Trump vows more coronavirus testing, but less than what the US may need

WASHINGTON (NYTIMES) – President Donald Trump, under growing pressure to expand coronavirus testing as states move to reopen their economies, unveiled a new plan on Monday (April 27) to ramp up the federal government’s help to states, but his proposal runs far short of what most public health experts say is necessary.

Trump’s announcement in the Rose Garden came after weeks of him insisting, inaccurately, that the nation’s testing capability “is fully sufficient to begin opening up the country,” as he said on April 18. Numerous public health experts say that is untrue, and Trump’s plan may do little to fix it.

An administration official said the federal government aimed to give states the ability to test at least 2 per cent of their populations per month, though the president did not use that figure and it was not in his written plan. Instead, Trump and other officials with him in the Rose Garden said the United States would “double” the number of tests it had been doing.

“These were not complaining people. They had everything they needed. They had their ventilators; they had their testing,” Trump said 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 other countries – for the components that make up the testing kits, including nasal swabs and chemicals that detect whether the virus is present in a specimen.

Rather than one coordinated federal response, the Trump administration has been engaging on an ad hoc basis as states take the lead. In Kansas, for example, after an outbreak of the coronavirus in the meatpacking industry threatened to shutter plants that supply one-quarter of the nation’s meat, tests were ferried in by Kansas National Guard pilots in Black Hawk helicopters – but only after Governor Laura Kelly, a Democrat, pleaded with Trump for help.

The Trump administration has come under intense criticism for not doing more, and for not providing specific guidance to the states about how much testing is necessary in its initial plan for reopening the economy, “Guidelines for Reopening America Again,” released this month. Outside experts have recommended that anywhere from 0.9 per cent to 50 per cent of the American public must be tested for the coronavirus every week.

“I think it’s really important that the White House has put out much more specific guidance for states around testing,” said Jen Kates, a senior vice president and director of global health and HIV policy for the Kaiser Family Foundation, who has analysed states’ capacity for testing. But the plan to test 2 per cent, she said, “may not be enough.”

Paul Romer, a Nobel Prize-winning economist from New York University who has recommended that 50 per cent of the population be tested each week, said testing 2 per cent “is not enough to test everyone in health care even once, let alone to keep retesting them every day, which is what it would take to keep those who do get infected from going on shift and infecting their colleagues.”

Congress has been pushing the Trump administration to come up with a clearer strategy. The US$484 billion (S$688 billion) stimulus package lawmakers passed last week designated US$25 billion to expand testing capacity and required the administration to come up with a plan to support the states.

Senator Patty Murray of Washington, the top Democrat on the Senate Health Committee, said Monday that Trump’s plan was meaningless.

“This document does nothing new and will accomplish nothing new,” Murray said in a statement. “It doesn’t set specific, numeric goals, offer a time frame, identify ways to fix our broken supply chain, or offer any details whatsoever on expanding lab capacity or activating needed manufacturing capacity. Perhaps most pathetically, it attempts to shirk obvious federal responsibilities by assigning them solely to states instead.” Undeterred, Trump said Monday that states must reopen “as quickly as possible, but safely.”

Still eager to be the dominant voice on the crisis, Trump reversed a decision announced by the White House to cancel his daily coronavirus news briefing Monday and went before the cameras again despite days of complaining that the events were not worth the time and effort because of journalistic bias. He took over the announcement of a testing plan originally put out by lower-level officials.

The administration has steadfastly resisted calls to nationalise the production and distribution of coronavirus test kits, and the plan Trump unveiled Monday reiterated that stance, making clear that the states are still primarily responsible for testing and Washington is the “supplier of last resort.” Rather than the more comprehensive surveillance testing sought by many public health experts, the administration is focused on a more limited goal of “sentinel” testing of targeted sites that are particularly vulnerable, like nursing homes and inner-city health centres.

In the seven weeks since Trump promised that anyone who needed a test could get one, the United States has conducted about 5.2 million tests, far more than any other country, but still the equivalent of about 1.6 per cent of the total population.

A group of experts convened by Harvard University’s Edmond J. Safra Centre for Ethics has called for 5 million tests a day by early June, ramping up to 20 million per day by late July.

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