with Paulina Firozi
It’s an understatement to say coronavirus testing has been a struggle for President Trump’s Department of Health and Human Services.
The agency wasted precious time in February and March when it should have been ramping up testing. Its earliest testing kits failed because of likely contamination. And now it’s not getting funding for testing and contact tracing out the door fast enough, Democrats are complaining.
Yet Trump made light of the whole thing over the weekend.
At a campaign rally in Tulsa on Saturday night, incidentally the first time in months that thousands of people have gathered in an indoor area, the president appeared to mock the need for testing. He called widespread testing a “double-edged sword” — comments that White House officials later downplayed as a joke.
“Here’s the bad part,” Trump said. “When you do testing to that extent, you’re going to find more people, you’re going to find more cases. So I said to my people, ‘Slow the testing down, please!’ ”
White House trade adviser Peter Navarro told CNN’s Jake Tapper the president was joking, saying the remarks came during a “light moment.”
“Come on now, Jake, you know it was tongue-in-check,” Navarro said. “That was tongue-in-cheek, please.”
Trump made a similar comment in an overnight tweet:
Our Coronavirus testing is so much greater (25 million tests) and so much more advanced, that it makes us look like we have more cases, especially proportionally, than other countries. My message on that is very clear!— Donald J. Trump (@realDonaldTrump) June 22, 2020
But to critics, it didn’t matter whether Trump was joking.
The remarks were in poor taste, many said, given the nation is still gripped by a pandemic that has killed nearly 120,000 Americans and hospitalized many more.
"Looking at it as a scoreboard is the wrong way to think about it,” said Amesh Adalja, an infectious-disease expert at the Johns Hopkins Center for Health Security. “To think of it as something you can manipulate or slow down based on what the numbers look like speaks to a complete misunderstanding of what an infectious-disease response should be.”
Several senior administration officials involved in the coronavirus response expressed frustration behind the scenes with Trump's comments, The Post's Yasmeen Abutaleb, Taylor Telford and Josh Dawsey report.
“One senior official described the coronavirus response as something of a political albatross,” they write. “The person noted that administration officials and the vice president have been trying to convince the public that Trump is working tirelessly to stamp out the virus — and faster than ever before.”
Yascha Mounk, associate professor at Johns Hopkins University:
Even here, it's important to acknowledge that Trump may be joking. So don't say "oh my god, the Trump administration deliberately slow-walked testing" unless you have the receipts.— Yascha Mounk (@Yascha_Mounk) June 21, 2020
The fact that the president made this "joke" after over 100,000 Americans died is bad enough.
Andy Slavitt, head of the Centers for Medicare and Medicaid Services under President Barack Obama:
If you stop giving mammograms there will be less cancer.— Andy Slavitt @ 🏡 (@ASlavitt) June 21, 2020
The United States has now conducted more than 26 million coronavirus tests, equivalent to about 8 percent of the nation’s population.
The Trump administration has largely met testing goals Azar laid out in May, after an initial slow response that won it heavy criticism.
Yet the ramped-up testing reveals a troubling reality: Coronavirus cases are on the rise in many states, as lockdowns ease and Americans start mingling more with each other. While part of the rise may be due to increased testing capturing more cases, that doesn’t fully explain the spikes, experts say.
The same day Trump talked about slowing testing, eight states reported their highest single-day case counts since the pandemic began. Daily new infections exceeded 30,000, the highest totals in more than seven weeks.
David Gelles, executive producer for CNN:
Arizona's coronavirus cases have nearly doubled in 14 days— David P Gelles (@gelles) June 21, 2020
Arizona health officials reported 2,592 new Covid-19 cases on Sunday, bringing the statewide total to 52,390
On June 7th, the state reported 26,989 total cases, according to John Hopkins University's tally.
FiveThirtyEight's Nate Silver:
Most cases in a day since May 1. In better news, this was a record day for tests. But, note that the positive test rate is ticking UP, not down. So while tests are increasing, cases are increasing faster.— Nate Silver (@NateSilver538) June 20, 2020
And now HHS is on the hook to spend $25 billion provided by Congress for testing and contact tracing.
Two leading Democrats complained yesterday the agency isn’t distributing the funds quickly enough.
HHS has yet to distribute one-third of the money for diagnostic and antibody testing and contact tracing provided as part of the fourth pandemic relief bill passed by Congress at the end of April, Senate Minority Leader Charles E. Schumer (D-N.Y.) and Sen. Patty Murray (D-Wash.) noted in a letter sent to HHS Secretary Alex Azar.
“While it has been months since these funds were first appropriated, the administration has failed to disburse significant amounts of this funding, leaving communities without the resources they need to address the significant challenges presented by the virus,” according to the letter, obtained by The Health 202.
In response, HHS noted it has distributed $14 billion of the $25 billion pot of funds. Eleven billion went to states and localities, as directed in the legislative text.
Yet it's true the agency hasn't yet laid out how it will spend $8 billion of the funding for which Congress didn’t provide specific directions. That lack of guidance is making the whole thing complicated for HHS because individual lawmakers are making demands for how it should be spent, said Michael Caputo, assistant secretary for public affairs.
“Now members [of Congress] are contacting HHS with their individual priorities and complaining the dollars are not spent to their wishes,” Caputo said in a statement. “Regardless, HHS is committed to working with Congress to ensure the healthcare delivery system gets the support needed at this time.”
HHS is also under fire for a blunder involving faulty coronavirus test kits.
The test kits for detecting the nation’s earliest cases of the virus failed because of “likely” contamination at the Centers for Disease Control and Prevention, whose scientists did not thoroughly check the kits despite “anomalies” during manufacturing, my colleague David Willman reports.
“A new federal review, conducted by two Department of Health and Human Services lawyers, also said there was ‘time pressure’ at the CDC to launch testing, and ‘lab practices that may have been insufficient to prevent the risk of contamination,’ ” David writes.
“The review is the first confirmation by the Trump administration that the original test kits were likely contaminated, and that the problem appeared to have occurred in late January within the CDC’s headquarters in Atlanta. In general, HHS has defended the administration’s efforts to counter the pandemic,” he writes.
The CDC’s failure with the test in the early stages led to a delay in widespread testing across the country.
The federal review said the contamination “most likely” happened at the agency's Respiratory Virus Diagnostic Lab during processing and testing. “It was at this stage of the manufacture, when the bulk reagent materials for the test kits were processed and tested at [the respiratory virus lab], that they were most likely exposed to positive control material," the report said.
Ahh, oof and ouch
AHH: Coronavirus cases are surging in California, Texas, Florida and Arizona weeks into their reopening process.
But their governors largely aren't reconsidering the moves to reopen the economy.
In California, there were early and aggressive stay-at-home orders that “made public health officers from Silicon Valley to Wine Country household names as coronavirus infection rates stayed low relative to the East Coast,” Scott Wilson writes. “Science-based decisions, for a time, appeared to win the argument over those worried foremost about the death of the California economy.”
But three weeks into the state’s gradual reopening, California Gov. Gavin Newsom (D) said he has no plans to reverse course, even as he acknowledged the rising number of cases.
“As we phase in — in a responsible way — a reopening of the economy, we’ve made it abundantly clear that we anticipate an increase in the total number of positive cases,” Newsom said last week.
“California recorded two straight days of record-high new infections last weekend, and recently it sailed past the milestone of 5,000 people killed by the virus. The state has recorded 167,000 total infections, and it is now reporting the highest weekly average of new cases — roughly 2,785 — since the virus began,” Scott writes.
OOF: South Korean health officials say the country is experiencing a second wave of the pandemic.
Authorities said Monday the wave is concentrated around its densely populated capital and stems from a holiday weekend in May, Reuters reports.
“In the metropolitan area, we believe that the first wave was from March to April as well as February to March,” Jeong Eun-kyeong, director of the Korea Centres for Disease Control and Prevention, said at a briefing. “Then we see that the second wave which was triggered by the May holiday has been going on.”
“At the end of February, South Korea reported a peak of more than 900 cases in a day, in the first large outbreak of the coronavirus outside of China,” Reuters writes. “An intensive tracking and testing campaign reduced the numbers to single digits by late April….But just as the country announced it would be easing social distancing guidelines in early May, new cases spiked, driven in part by infections among young people who visited nightclubs and bars in Seoul over the holiday weekend.”
OUCH: McKinsey is helping HHS oversee and audit relief payments for at least 10 of the consulting firm's former clients.
McKinsey has previously worked for at least ten of the hospitals and chains that are now receiving relief funds from the federal government, Politico’s Daniel Lippman and Maggie Severns report. McKinsey received a $4.9 million contract to help HHS set up audit procedures for the funds.
Most of the $175 billion in relief dollars had yet to be paid out to hospitals when McKinsey was hired. But the firm denied playing any role in deciding which hospitals got funds.
“Among those that have already received payments are at least 10 hospitals and chains that have in recent years retained McKinsey & Co.’s extensive health care business, which employs more than 1,700 consultants," Daniel and Maggie write. "The hospitals have paid as much as $20 million for McKinsey’s services in a single year as they seek to streamline costs and boost revenue, according to public disclosures.”
A McKinsey spokesman told Politico the company does not determine which organizations receive federal funds, and added it does not determine any “payment methodology or priority of how payment should be made.”
“Nonetheless, neither the firm nor HHS specified whether consultants who previously worked for chains in the past were now helping audit their grants under the federal recovery act,” Daniel and Maggie add. “But a McKinsey spokesperson said the firm’s partners overseeing its work with HHS have not served health care providers in the past four years, and most McKinsey employees on the project have never worked with health care providers.”
Working toward a vaccine
Researchers want to make sure the coronavirus vaccine candidates will protect older adults that are particularly at risk.
Health experts are worried about the possibility that older people’s weaker immune systems mean a vaccine will be less effective, the Wall Street Journal’s Jared S. Hopkins reports.
“To find a vaccine that works safely in older adults, researchers at Pfizer and other companies are exploring possible options such as increasing the doses or adding a booster to the shot,” Jared writes. “At least one vaccine specifically for the elderly is in development. And Pfizer, the University of Oxford and others have started testing their coronavirus vaccine candidates in older adults.”
“It would not be particularly encouraging if we have a vaccine that’s capable of protecting 20-year-olds who probably have a pretty low risk anyway of getting sick, and doesn’t work at all for people over 65,” National Institutes of Health director Francis Collins told him.
Researchers at Boston Children’s Hospital are working to develop a vaccine specifically for older adults, and the hospital has narrowed the search to about seven candidates.
The economic fallout
Two new studies show massive federal assistance prevented people from falling into poverty amid the lockdowns.
The studies found only small changes to the poverty rate, even though many low-income people lost their jobs in March, April and May, the New York Times’s Jason DePerle reports.
A Columbia University team's forecast “has poverty rising only slightly this year to 12.7 percent, from 12.5 percent before the coronavirus," he writes. “Without the Coronavirus Aid, Relief and Economic Security Act — the March law that provided one-time checks to most Americans and weekly bonuses to the unemployed — it would have reached 16.3 percent, the researchers found. That would have pushed nearly 12 million more people into poverty.”
A separate study from researchers at the University of Chicago and Notre Dame found incomes actually rose among needy Americans in April. “They estimate that poverty in April and May fell to 8.6 percent for the previous 12 months, from 10.9 percent in January and February,” Jason writes.
“The studies carry important caveats," Jason adds. "Many Americans have suffered hunger or other hardships amid long delays in receiving the assistance, and much of the aid is scheduled to expire next month. Millions of people have been excluded from receiving any help, especially undocumented migrants, who often have American children."
A few more stories to catch up on after the weekend:
In the region:
- The District of Columbia will join the rest of the region in moving to the second phase of its coronavirus recovery plan, which means gyms can reopen, and restaurants can reopen indoor seating at limited capacity, Rachel Chason and Ian Shapira report.
In the states:
- New York City hired 3,000 workers for contact tracing, but so far they’ve had trouble gathering information from infected people, or even reaching them at all, the New York Times’s Sharon Otterman reports.
The Trump administration’s efforts:
- White House trade adviser Peter Navarro acknowledged the Trump administration is preparing for a possible second coronavirus wave. In an interview on CNN’s “State of the Union,” he said: “We are filling the stockpile in anticipation of a possible problem in the fall…We’re doing everything we can beneath the surface.” But he added: “I’m not saying it’s going to happen, but of course you prepare.”
The latest on hydroxychloroquine:
- The National Institutes of Health stopped its clinical trial of hydroxychloroquine, a drug Trump has repeatedly touted, saying that it is “very unlikely to be beneficial.”