GAINESVILLE, Fla. -- The Trump administration shelved a document created by the nation's top disease investigators with step-by-step advice to local authorities on how and when to reopen restaurants and other public places during the coronavirus outbreak.
Meanwhile on Thursday, the head of the National Institutes of Health said the nation faces "truly daunting" challenges to deploy millions of coronavirus tests to safely reopen the economy.
The 17-page shelved report by a Centers for Disease Control and Prevention team, titled "Guidance for Implementing the Opening Up America Again Framework," was researched and written to help faith leaders, business owners, educators, and state and local officials as they begin to reopen.
It was supposed to be published last Friday, but agency scientists were told that the guidance "would never see the light of day," according to a CDC official. The official was not authorized to talk to reporters and spoke to The Associated Press on the condition of anonymity.
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A person close to the White House's coronavirus task force said the CDC documents were never cleared by CDC leadership for public release. The person said White House officials have refrained from offering detailed guidance for how specific sectors should reopen because the virus is affecting various parts of the country differently. The person spoke on the condition of anonymity to discuss internal deliberations.
The AP obtained a copy from a second federal official who was not authorized to release it. The guidance was described in AP stories last week, before the White House decision to shelve it.
The CDC has not had a regular, pandemic-related news briefing in nearly two months. CDC Director Dr. Robert Redfield has been a member of the White House coronavirus task force but has been largely absent from public appearances.
"CDC has always been the public health agency Americans turn to in a time of crisis," said Dr. Howard Koh, a Harvard professor and former health official in the Obama administration during the H1N1 swine flu pandemic in 2009. "The standard in a crisis is to turn to them for the latest data and latest guidance and the latest press briefing. That has not occurred, and everyone sees that."
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The Trump administration has instead sought to put the onus on states to handle the coronavirus response.
REOPENING GUIDANCE
The rejected reopening guidance was described by one of the federal officials as a touchstone document that was to be used as a blueprint for other groups inside the CDC that are creating the same type of instructional materials for other facilities.
The guidance contained detailed advice for making site-specific decisions related to reopening schools, restaurants, summer camps, churches, day care centers and other institutions. It had been widely shared within the CDC and included detailed "decision trees," flow charts to be used by local officials to think through different scenarios. One page of the document can be found on the CDC website via search engines, but it did not appear to be linked to any other CDC pages.
Some of the report's suggestions already appear on federal websites. But the guidance offered specific, tailored recommendations for reopening in one place.
For example, the report suggested that restaurants and bars install sneeze guards at cash registers and avoid having buffets, salad bars and drink stations. Similar tips appear on the CDC's site and a Food and Drug Administration page.
But the shelved report also said that as restaurants start seating diners again, they should space tables at least 6 feet apart and try to use phone app technology, rather than distributing buzzers, to alert patrons when their tables are ready. That's not on the CDC's site now.
"States and local health departments do need guidance on a lot of the challenges around the decision to reopen," said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. "You can say that restaurants can open, and you need to follow social distancing guidelines. But restaurants want to know, 'what does that look like?'"
The White House's "Opening Up America Again" guidelines released last month instructed state and local governments to reopen in accordance with federal and local "regulations and guidance" and to monitor employees for symptoms of covid-19.
The White House guidance also included advice developed earlier in the pandemic like social distancing and encouraging working from home.
At a briefing Wednesday, White House spokeswoman Kayleigh McEnany echoed the administration's stance that states are most responsible for their own covid-19 response. "We've consulted individually with states, but as I said, it's [a] governor-led effort. It's a state-led effort on which the federal government will consult. And we do so each and every day."
States that directly reach out to the CDC can tap guidance that's been prepared.
"I don't think that any state feels that the CDC is deficient. It's just the process of getting stuff out," Plescia said.
TESTING GOALS
On availability of tests, National Institutes of Health Director Francis Collins told the Senate Health, Education, Labor and Pensions committee that government and private industry have launched a $2.5 billion, taxpayer-funded effort to develop, manufacture and distribute technology capable of accurately testing millions of people a week by the end of the summer or the fall, before the annual flu season.
"I must tell you, senators, that this is a stretch goal that goes well beyond what most experts think will be possible," Collins said. "I have encountered some stunned expressions when describing these goals and this timetable to knowledgeable individuals. The scientific and logistical challenges are truly daunting."
Nonetheless, Collins said "the track record of American ingenuity" gives him optimism. More than three months into the epidemic, the lack of testing is widely acknowledged as a central failing in the nation's response.
The U.S. is currently testing more than a million people a week for covid-19, and White House coronavirus adviser Dr. Deborah Birx has said that weekly number should rise to 2 million or 2.5 million by the middle of June.
Collins said the goal is to have highly accurate tests that can provide quick results at the "point-of-care," such as a doctor's office or a community health clinic.
At the White House on Thursday, Trump welcomed Texas Gov. Greg Abbott and held a National Day of Prayer service in the Rose Garden, praying for front-line workers and the families of those who have fallen sick.
"Texas is opening up and a lot of places are opening up. And we want to do it, and I'm not sure that we even have a choice," Trump told reporters. "I think we have to do it. You know, this country can't stay closed and locked down for years."
Texas is among a long list of states that have been gradually allowing businesses to reopen. However, White House guidelines recommend that states wait until they have seen a two-week decline in documented cases before beginning phased reopenings.
Trump has taken a hands-off approach to the reopening process, insisting that decisions be left to the states.
Later, in the Rose Garden, the president and first lady Melania Trump expressed their sympathies for people who have lost loved ones, then faith leaders from different religious affiliations offered prayers from a separate lectern.
"In recent days and weeks, our country has endured a grave hardship. We pray for every family stricken with grief and devastated with a tragic loss," as well as the doctors, nurses and first responders "waging war against the invisible enemy," Trump said.
MASKS RULING REVERSED
In other news, the Food and Drug Administration reversed a decision to allow the emergency use of dozens of N-95 face masks made in China, after government testing found that many didn't work properly.
The agency had authorized use of the masks to help address shortages of personal protective equipment, on the condition that their effectiveness was verified by independent testing labs. That policy, put in place April 3, is being reversed based on testing by the National Institute for Occupational Safety and Health that found that many masks from China failed to meet filtration standards.
Dow Jones earlier reported that the FDA was pulling the authorization.
Also, the White House said Thursday that a member of the military serving as one of the president's valets has tested positive for covid-19. It said Trump and Vice President Mike Pence have since tested negative for the virus and "remain in good health."
The White House was moving to shore up its protocols to protect the nation's political leaders. Trump said some staffers who interact with him closely will now be tested daily. Pence told reporters that he and Trump will now be tested daily, as well.
Trump, 73, said the incident was a bit concerning. "It's a little bit strange but it's one of those things," he told reporters. "As I said, you know, I said yesterday, governor, all people are warriors in this country. Right now we're all warriors."
Trump said the health scare showed the "fallacy" of calls for widespread nationwide testing. "Testing is not a perfect art," he said, adding, "even when you test once a day somebody could, something happens where they catch something."
In New York City, new research reveals that the coronavirus outbreak grew so large by early March that the city became the primary source of new infections in the United States, as thousands of infected people traveled from the city and seeded outbreaks around the country.
The research indicates that a wave of infections swept from New York City through much of the country before the city began setting social distancing limits to stop the spread. That helped to fuel outbreaks in Louisiana, Texas, Arizona and as far away as the West Coast.
The findings are drawn from geneticists' tracking signature mutations of the virus, travel histories of infected people and models of the outbreak by infectious disease experts.
"We now have enough data to feel pretty confident that New York was the primary gateway for the rest of the country," said Nathan Grubaugh, an epidemiologist at the Yale School of Public Health.
Information for this article was contributed by Jason Dearen, Mike Stobbe, Darlene Superville, Zeke Miller, Ricardo Alonso-Zaldivar, Jill Colvin, Paul Weber and Kevin Freking of The Associated Press; by Anna Edney of Bloomberg News; and by Benedict Carey and James Glanz of The New York Times.
A Section on 05/08/2020