President Trump unveils a plan to help states expand testing. Experts say it is not enough.
In the seven weeks since the president promised that anyone who needed a test could get one, the United States has conducted about 5.4 million tests, far more than any other country, but still the equivalent of only about 1.6 percent of the total population.
A group of experts convened by Harvard University’s Edmond J. Safra Center for Ethics has called for five million tests a day by early June, ramping up to 20 million per day by late July.
Under growing pressure to expand coronavirus testing as states move to reopen their economies, President Trump unveiled a plan on Monday to ramp up the federal government’s help to states, but his proposal ran far short of what most public health experts say is necessary.
Mr. Trump’s announcement came after weeks of his insisting, inaccurately, that the nation’s testing capability was “fully sufficient to begin opening up the country,” as he put it on April 18. Numerous public health experts say that is untrue, and Mr. Trump’s plan may do little to fix it.
Mr. Trump on Tuesday defended his administration’s efforts.
An administration official said the federal government aimed to give states the ability to test at least 2 percent of their populations per month, though the president did not use that figure and it was not in his written plan. Instead, Mr. Trump and other officials with him in the Rose Garden said the United States would “double” the number of tests it had been conducting.
“These were not complaining people. They had everything they needed. They had their ventilators, they had their testing,” Mr. Trump said on Monday after a call with governors. “We’re getting them what they need.”
In fact, governors have been complaining that they do not have nearly enough tests to give them the kind of information they need to make difficult decisions about reopening. They say they are competing with one another — and with other countries — for the components that make up the testing kits, including nasal swabs and needed chemicals.
Rather than one coordinated federal response, the Trump administration has been engaging on an ad hoc basis as states take the lead.
The C.D.C. expands the list of symptoms, and the W.H.O. warns of a long road ahead.
Even as governors across the United States proceeded cautiously with plans to allow businesses to reopen and other nations looked for ways to restart stalled economies, the workings of the virus continued to vex the scientific and medical community.
For weeks, most people in the United States have been told that they qualify for a test only if they have three symptoms associated with the disease: high fever, cough and shortness of breath.
As health experts have gained more experience with Covid-19, the disease caused by the virus, they are finding that many infected people have no fevers or that their fevers wax and wane over a period of weeks and are sometimes accompanied by chills.
The Centers for Disease Control and Prevention has now expanded the list of symptoms to include repeated shaking with chills, muscle pain, headache, sore throat and a loss of taste or smell.
That differs from the guidance of the World Health Organization, which says that the most common symptoms are fever, dry cough and tiredness.
“Some patients may have aches and pains, nasal congestion, sore throat or diarrhea,” the W.H.O. says. “These symptoms are usually mild and begin gradually.”
The Oxford scientists say that with an emergency approval from regulators, the first few million doses of their vaccine could be available by September — at least several months ahead of any of the other announced efforts — if it proves to be effective.
Dr. Tedros Adhanom Ghebreyesus, the director of the W.H.O., told a virtual news conference in Geneva on Monday that the pandemic was far from over.
“We have a long road ahead of us and a lot of work to do,” he said.
States have different strategies for restarting the economy. Trump suggests opening some schools.
In some states, restaurants would remain closed. In others, they would be allowed to open with stringent new seating requirements. From the construction industry to entertainment, the rules of engagement varied depending on the state or city.
Gov. Greg Abbott of Texas announced that stores, restaurants, movie theaters and malls would be allowed to reopen with limited capacity on Friday. In Ohio, Gov. Mike DeWine unveiled a more incremental plan that would allow manufacturing work to resume and offices to reopen next week.
Arizona and Florida have stay-at-home orders that are set to expire on Thursday, but the governors of both states have been vague about their plans.
Organized like a PowerPoint presentation with roughly 25 slides, the tutorial describes what the virus is; how it is treated; how to avoid getting it; and the conditions laid down by the state — wearing masks, not congregating — for a safe work environment.
Each employee is supposed to fill out a short form attesting to having read the material. Vermont will not actually police compliance, although Gov. Phil Scott said that every company should appoint a safety officer to monitor work conditions.
“This is evolving, it’s not perfect, it’s not a flip of the switch, it is just something we have to provide, guidance, and there is going to be some social pressure as well to adhere to these procedures,” Mr. Scott told reporters on Monday. “I think guidance and education is the best policy.”
The state allowed people in solitary professions to return to work last week, including appraisers, property managers and attorneys who work alone.
It added manufacturing and construction businesses but limited the number of workers at any one location to five. Outdoor retailers like gardening centers and greenhouses can also reopen, but with a maximum of 10 people.
Even as governors moved to ease restrictions, business owners were often left trying to make sense of a cacophony of messages from President Trump, governors, county commissioners and mayors.
“I couldn’t sleep last night because I was so confused,” Jose Oregel said on Monday morning before reopening his barbershop in Greeley, Colo.
In a call with the nation’s governors, Mr. Trump’s growing impatience with the restrictions was evident.
He suggested that some governors should move to reopen their public schools before the end of the academic year.
“Some of you might start to think about school openings,” Mr. Trump said, according to an audio recording obtained by The New York Times. “The young children have done very well in this disaster that we’ve all gone through, so a lot of people are thinking about the school openings.”
At least one state was already moving forward with the possibility of reopening schools. Montana, which has among the fewest cases and deaths, will give schools the option to reopen starting May 7.
Rhode Island gives the appearance of a state where the coronavirus is a fire raging, the average number of daily infections more than quadrupling since the start of this month.
The reality is more complicated and encouraging, as state health workers have tested more residents per capita in Rhode Island than in any other state, leading them to discover many infections that might have gone overlooked elsewhere.
“All I hear is testing, testing, testing,” said Dr. Ashish Jha, who is director of Harvard’s Global Health Institute and is helping Rhode Island’s government. “The bottom line is that there is no magic formula and the federal government is too often absent. But there are common lessons from states that have done a good job.”
Five percent of Rhode Island’s residents have undergone a test, compared with about 1 percent of people in states like Texas and Georgia, where reopening efforts are taking shape. Rhode Island has been conducting an average of 283 tests per 100,000 residents a day, compared with 79 tests per 100,000 people in the United States overall.
“Rhode Island is shining a light into the dark in a way that very few other states are doing,” said Mark Lurie, a professor of epidemiology at Brown University in Providence.
Remote learning is driving some parents to their breaking points.
With teachers relegated to computer screens, parents have to play teacher’s aide, hall monitor, counselor and cafeteria worker — all while trying to do their own jobs under extraordinary circumstances.
Essential workers are in perhaps the toughest spot, especially if they are away from home during school hours, leaving just one parent, or no one at all, at home when students need them most.
Yarlin Matos of the Bronx, whose husband still goes to work as a manager at a McDonald’s, has seven children, ages 3 to 13, to keep on track. She spent part of her stimulus check on five Amazon Fire tablets because the devices promised by the city’s Education Department had not arrived.
Ms. Matos, a psychology major at Bronx Community College, said she must stay up late, sometimes until 3 a.m., trying to get her own work done after helping her children.
“I had a breaking moment where I had to lock myself in the bathroom and cry,” she said. “It was just too much.”
Parental engagement has long been seen as critical to student achievement, as much as class size, curriculum and teacher quality. That has never been more true than now, and all across the country, moms and dads pressed into emergency service are finding it one of the most exasperating parts of the pandemic.
Ciarra Kohn’s third-grade son uses five different apps for school. Her 4-year-old’s teacher sends lesson plans, but Ms. Kohn has no time to do them.
Her oldest, a sixth-grader, has eight subjects and eight teachers and each has a different method. Sometimes when Ms. Kohn does a lesson with him, she’ll ask if he understood it — because she didn’t.
“I’m assuming you don’t, but maybe you do,” said Ms. Kohn, of Bloomington, Ill., referring to her son. “Then we’ll get into an argument, like, ‘No, Mom! She doesn’t mean that, she means this!’”
The officials say new Treasury Department rules that prohibit local governments from using their share of $150 billion provided last month for “revenue replacement” are impractical. Requiring that such assistance be confined to costs directly tied to the pandemic will be of limited help, they say, particularly in communities that have a low incidence of cases but have seen their revenue dry up because of the shutdown of the economy.
“It is clear the revenue loss is going to be coronavirus related; it is just that the expenditures are not specifically for coronavirus,” said Senator Sherrod Brown of Ohio, one of 46 senators in the Democratic caucus who signed a letter made public on Sunday urging the administration to revise the ban.
The Federal Reserve said on Monday that it would substantially expand its municipal lending program, allowing smaller cities and counties to sell their investment-grade debt to the central bank.
Virtual coffees with college students for high school juniors. Zoom sessions between applicants and admissions officers. Student guides offering welcoming messages in video selfies and scenic views of university campuses captured by drones.
This is what spring college tour season looks like across America, where universities are going to great lengths to show off lecture halls, green space, libraries and laboratories that have all been emptied out by the pandemic.
“The hardest thing to recreate is what we call that ‘wow’ moment, when you’re on campus and you’re like, ‘Mom, this is where I need to be,’” said Sunil Samuel, an admissions officer at Hofstra University in Hempstead, N.Y.
Isaiah Finley, a junior at Shaker Heights High School in Shaker Heights, Ohio, had to cancel a planned spring break road trip with two friends to visit several colleges in New York City, where he wants to pursue a career in theater. Touring campuses online just isn’t the same, he said.
“I’m a person big on being in the moment — when you feel something in you from being in the environment,” Mr. Finley said. “Me sitting in my house and watching a video probably wouldn’t tell me anything different than looking at pictures.”
Virtual tours or not, some high school counselors said they were having trouble getting students to engage. With sick relatives, family members experiencing job losses and general worries about the virus mounting, some students have tuned out of the college process.
“It’s really hard right now,” said Kelley Winter, a counselor at Lincoln Southeast High School in Lincoln, Neb., where school is called off for the year. “We are just trying to get kids to log into the system to complete their classes, so I don’t know how many of them right now have college on the brain.”
But some scientists express fear that Mr. Trump’s remarks could breathe life into a fringe movement that embraces the medicinal powers of a powerful industrial bleach known as chlorine dioxide, which the president did not mention specifically.
“For a lot of people, Trump represents an alternative to pointy-headed experts in white lab coats who speak a language we can’t understand,” said Dr. Alan Levinovitz, a professor at James Madison University who studies the relationship between science and religion. “When you feel existentially threatened by a deadly virus, and the president says you can take control of your health with a product in your kitchen cabinet, that’s incredibly empowering.”
The problem, of course, is that ingesting or injecting industrial bleach can be deadly. Chlorine dioxide destroys red blood cells, wreaks havoc on the digestive system and can cause severe damage to the liver and kidneys.
Minutes after a $310 billion aid program for small companies opened for business on Monday, the online portal for submitting applications crashed. And it kept crashing all day, much to the frustration of bankers around the country who were trying — and failing — to apply on behalf of desperate clients.
Some bankers were so irritated that they vented on social media against the Small Business Administration, which is running the program. Rob Nichols, the chief executive of the American Bankers Association, wrote on Twitter that the trade group’s members were “deeply frustrated” at their inability to access the system. Until the problems were fixed, he said, “#AmericasBanks will not be able to help more struggling small businesses.”
But for the second time in a month, the relief effort, called the Paycheck Protection Program, turned into chaos, sowing confusion among lenders and borrowers. A centerpiece of the government’s $2 trillion economic stimulus package, the program offers small companies — typically those with up to 500 workers — forgivable loans of up to $10 million. The S.B.A. is backing the loans, but customers must apply through financial institutions.
When the aid program first went live on April 3, the Treasury Department’s goal was to quickly steer money to the neediest businesses — hair salons, coffee shops, dry cleaners and others. But many large banks needed more time to set up their systems and held off for days on taking applications, leading to an outcry from borrowers who could not afford to keep waiting. Many were also furious that hundreds of publicly traded companies, as well as wealthy clients of some big banks, got access to those funds.
The pandemic has left retailers scrambling to meet a crushing demand for everything from milk to toilet paper to flour and yeast.
“The number of orders we see coming in for sympathy is stunning,” said Alan Friedman, who runs a silk screen card company, Great Arrow Graphics, in Buffalo, N.Y., and is a board member of the Greeting Card Association, the industry trade group. “It seems like just about everyone knows someone who has died.”
CVS, one of the nation’s largest sellers of greeting cards, said that it was seeing “higher demand for sympathy cards than most other types of greeting cards during the pandemic” and was experiencing shortages in certain stores. Shoppers across the country have posted on social media that their local Winn Dixies or ShopRites were running out of cards.
Before the pandemic, the greeting card industry had experienced declining sales. But with many people unable to attend funerals or drop off food for a grieving neighbor, or even offer an embrace, mailing a sympathy card seems more necessary.
New York and New Jersey, the two states hit hardest by the virus, have shown enough progress that their governors started on Monday to offer details on how reopening might go in the months ahead.
The optimistic signs came as both states announced one-day death tolls — 337 in New York, and 106 in New Jersey — that were less than half of their peaks.
Gov. Andrew M. Cuomo of New York suggested that some businesses in what he called low-risk industries like construction or manufacturing might restart in parts of the state after May 15. Much of the state, including New York City and its suburbs, would remain shut down longer, he said.
”I don’t think you’ll see us taking in each case identical steps, but I think you’ll see our steps harmonized,” Mr. Murphy said.
Mr. Murphy said schools in New Jersey might be able to reopen before the end of June. And Mayor Bill de Blasio of New York said he thought the city’s beaches could be partially open by the end of the summer.
Even as the virus’s spread appeared to be slowing, Mr. Cuomo cautioned that the economic effects of the outbreak had probably not reached their peak. With over a million New Yorkers out of work, food banks across the state are experiencing huge jumps in demand, he said.
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Reporting was contributed by Alan Blinder, Eileen Sullivan, Pam Belluck, Michael Gold, Jack Healy, Michael Powell, Shawn Hubler, Andrew Jacobs, Marc Santora, Ali Watkins, Michael Rothfeld, William K. Rashbaum, Brian M. Rosenthal, Anahad O’Connor, Elizabeth A. Harris, Sapna Maheshwari, Michael Corkery, Dionne Searcey and Neil MacFarquhar.