about because “I am determined to keep the Met in the consciousness of the broader public, and I am determined to use any possible means to do that.”

Since the opera house went dark, it has posted a free stream from its vast Met Opera On Demand library every night. (Mr. Gelb said that in the past five weeks, the number of paid subscribers to that on-demand service has doubled, to 30,000.) Each stream is accompanied by a “Donate Now” button; the At-Home Gala has one, too, though Mr. Gelb was quick to emphasize that this is not “a PBS telethon.”

The introduction of economic stimulus payments over the past several weeks has brought mixed results and some confusion as the government has struggled to get cash into the hands of some 150 million eligible recipients.

While tens of millions of Americans received payments quickly through direct deposit last week, many others have been offered little information about when their payments might arrive, or have battled identity theft or seizures of their payments by their banks.

The payments have also become a political device, as President Trump has sought to associate the payments with his leadership.

Several people whose payments were approved for direct deposit this month have reported receiving letters from the Treasury Department with a signed statement from the president about the White House’s efforts to address the coronavirus crisis.

“As we wage total war on this invisible enemy, we are also working around the clock to protect hardworking Americans like you from the consequences of the economic shutdown,” one letter said.

The Treasury Department announced last week that some Americans would receive their payments by check, and that in a departure from standard practice, the checks would bear the president’s name.

Regardless of how their payments arrive, more Americans may experience additional delays in the weeks ahead because of systemic disconnects between the Internal Revenue Service and the sprawling tax preparation industry, according to a report in ProPublica.

With the coronavirus outbreak freezing public life, the prospective Democratic presidential nominee, Joseph R. Biden Jr., has been forced to adapt to a cloistered mode of campaigning never before seen in modern American politics.

Interviews with dozens of people in touch with the former vice president and his advisers revealed a newly detailed picture of Mr. Biden’s life in seclusion, one spent in long-distance consultation with a wide array of coalition leaders helping him map out the fall campaign and a potential administration.

For the most part, Mr. Biden is seeking to run a campaign based on something like digital-age fireside chats, offering himself as a calmly authoritative figure rather than a brawler like his opponent.

He does not make a habit of watching the president’s briefings in full; he is said to be fixated mainly on the eventual challenge — if he wins — of governing amid a pandemic.

But he has lamented being deprived of human contact, and he has expressed exasperation with media coverage critiquing his limited visibility compared with President Trump’s daily performances in the White House briefing room.

In normal times, Hussam Ghazzi would usually celebrate the Islamic holy month of Ramadan with friends in New York City. But this year, he is observing the holiday alone in his Manhattan apartment, where he has been holed up for the past five weeks during the coronavirus pandemic.

The isolation has taken an emotional toll on Mr. Ghazzi, 35, but he found some solace on Friday night when he logged on to a friend’s virtual Iftar, the breaking of the fast at sunset, not long after city residents clapped en masse to thank health care workers.

“Even though we were in different time zones, it gave us an opportunity to all be together,” he said.

Like so many other facets of everyday life, the coronavirus pandemic has upended the rituals and traditions of Ramadan, when Muslims fast from sunrise to sunset. With mosques closed, imams reading the Quran online, and families practicing social distancing at home, the holiday, which began on Thursday night, is looking profoundly different across the globe.

The disease caused by the coronavirus has killed more than 10,500 residents and staff members at nursing homes and long-term care facilities nationwide, according to a New York Times analysis. That is nearly a quarter of deaths in the United States from the pandemic.

But states including California, New Jersey and New York are increasingly turning to nursing homes to relieve the burden on hospitals and take in Covid-19 patients considered stable enough to be released.

Although there is no evidence so far that the practice has allowed infections to spread in nursing homes, many residents and advocates fear that it is only a matter of time. One lawsuit in New Jersey alleges that a worker was likely to have been sickened by a Covid-19 patient readmitted from a hospital.

In New York, the epicenter of the outbreak, Gov. Andrew M. Cuomo described nursing homes on Saturday as a “feeding frenzy for this virus.” But the state issued a strict new rule last month: Nursing homes must readmit residents sent to hospitals with the coronavirus and accept new patients as long as they are deemed “medically stable.”

Homes can turn patients away if they claim they can’t care for them safely — but administrators say they worry that could provoke regulatory scrutiny.

In contrast to these states, Connecticut and Massachusetts designated certain facilities for Covid-19 patients alone — considered the safest way to free up hospital beds. The Washington Health Care Association, which represents long-term care facilities in Washington State, has asked officials to adopt a similar policy. So far, they have not.

“It’s got to happen,” said Robin Dale, the association’s president. “Then we would not have this hodgepodge of every nursing home in the state having one or two positives and crossing your fingers that it works out.”

There is a growing list of detailed plans for how the federal government can bring the United States economy safely out of lockdown and back on a path to normalcy amid the coronavirus pandemic. Congress is not following any of them.

Danielle Allen, the director of Harvard’s Edmond J. Safra Center for Ethics, said Congress had fallen well short of the $50 billion to $300 billion that her group said would be needed to fund 20 million tests a day — the amount her organization said would be required to “fully remobilize the economy” by August.

The Nobel Prize-winning economist Paul Romer envisions an even higher number: He wants the country to be able to test every American for the virus once every two weeks, which works out to 25 million tests per day. He has called for $100 billion to begin building that capacity, four times what was in the latest aid package that President Trump signed on Friday.

“No one is talking about the number I’m talking about,” Mr. Romer said. “This is a case of, the more the better. We should take anything we can get, in terms of tests.”

If the government is unable to scale up testing to the degree that experts are calling for, economists warn there is a good chance unemployment will remain high and thousands of businesses stay at risk of failing.

Yet as the Congressional Budget Office on Friday released a set of dire economic forecasts, Republicans and Democrats who have previously agreed on a series of ever-larger taxpayer-financed spending packages were already clashing over the scope and timing of the next aid package — particularly whether it should contain relief for state and local governments. No action was expected until May.

“There are no laws of physics that have to be overcome to do what we need to do,” Ms. Allen said. “There are laws of politics that have to be overcome.”


Credit…via Kahn family

Philip Kahn liked to say that history repeats itself, a truism that has hit home for his family in extraordinary fashion.

His twin brother, Samuel, died as an infant during the Spanish Flu pandemic of 1918-19. Now Mr. Kahn himself has died of the coronavirus. He was 100.

“He was a very healthy 100,” Warren Zysman, one of his grandsons, said in a phone interview. “He watched the news, he was completely aware of the pandemic. When he started coughing, he knew he might have it, and he knew the irony of what was going on.”

Mr. Kahn, a decorated World War II veteran, died on April 17 at his home on Long Island. He had never known his brother; the twins were born in Manhattan on Dec. 15, 1919, while the Spanish flu was still raging. The boys were only few weeks old when Samuel died.

“He always told me how hard the loss of his brother was for his parents,” Mr. Zysman said, “and that he carried this void with him his entire life.”

If you are in need of inspiration for some games to play with your friends or family this weekend, here are some tried-and-true classics, a few new video game finds, and several tips on analog favorites.

Reporting was contributed by Vikas Bajaj, Scott Cacciola, Michael Levenson, Joshua Barone, Karen Barrow, Alexander Burns, Ben Casselman, Emily Cochrane, Caitlin Dickerson, Richard Fausset, Ellen Gabler, Katie Glueck, Shane Goldmacher, Michael M. Grynbaum, Maggie Haberman, Christine Hauser, Lara Jakes, Gina Kolata, Sharon LaFraniere, Dan Levin, Apoorva Mandavilli, Jonathan Martin, Zach Montague, Kwame Opam, Katie Rogers, Rick Rojas, Katharine Q. Seelye, Farah Stockman, Sheryl Gay Stolberg, Jim Tankersley and Alan Yuhas.

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