But to many health experts, governors, and lawmakers, Trump’s approach looks like a slow-motion repeat of his administration’s initial failure to prepare for the deadly virus last winter. As he careens into a second, potentially chaotic phase of his response, they say he risks reigniting the spread by ignoring calls for a stronger federal role in testing and in contact tracing to control the disease.
“The federal government has to be the force behind getting testing up fast,” said Jeffrey Shaman, a professor of environmental health sciences at Columbia University who led a team of researchers modeling the outbreak’s spread. “Having the federal resources behind it consistently in a coherent fashion with a competent leader leading it is desperately needed.”
Trump’s road map lists testing under “state preparedness responsibilities,” suggesting states are largely on their own, but he also offered a series of guidelines.
He recommends they gradually allow businesses, including restaurants and movie theaters, to reopen with strict distancing protocols, while vulnerable people continue to stay home in the first phase of the plan. The guidelines apply to states that have seen a downward trajectory in coronavirus cases for 14 days. If cases do not surge after that initial step, schools would then reopen and businesses would face less-strict distancing measures. In the third phase, only senior citizens and others particularly vulnerable to the disease would practice social distancing.
Trump and his administration were criticized harshly for being slow to take the virus seriously in February and early March, aside from an early decision to stop some flights from China. The response led to domestic shortages of personal protective equipment and ventilators when the virus hit hard and states needed them most.
But Trump appears not to have learned a lesson from that period, now that states are begging the federal government to help them dramatically scale up their testing abilities. Trump believes that states exaggerated their need for the life-saving equipment in the first place, and has made it clear he believes it’s their responsibility to handle testing.
“Some states wanted 40,000 ventilators. I said, ‘That doesn’t work.’ And they ended up with 7 or 8,000 and they had no problem,” Trump said Tuesday.
As for testing, “it’s up to the governors,” he said.
“We’re not going to be running a parking lot in Arkansas,” the president added Wednesday, referring to drive-through testing sites.
Trump’s message this week spooked governors coast to coast, leaving them unsure how to begin to get people back to work without federal help to obtain testing supplies from an overburdened international supply chain and to expand lab capacity. Trump has been reluctant to use his powers under the Korean War-era Defense Production Act to obtain ventilators and protective equipment, and does not appear poised to deploy it for testing supplies, either.
“This is a huge frustration for all of us,” Washington Governor Jay Inslee said Wednesday of the lack of testing kits from the federal government. Washington state can only process about 4,500 tests a day due to shortages of swabs and other materials — far below what the state would need to stay on top of any new outbreaks in a world with less social distancing.
New York Governor Andrew Cuomo was even more blunt. “I want to make sure we’re clear: I can’t do it,” he said on CNN, explaining that the international supply chain involved in obtaining testing equipment creates a byzantine challenge for governors. “The president said the states must do it. The states are saying, ‘We can’t.’ ”
About 140,000 people per day are being tested in the United States — far below the millions of daily tests that experts think are necessary to get a handle on the disease once social distancing protocols are eased. Public health specialists including former Centers for Disease Control and Prevention director Tom Frieden have also recommended the government hire an army of 300,000 contact tracers around the country, who would use test results to ensure ill people and those who came into contact with them stayed in quarantine for two weeks.
Adequate testing is even more crucial as preliminary studies suggest many people without any symptoms can carry and spread the virus.
The president has insisted the country has the best testing “in the world,” despite lagging significantly behind South Korea and Germany in per capita testing. Both countries have also managed to control their outbreaks better than the United States, which currently has the most coronavirus cases of any country in the world.
Trump’s rosy assessment goes against the opinion of the federal government’s top infectious disease expert, Dr. Anthony Fauci, who said this week that the nation’s testing capacity was not at a level to safely allow a lifting of social distancing.
“We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” he told the Associated Press.
Even some of Trump’s staunchest allies have warned that dramatically more tests are needed to get people back to work. “We are struggling with testing at a large scale,” Senator Lindsey Graham told ABC’s “The View.” “You really can’t go back to work until we have more tests.”
The nation’s decentralized system of government means states inherently have more power and responsibility to direct their own response to the virus compared to local entities in other countries facing the same challenge. But states are experiencing crushing revenue losses from the economic shutdown just as they’re expected to put in place complex testing and contact tracing systems and purchase personal protective equipment and devices. A lack of significant financial support from the federal government could lead to a patchwork response that allows the virus to reignite and spread.
“There’s a total vacuum of leadership in the federal government right now,” said Representative Seth Moulton of Salem, who self-quarantined last month after experiencing coronavirus symptoms but did not qualify for a test. “There’s a sense in which we should be grateful that governors are stepping up to try to fill that void, but the virus doesn’t know state lines, so unless all the governors are on the same page and it happens to be the right page, this has the potential to go wildly off the rails.”
Senate minority leader Chuck Schumer, a Democrat from New York, unveiled a $30 billion plan this week to ramp up testing and contact tracing, though it’s unclear if any Republicans support the measure.
But the president said Thursday that he believes widespread testing is not necessary to reopen much of the country. “If we see a hot spot development, we’ve learned a lot, we’ll be able to suppress it, whack it,” Trump said. His health officials said they would be sending some federal officials to assist states in contact tracing, but did not specify how many.
Columbia’s Shaman said he veers between optimism and pessimism about whether the United States can achieve what countries like South Korea have in at least temporarily beating back the virus while allowing citizens to go back to work.
“We need consistent messaging and we need a proactive federal response, which we have not had,” he said. “We may have to find our own path. And unfortunately that requires trial and error.”
Liz Goodwin can be reached at elizabeth.goodwin@globe.com. Follow her on Twitter @lizcgoodwin
