Coronavirus Live Updates: U.S. Testing Czar Says It’s Not Currently Possible for All Tests to Come Back Within 3 Days

Sanofi and GlaxoSmithKline strike the biggest vaccine deal yet with the U.S. government. Once a site of major outbreak, Italy now offers lessons for keeping the virus in check.

Major League Baseball’s outbreak spread into another clubhouse on Friday when the St. Louis Cardinals postponed their game in Milwaukee after two players tested positive.

“Even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50 percent, in the sense of the totality of the country. But we are cautiously optimistic that this will be successful because in the early studies in humans, the Phase 1 study, it clearly showed that individuals who were vaccinated mounted a neutralizing antibody response that was at least comparable, and in many respects better, than what we see in convalescent serum from individuals who have recovered from Covid-19.” “This virus is indiscriminate regarding whom and when it strikes. We continue to learn its characteristics, its behavior and its effect on Americans across socio-economic spectrum. We are operating in a highly dynamic environment. We are adapting evidence-based strategies and pushing for innovative solutions to confront this unprecedented public health crisis. I am appealing to all Americans to be part of the public health solution. Wearing a simple mask properly — it’s critical to limiting the transmission. Be smart about social distancing and being in crowded spaces, stay six feet apart from others, if possible, and be vigilant about hand hygiene. And together, we can turn the tide of this pandemic.” “This is just a small part of President Trump’s plan to combat the coronavirus — part of the plan, included stopping flights to China, which as Dr. Fauci testified under oath, saved lives. That was President Trump’s call. He got criticized from it.” “Much of this is inconvenient to the public. Nobody feels comfortable getting up every morning and looking for a mask. Nobody feels comfortable walking around all day with a mask. It’s inconvenient for everybody. So it’s uncomfortable for everybody. But the plan must include guidance and support for state and local governments, health departments, schools and community organizations.”

As schools, universities and businesses struggle to reopen without the coronavirus testing they need to curb outbreaks, the Trump administration’s testing czar testified to Congress Friday that it was currently impossible to get all tests back within three days.

The testing czar, Adm. Brett P. Giroir, told lawmakers that getting all coronavirus tests back between 48 and 72 hours, which many health officials said is critical, “is not a possible benchmark we can achieve today given the demand and the supply.”

Admiral Giroir said that it would be “absolutely” achievable in the future, and that half of all test results were being processed within 24 hours. While not all tests can be turned around within three days, he said, the average wait time for the rest was around that time or less — an assessment that is sharply at odds with what patients and health professionals around the country say they are experiencing.

He told lawmakers the nation was now averaging about 820,000 tests each day, and that roughly half were “done in either point-of-care technologies with results in 15 minutes or less or at local hospitals for which the turnaround time is generally within 24 hours.”

And he said that three-quarters of tests from commercial labs were coming back within 5 days.

The remainder, he said, are processed by commercial labs like Quest Diagnostics and LabCorp. Three-quarters of those tests were coming back within 5 days, he said.

Admiral Giroir spoke alongside Dr. Anthony S. Fauci, the nation’s top infectious disease expert, and Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, during a hearing of the House Select Subcommittee on the Coronavirus Crisis, a special panel created by Speaker Nancy Pelosi to oversee the Trump administration’s coronavirus response.

His comments on testing turnaround times were met with puzzlement by public health experts, who say that even if the figures are accurate, they do not reflect the reality on the ground. Reporting test results and wait times in aggregate, these experts say, does not indicate things are getting better. Testing shortages persist. And in some places, tests cannot be processed at all because of a lack of reagents — the chemicals needed to detect whether the virus is present — or lab capacity.

“Across the board, the supply chain is still fragile and fragmented,” said Amanda Harrington, director of the Clinical Microbiology Laboratory at Loyola University Medical Center in Maywood, Ill. “We have assays we don’t know if we can run tomorrow.

Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the administration needed a “national dashboard for testing” where data is collected and made publicly available.

Democrats on the House panel wasted little time in pointing out that the caseload is much lower in Europe and Asia than in the United States. Dr. Fauci said countries in those parts of the world were more aggressive about shutting down as the pandemic raged.

“When they shut down, they shut down to the tune of about 95 percent, getting their baseline down to tens or hundreds of cases a day,” Dr. Fauci said. By contrast, he said, only about 50 percent of the United States shut down, and the baseline of daily cases was much higher — as many as 20,000 new cases a day — even at its lowest. More recently, the United States has recorded as many as 70,000 new cases a day.

Dr. Fauci also cast doubt on a study, touted by Mr. Trump and conservatives, conducted by Henry Ford Hospital in Detroit that showed an apparent benefit for hydroxychloroquine, the anti-malaria drug that President Trump has touted as a Covid-19 treatment. “That study is a flawed study,” Mr. Fauci said. (Read more about the most-talked-about treatments for the coronavirus.)

Considered a cornerstone of the public health arsenal to suppress the virus, contact tracing has largely failed in the United States, as the virus’s pervasiveness and major lags in testing have rendered the system almost pointless.

The goal of contact tracing is to reach people who have spent more than 15 minutes within six feet of an infected person and ask them to voluntarily quarantine at home for two weeks, even if they test negative, monitoring themselves for symptoms during that time. On Friday, Dr. Fauci said that if someone gets tested, “they should assume that it might be positive and should essentially isolate themselves before they go back and get the result of the test.”

In some of the hardest-hit regions, contact-tracing efforts seem futile, as many people have refused to participate or cannot even be located, further hampering health care workers.

In Arizona’s most populated region, for example, the virus is so ubiquitous that contact tracers have been unable to reach a fraction of those infected. In Austin, Tex., the story is much the same. Cities in Florida, which has been seeing an average of more than 10,000 new cases a day in the past week, have largely given up on contact tracing. Things are equally dismal in California. And in New York City’s tracing program, workers have complained of crippling communication and training problems.

From the very beginning, states and cities have struggled to detect the prevalence of the virus because of spotty and sometimes rationed diagnostic testing and long delays in getting results. For the tests currently available and in high demand, there is not a consensus on who should get them. Some experts say everyone should get tested, even those without symptoms. Others say the tests should be reserved for the people who have symptoms or are more vulnerable to infection.

On Friday, the National Institutes of Health announced that seven companies have received $248.7 million to ramp up test production and deliver millions more weekly tests as early as September.

The tests, which include three simple “point of care” tests that don’t need to be shipped to laboratories, were selected as promising candidates to address the serious shortages that have plagued testing efforts since March.

The funding comes through the N.I.H.’s Rapid Acceleration of Diagnostics (RADx) initiative, which launched at the end of April. The director of the N.I.H., Dr. Francis Collins, described this first batch of seven awardees as the “first of more awards to come.”

Three of the grant recipients are focused on tests that can be run from start to finish in a doctor’s office or pharmacy, perhaps without the patient ever leaving the room with results in 30 minutes or less.

And the other four awardees are developing new laboratory protocols intended to streamline how samples are processed, as shortages of laboratory supplies have substantially hampered testing as well.

Dr. Collins cautioned that the streamlined processing will not resolve all the backlog issues for overburdened testing facilities, many of which have struggled to receive timely orders from manufacturers. Shortages of swabs, which collect samples from patients and are required for many tests, could still hold up the process as well.

The French drug maker Sanofi said on Friday that it had secured an agreement of up to $2.1 billion to supply the U.S. federal government with 100 million doses of its experimental coronavirus vaccine, the largest such deal announced to date.

The arrangement with Sanofi and its partner, the British pharmaceutical company GlaxoSmithKline, brings the Trump administration’s investment in coronavirus vaccine projects to more than $8 billion. This effort, known as Operation Warp Speed, is placing bets on multiple vaccines and is paying companies to manufacture millions of doses before clinical trials have been completed.

“The global need for a vaccine to help prevent Covid-19 is massive, and no single vaccine or company will be able to meet the global demand alone,” Thomas Triomphe, executive vice president and global head of Sanofi Pasteur, the company’s vaccine division, said in a statement.

Also on Friday, the European Union said that it was working on a deal with Sanofi to buy up to 300 million doses of potential vaccines to distribute to citizens in its 27 member countries. The announcements came two days after Sanofi said it had a deal with the British government to supply up to 60 million doses of the vaccine. Financial details about those deals were not disclosed.

Under the U.S. deal, the companies will receive federal funding to pay for clinical trials as well as for manufacturing the vaccine. The company expects to begin clinical trials to test for safety in September, followed by late-stage efficacy trials before the end of this year. Sanofi said it could apply for regulatory approval in the first half of next year.

If the vaccine is successful, it would be made available to Americans at no cost, other than what providers charge to administer it, the U.S. federal government said in a statement.

The head of Operation Warp Speed, Moncef Slaoui, is a former GSK executive who as of May held just under $10 million in GSK stock. Dr. Slaoui said in an interview in May that he was determined to avoid any conflicts of interest, but that his GSK stock represented his retirement from 29 years at the company, and that he had told federal officials he would not take the job if he had to sell it.

A handful of other vaccine candidates are already in late-stage clinical trials and some, such as AstraZeneca and Moderna, have said a vaccine could be ready before the end of this year.

White House officials and Democrats blamed each other on Friday for the looming expiration by day’s end of a $600 weekly jobless aid payment that has become a critical lifeline for tens of millions of Americans, as they remained at an impasse on passing another round of federal pandemic relief.

At a news conference at the White House, Mark Meadows, the chief of staff, accused Democrats of playing “politics as usual” on Capitol Hill. At the other end of Pennsylvania at the Capitol, Speaker Nancy Pelosi of California declared that administration officials “do not understand the gravity of the situation.”

Both said they planned to continue discussions on Friday, and potentially into the weekend to find a compromise. But the talks will come too late to help laid-off workers set to lose their aid. Many state unemployment systems have already stopped sending payments.

Economist have said the faltering economy is likely to face further devastation without the security of additional payments.

Grasping for more time to reach an agreement, Republicans on Thursday at first proposed extending the benefit at a much lower rate through the end of the year, and then proposed continuing the $600-per-week benefit for one week. But Democrats, who want to extend the $600 weekly payments through the end of the year, rejected those alternatives. Ms. Pelosi said on Friday that they would do nothing to address the magnitude of the problem or bridge the deep divides separating her party’s $3 trillion aid proposal with at $1 trillion plan endorsed by Republicans.

“When you have a six-day, one-week extension on a provision, it is usually — has always been — to accommodate a legislative topic if you’re on the verge of having an agreement,” Ms. Pelosi said. “Why don’t we just get the job done? Why don’t we just get the job done?”

Representative Steny H. Hoyer of Maryland, the majority leader, said on Friday that lawmakers who were to begin their annual August recess would be on call to return to Washington for potential votes on the recovery package, should lawmakers and the White House reached an agreement.

When the virus erupted in the West, Italy was the nightmarish epicenter, a place to avoid at all costs and a shorthand in the United States and much of Europe for uncontrolled contagion.

Fast forward a few months, and the United States has suffered tens of thousands more deaths than any country in the world. European states that once looked smugly at Italy are facing new flare-ups.

And Italy? Its hospitals are basically empty of Covid-19 patients. Daily deaths attributed to the virus in Lombardy, the region that bore the brunt of the pandemic, hover around zero. The number of new daily cases has plummeted to “one of the lowest in Europe and the world,” said Giovanni Rezza, director of the infective illness department at the National Institute of Health.

How Italy has gone from being a global pariah to a model — however imperfect — of viral containment holds fresh lessons for the rest of the world, including the United States.

Italy has consolidated, or at least maintained, the rewards of a tough nationwide lockdown through a mix of vigilance and painfully gained medical expertise.

The country set aside economic pressures and only began easing its exceptionally tight lockdown based on case counts.

Local doctors, hospitals and health officials collect more than 20 indicators on the virus daily and send them to regional authorities, who then forward them to the National Institute of Health.

The result is a weekly X-ray of the country’s health upon which policy decisions are based. That is a long way from the state of panic, and near collapse, that hit Italy in March.

The British economy is facing its worst recession since “The Great Frost” of 1709, a horrifically cold winter. Large retailers are shutting stores, and inconsistent quarantine rules are raising anxiety about a second pandemic wave.

While that’s left businesses in Central London very quiet, shops and cafes outside town centers are seeing a fragile recovery.

Among them is Summertown, a suburb north of Oxford, which is about to get a new bookstore.

Without tourists and office workers, city centers in Britain are suffering steep economic losses. Even though shops and restaurants have been allowed to reopen, foot traffic in central London was down 72 percent in mid-July compared with last year.

Suburban businesses, however, seem to be benefiting from people’s desire to meet and shop in less densely populated places closer to home.

The suburbs are not exactly booming. Outside of London, even businesses fortunate enough to see a steady return of customers are scaling down their ambitions.

From April to June, gross domestic product fell by 11.9 percent from the first quarter in the European Union, and by 12.1 percent in the core group of countries that use the euro currency. On an annualized basis, European Union economies shrank by 14.4 percent, and eurozone economies by 15 percent, the sharpest contractions since statistics started being kept in 1995. Here are other developments from around the globe:

Britain has barred millions of people in northern England from meeting other members of other households at their homes, paused reopenings set for Aug. 1 and moved to make face masks mandatory in more places, after a day on which it reported 38 new coronavirus deaths and nearly 900 known new infections, its highest case numbers in a month.

As we see these rises around the world, we can’t fool ourselves that we are exempt. We must be willing to react to the first signs of trouble. Today, the weekly survey by the Office for National Statistics reports that the prevalence of the virus in the community in England is likely to be rising for the first time since May. With those numbers creeping up, our assessment is that we should now squeeze that brake pedal — squeeze that brake pedal in order to keep the virus under control. On Saturday the 1st of August, you remember we had hoped to reopen in England a number of the higher-risk settings that had remained closed, and today I’m afraid we’re postponing those changes for at least a fortnight. That means until the 15th of August, at the earliest, casinos, bowling alleys, skating rinks and the remaining close-contact services must remain closed. I won’t stand by and allow this virus to threaten to cause more pain and more heartache in our country.

French health authorities on Friday reported a 54 increase in new cases over the past week and a rise in hospitalizations. Community transmission is accelerating most among young adults aged 20 to 30, according to Santé Publique France. The authority called for increased vigilance in preventive measures and cited a decline in social distancing and avoidance of hand-shaking and hugs, while reporting an increase in public mask-wearing.

A stark lack of testing in many African countries has kept officials from being able to track the pandemic, prompting fears that a recent surge in cases across the continent may be just the “tip of the iceberg,” according to the International Rescue Committee. The organization said many African nations needed international support to increase their testing capacity or the continent could face “an undetected and uncontrolled spread.”

Vietnam, which has been fighting a fresh virus outbreak after more than three months without reporting a locally transmitted case, has announced its first death from the coronavirus. The victim was a 70-year-old resident of the city of Hoi An who had been living with kidney disease for more than a decade. The man was admitted to a hospital on July 9 with chest tightness and fatigue, and tested positive for the virus on Sunday. He died Friday morning.

On Friday, Japan announced 1,305 new cases, breaking a record set the day before. As cases spike in Tokyo, Gov. Yuriko Koike has requested that karaoke venues and bars and restaurants serving alcohol close by 10 p.m. from Aug. 3 through the end of the month. Businesses that cooperate will be offered 200,000 yen, or about $1,900.

Major League Baseball’s outbreak spread into another clubhouse on Friday when the St. Louis Cardinals postponed their game in Milwaukee after two players tested positive.

The Cardinals-Brewers game is the third postponement on baseball’s Friday night schedule, following earlier ones involving the Miami Marlins, who were to play the Washington Nationals, and the Philadelphia Phillies, who were to host Toronto. The Marlins have had 18 players (including another on Friday) and two staff members test positive this week; those cases have already upended baseball’s revised schedule.

One of the biggest adjustments for major leaguers during this 60-game season will be playing in empty, cavernous stadiums, at least for the time being. While baseball has attempted to fill the void with cardboard fans, artificial noise and even virtual “crowds” on broadcasts, there is no denying that games are being held in an atmosphere that is far from normal.

“I think it’s going to affect things in weird ways that we can’t even fully anticipate right now,” Russell Carleton, a psychologist and analyst who has consulted with the Cleveland Indians and the Mets, said of 2020’s empty stadiums. “And it’s going to vary from guy to guy.”

A little over a week into the schedule, it’s too early to draw any hard conclusions about the on-field effects of the lack of fans. But while acknowledging the fragile nature of this season many observers are viewing it as a unique opportunity to test theories and examine new data about the sport.

The Salzburg Festival is still going on but its centennial season is abbreviated and has come with an elaborate protection plan.

The Barrington Stage Company in Massachusetts was planning to become the first theater in the U.S. to stage an indoor show featuring an Actors’ Equity performer since the outbreak closed theaters. The company removed many seats in its theater, reconfigured its air conditioning system, and redesigned bathrooms. But the state of Massachusetts decided not to permit indoor theater, so the show, “Harry Clarke,” is moving outdoors.

Bryan Cranston, the star of “Breaking Bad,” has posted a video of himself donating plasma following his recovery from Covid-19. The actor called plasma “liquid gold” and said it could be rich in antibodies and could benefit others in their recovery

The British artist Heather Phillipson’s latest work is a 31-foot statue of a dollop of whipped cream, with a fly on it. After a months of discussion about whether it could be installed during the pandemic, it was finally unveiled in London’s Trafalgar Square on Thursday.

New York City public schools, the nation’s largest school system, will be able to reopen its school buildings in September only if the city maintains a test positivity rate below 3 percent, Mayor Bill de Blasio announced on Friday. That conservative threshold is even lower than the 5 percent test positivity rate which has been set by Gov. Andrew M. Cuomo as a cut-off for school reopening and recommended by public health experts.

The average positivity for New York City has generally remained lower even than the new city threshold, according to city and state figures. But even a modest uptick in cases over the next few weeks could nudge that rate closer to the new threshold, which raises fresh questions about whether city schools will open part-time on Sept. 10 as planned in a hybrid model.

New York is one of the only large districts in the country that is currently planning to reopen its buildings at all: Children will report to school one to three days a week to allow for social distancing. All staff members will be asked to take tests before the start of school, with expedited results. Education officials in the city laid out a plan on Thursday for what would happen in the seemingly inevitable event that cases are confirmed in a classroom.

The protocol means it is likely that at many of the city’s 1,800 schools, individual classrooms or even entire buildings will be closed at points during the school year.

Officials said confirmed infections among students, teachers and staff members would be treated the same. One or two cases in a single classroom would require those classes to close for 14 days; all students and staff members in that classroom would be ordered to self-quarantine, and students would learn remotely. The rest of the school would continue to operate.

But if two or more people in different classrooms in the same school tested positive, the entire building would close while disease detectives from the city’s Department of Health were brought in to investigate the cases, which could take several days. Depending on the results of the investigation, the building could reopen, but the classrooms with positive cases would remain closed for 14 days.

The Trump administration wasted around $500 million by overpaying for ventilators through negotiations that were “inept,” a panel of the House Oversight and Reform Committee said in a report released Friday. It faulted Peter Navarro, Mr. Trump’s top trade adviser, and Jared Kushner, his son-in-law and senior adviser, for negotiating a deal in which the panel said they paid almost five times the price per device than under a previous contract with the same vendor.

Florida broke a record — the most deaths the state reported in a single day — for the fourth day in a row: On Friday, the state announced 257 additional fatalities.

Even with significant gaps in the available data, there are strong indications that Native American people have been disproportionately affected by the virus. The rate of known cases in the eight counties with the largest populations of Native Americans is nearly double the national average, a Times analysis has found.

New York City added 15 more streets to its outdoor dining program on Friday, bringing the total to 62 locations. The new locations, which will be closed to car traffic on weekends, include streets in the Bronx, Brooklyn and Manhattan, the mayor announced.

The Hong Kong government said on Friday that it would postpone the city’s September legislative election by a year because of the coronavirus pandemic, a decision seen by the pro-democracy opposition as a brazen attempt to thwart its electoral momentum and avoid the defeat of pro-Beijing candidates.

“It is a really tough decision to delay but we want to ensure fairness, public safety and public health,” said Carrie Lam, Hong Kong’s chief executive.

The delay was a blow to opposition politicians, who had expected to ride to victory in the fall on a wave of deep-seated dissatisfaction with the government and concerns about a sweeping new national security law imposed on the city by Beijing. And it was the latest in a quick series of aggressive moves by the pro-Beijing establishment to sideline the pro-democracy movement.

On Thursday, 12 pro-democracy candidates said they had been barred from running, including four sitting lawmakers and several prominent activists like Joshua Wong. Mr. Wong said he was barred in part because of his criticism of the new security law. He called the disqualifications “the most scandalous election fraud ever in Hong Kong history.”

Even as Hong Kong cast the decision as one made for public health reasons, to curb the spread of the virus, the pro-democracy opposition has accused the government of using social-distancing rules to clamp down on the protest movement that began more than a year ago.

Reporting was contributed by Liz Alderman, Ian Austen, Luke Broadwater, Julia Calderone, Emily Cochrane, Kate Conger, Michael Cooper, Michael Crowley, Robert Gebeloff, Michael Levenson, Giulia McDonnell Nieto del Rio, Eshe Nelson, Richard A. Oppel Jr., Richard C. Paddock, Elian Peltier, Matt Phillips, Austin Ramzy, Motoko Rich, Amanda Rosa, Eliza Shapiro, Megan Specia, Sheryl Gay Stolberg, Eileen Sullivan, Katie Thomas, Neil Vigdor, Katherine J. Wu and Mihir Zaveri.

Source: https://www.nytimes.com/2020/07/31/world/coronavirus-covid-19.html

News – Coronavirus Live Updates: U.S. Testing Czar Says It’s Not Currently Possible for All Tests to Come Back Within 3 Days

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