This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/04/25/us/politics/virus-testing-shortages-states-trump.html

The article has changed 30 times. There is an RSS feed of changes available.

Version 10 Version 11
Testing Remains Scarce as Governors Weigh Reopening States Testing Remains Scarce as Governors Weigh Reopening States
(3 days later)
WASHINGTON — About a week after the first report of a Covid-19 case at a meatpacking plant in southwest Kansas in early April, the state’s governor, Laura Kelly, issued a pointed warning to President Trump: Without test kits to separate the well from the sick, a fast-moving outbreak could idle facilities that produce roughly one-quarter of the nation’s meat supply.WASHINGTON — About a week after the first report of a Covid-19 case at a meatpacking plant in southwest Kansas in early April, the state’s governor, Laura Kelly, issued a pointed warning to President Trump: Without test kits to separate the well from the sick, a fast-moving outbreak could idle facilities that produce roughly one-quarter of the nation’s meat supply.
Within three days, 80 blue-and-white boxes of test kits and testing machines arrived, and two Black Hawk helicopters from the Kansas National Guard whisked them to the afflicted region. As the test results came in last week, the costs of the delay became clear: 250 workers in six plants were already infected.Within three days, 80 blue-and-white boxes of test kits and testing machines arrived, and two Black Hawk helicopters from the Kansas National Guard whisked them to the afflicted region. As the test results came in last week, the costs of the delay became clear: 250 workers in six plants were already infected.
In Albany, Ga., a hot spot for the disease, a hospital finally figured out a way to run its own coronavirus tests, rather than relying on limited state capacity or outsourcing the work to slow-moving private labs. But it still struggles to run as many tests as it would like because of a shortage of components.In Albany, Ga., a hot spot for the disease, a hospital finally figured out a way to run its own coronavirus tests, rather than relying on limited state capacity or outsourcing the work to slow-moving private labs. But it still struggles to run as many tests as it would like because of a shortage of components.
In Ohio, a research institution in Columbus is teaming up with a plastics company to churn out nasal swabs on 3-D printers for use in the state. But when Mysheika W. Roberts, the city’s health commissioner, offered test kits to local health centers, she learned they lacked the protective gear they needed to put them to use.In Ohio, a research institution in Columbus is teaming up with a plastics company to churn out nasal swabs on 3-D printers for use in the state. But when Mysheika W. Roberts, the city’s health commissioner, offered test kits to local health centers, she learned they lacked the protective gear they needed to put them to use.
As governors decide about opening their economies, they continue to be hampered by a shortage of testing capacity, leaving them without the information that public health experts say is needed to track outbreaks and contain them. And while the United States has made strides over the past month in expanding testing, its capacity is nowhere near the level Mr. Trump suggests it is.As governors decide about opening their economies, they continue to be hampered by a shortage of testing capacity, leaving them without the information that public health experts say is needed to track outbreaks and contain them. And while the United States has made strides over the past month in expanding testing, its capacity is nowhere near the level Mr. Trump suggests it is.
There are numerous reasons. It has proved hard to increase production of reagents — sensitive chemical ingredients that detect whether the coronavirus is present — partly because of federal regulations intended to ensure safety and partly because manufacturers, who usually produce them in small batches, have been reluctant to invest in new capacity without assurance that the surge in demand will be sustained.There are numerous reasons. It has proved hard to increase production of reagents — sensitive chemical ingredients that detect whether the coronavirus is present — partly because of federal regulations intended to ensure safety and partly because manufacturers, who usually produce them in small batches, have been reluctant to invest in new capacity without assurance that the surge in demand will be sustained.
Some physical components of test kits, like nasal swabs, are largely imported and hard to come by amid global shortages. Health care workers still lack the protective gear they need to administer tests on a wide-scale basis. Labs have been slow to add people and equipment to process the swelling numbers of tests.Some physical components of test kits, like nasal swabs, are largely imported and hard to come by amid global shortages. Health care workers still lack the protective gear they need to administer tests on a wide-scale basis. Labs have been slow to add people and equipment to process the swelling numbers of tests.
On top of all that, the administration has resisted a full-scale national mobilization, instead intervening to allocate scarce equipment on an ad hoc basis and leaving production bottlenecks and shortages largely to market forces. Governors, public health officials and hospital executives say they are still operating in a kind of Wild West economy that has left them scrambling — and competing with one another — to procure the equipment and other materials they need.On top of all that, the administration has resisted a full-scale national mobilization, instead intervening to allocate scarce equipment on an ad hoc basis and leaving production bottlenecks and shortages largely to market forces. Governors, public health officials and hospital executives say they are still operating in a kind of Wild West economy that has left them scrambling — and competing with one another — to procure the equipment and other materials they need.
“You are using a free-market model in a public health emergency,” Governor Kelly, a Democrat, said an interview, “and I’m not sure those two go together particularly well.”“You are using a free-market model in a public health emergency,” Governor Kelly, a Democrat, said an interview, “and I’m not sure those two go together particularly well.”
The United States conducted about 1.2 million tests from April 16 to April 22, up from about 200,000 tests from March 16 to March 22, according to data from the Covid Tracking Project.The United States conducted about 1.2 million tests from April 16 to April 22, up from about 200,000 tests from March 16 to March 22, according to data from the Covid Tracking Project.
But as states begin to reopen, the nation is far from being able to conduct the kind of widespread surveillance testing that health experts say would be optimal. Many states are still struggling to conduct much more urgent testing of patients with symptoms, or those in high-risk groups. Few have the money or the personnel to also check on the presence of the virus in the general population or to reach out to people who have been in contact with those confirmed to be ill.But as states begin to reopen, the nation is far from being able to conduct the kind of widespread surveillance testing that health experts say would be optimal. Many states are still struggling to conduct much more urgent testing of patients with symptoms, or those in high-risk groups. Few have the money or the personnel to also check on the presence of the virus in the general population or to reach out to people who have been in contact with those confirmed to be ill.
“We are not in a situation where we can say we are exactly where we want to be with regard to testing,” Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said this week in an interview with Time.“We are not in a situation where we can say we are exactly where we want to be with regard to testing,” Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said this week in an interview with Time.
The three-phase White House plan, Opening Up America Again, does not detail a national testing strategy or provide numerical benchmarks for how much testing is necessary. It says states should have a “downward trajectory of positive tests” or a “downward trajectory of documented cases” over two weeks, while conducting robust contact tracing and “sentinel surveillance” testing of asymptomatic people in vulnerable populations, such as nursing homes.The three-phase White House plan, Opening Up America Again, does not detail a national testing strategy or provide numerical benchmarks for how much testing is necessary. It says states should have a “downward trajectory of positive tests” or a “downward trajectory of documented cases” over two weeks, while conducting robust contact tracing and “sentinel surveillance” testing of asymptomatic people in vulnerable populations, such as nursing homes.
Congress is pushing the administration to give states more guidance. The $484 billion relief package passed last week included $25 billion to expand testing and required the administration to come up with a strategic testing plan to support the states.Congress is pushing the administration to give states more guidance. The $484 billion relief package passed last week included $25 billion to expand testing and required the administration to come up with a strategic testing plan to support the states.
In the meantime, a flurry of research groups, professors and other experts have stepped in with proposals. On the low end, the liberal Center for American Progress estimates that eight-tenths of one percent of the national population must be tested each week to contain the virus. On the high end, a group from Harvard has put the figure at as much as 21 percent.In the meantime, a flurry of research groups, professors and other experts have stepped in with proposals. On the low end, the liberal Center for American Progress estimates that eight-tenths of one percent of the national population must be tested each week to contain the virus. On the high end, a group from Harvard has put the figure at as much as 21 percent.
Most states — including Georgia, where nonessential businesses have been allowed to start reopening — fall far short of even the lowest estimates.Most states — including Georgia, where nonessential businesses have been allowed to start reopening — fall far short of even the lowest estimates.
In Ohio, Gov. Mike DeWine announced a deal with Massachusetts-based Thermo Fisher Scientific on Friday that would begin providing the state with 7,200 tests a day by Wednesday and scale up to 22,000 a day by the end of May. That trajectory is enough, he said in an interview, to make him feel comfortable about taking the first steps toward reopening businesses on Monday.In Ohio, Gov. Mike DeWine announced a deal with Massachusetts-based Thermo Fisher Scientific on Friday that would begin providing the state with 7,200 tests a day by Wednesday and scale up to 22,000 a day by the end of May. That trajectory is enough, he said in an interview, to make him feel comfortable about taking the first steps toward reopening businesses on Monday.
That type of entrepreneurial response by some states is all well and good, said Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention, but it does not help other states that are still struggling.That type of entrepreneurial response by some states is all well and good, said Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention, but it does not help other states that are still struggling.
“It’s great to have innovation from academia and the private sector to come up with new ways to do things as efficiently as possible,” he said, “but on the other hand we do need national coordination.”“It’s great to have innovation from academia and the private sector to come up with new ways to do things as efficiently as possible,” he said, “but on the other hand we do need national coordination.”
Mr. Trump continues to insist that the current approach is adequate.Mr. Trump continues to insist that the current approach is adequate.
“America’s testing capability and capacity is fully sufficient to begin opening up the country, totally,” he said at one point this month. At another, he said, “We are doing more testing I think than probably any of the governors even want.”“America’s testing capability and capacity is fully sufficient to begin opening up the country, totally,” he said at one point this month. At another, he said, “We are doing more testing I think than probably any of the governors even want.”
That is not true.That is not true.
After getting 2,000 tests kits to southwest Kansas and assessing the scale of the outbreak there, Ms. Kelly decided it was not necessary to close the meatpacking plants.After getting 2,000 tests kits to southwest Kansas and assessing the scale of the outbreak there, Ms. Kelly decided it was not necessary to close the meatpacking plants.
But she said the tortuous path to freeing up even minimal supplies for testing remains the biggest reason she was reluctant to lift the stay-at-home order she imposed on March 28.But she said the tortuous path to freeing up even minimal supplies for testing remains the biggest reason she was reluctant to lift the stay-at-home order she imposed on March 28.
“We are nowhere near where we need to be with testing supplies,” she said on Thursday. “I’m looking down a lot of rabbit holes trying to figure out how we are going to get those test kits here. It’s imperative if we are going to be able to lift that stay-at-home order.”“We are nowhere near where we need to be with testing supplies,” she said on Thursday. “I’m looking down a lot of rabbit holes trying to figure out how we are going to get those test kits here. It’s imperative if we are going to be able to lift that stay-at-home order.”
Kansas has one of the lowest Covid-19 testing rates in the nation. Dr. Lee A. Norman, the state’s top health official, estimated that Kansas needed tens of thousands more testing kits.Kansas has one of the lowest Covid-19 testing rates in the nation. Dr. Lee A. Norman, the state’s top health official, estimated that Kansas needed tens of thousands more testing kits.
The state is so short of plastic test swabs that he has appealed to dentists to manufacture them in their offices by modifying 3-D printers used to make dental models.The state is so short of plastic test swabs that he has appealed to dentists to manufacture them in their offices by modifying 3-D printers used to make dental models.
Since March 20, Kansas has sent the Federal Emergency Management Agency nine requests for medical supplies, including for 235,000 testing swabs, 60,000 kits to transport samples and 178,200 kits to analyze them. As of Wednesday, the agency had sent “nothing,” said Jonathan York, the state’s coordinating officer. Federal officials told him that other states were in more desperate shape.Since March 20, Kansas has sent the Federal Emergency Management Agency nine requests for medical supplies, including for 235,000 testing swabs, 60,000 kits to transport samples and 178,200 kits to analyze them. As of Wednesday, the agency had sent “nothing,” said Jonathan York, the state’s coordinating officer. Federal officials told him that other states were in more desperate shape.
In mid-April, the federal government delivered 273,000 surgical masks, the kind needed to protect medical workers who administer tests. But Dr. Norman said the masks, which had been privately donated, “were so substandard they wouldn’t even make a good coffee filter.”In mid-April, the federal government delivered 273,000 surgical masks, the kind needed to protect medical workers who administer tests. But Dr. Norman said the masks, which had been privately donated, “were so substandard they wouldn’t even make a good coffee filter.”
Late Friday, the Centers for Disease Control and Prevention, which has helped the state obtain some supplies, told officials it intended to ship at least 25,000 of the 80,000 test kits it had requested.Late Friday, the Centers for Disease Control and Prevention, which has helped the state obtain some supplies, told officials it intended to ship at least 25,000 of the 80,000 test kits it had requested.
State officials have had no luck trying to buy supplies themselves. Dr. Norman said Kansas had standing requests with private suppliers for $43 million in equipment, a “staggering” sum equivalent to nearly a third of his department’s annual public health budget.State officials have had no luck trying to buy supplies themselves. Dr. Norman said Kansas had standing requests with private suppliers for $43 million in equipment, a “staggering” sum equivalent to nearly a third of his department’s annual public health budget.
“But the pipelines have pretty much dried up,” he said.“But the pipelines have pretty much dried up,” he said.
Kansas is still dealing with the hangover of seven years of draconian budget cuts under former Gov. Sam Brownback, a Republican. Ms. Kelly said the state health department “had been pretty much decimated” by the time she became governor in 2018, with the laboratory that now processes many Covid-19 tests resembling “something out of the past.”Kansas is still dealing with the hangover of seven years of draconian budget cuts under former Gov. Sam Brownback, a Republican. Ms. Kelly said the state health department “had been pretty much decimated” by the time she became governor in 2018, with the laboratory that now processes many Covid-19 tests resembling “something out of the past.”
The state plans to rely heavily on volunteers to create a corps of 400 workers to monitor the contacts of people who test positive.The state plans to rely heavily on volunteers to create a corps of 400 workers to monitor the contacts of people who test positive.
Although the state is far from meeting the broad guidelines for testing capacity the White House has recommended for reopening, Ms. Kelly is under growing pressure to allow her stay-at-home order to expire as scheduled on May 3. The Republican-controlled state legislature has moved to curb her emergency powers, and protesters gathered on Thursday on the statehouse grounds.Although the state is far from meeting the broad guidelines for testing capacity the White House has recommended for reopening, Ms. Kelly is under growing pressure to allow her stay-at-home order to expire as scheduled on May 3. The Republican-controlled state legislature has moved to curb her emergency powers, and protesters gathered on Thursday on the statehouse grounds.
“What is an acceptable level of risk?” Dr. Norman asked. “We cannot get it down to zero, so how can we guarantee that people won’t get sick?”“What is an acceptable level of risk?” Dr. Norman asked. “We cannot get it down to zero, so how can we guarantee that people won’t get sick?”
Whatever the course of action, he said, “there will be death.”Whatever the course of action, he said, “there will be death.”
As Phoebe Putney Memorial Hospital in Albany, Ga., began filling up last month with gasping patients, Scott Steiner, the hospital system’s president, immediately encountered the ways in which a lack of testing capacity left the region vulnerable.As Phoebe Putney Memorial Hospital in Albany, Ga., began filling up last month with gasping patients, Scott Steiner, the hospital system’s president, immediately encountered the ways in which a lack of testing capacity left the region vulnerable.
He wanted to test as many patients and staff members as he could, but the state’s laboratory had set criteria so strict that few people qualified. When he turned to LabCorp, a private company, results took as many as 10 days to come back. With no way to know if patients were positive, doctors and nurses burned through precious protective equipment until the results came in.He wanted to test as many patients and staff members as he could, but the state’s laboratory had set criteria so strict that few people qualified. When he turned to LabCorp, a private company, results took as many as 10 days to come back. With no way to know if patients were positive, doctors and nurses burned through precious protective equipment until the results came in.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
So Mr. Steiner decided the hospital had no choice but to develop the capacity to test on its own. He and his staff considered buying a testing machine from Abbott Laboratories, a company that had been praised by Mr. Trump, but worried about competing with the federal government over scarce supplies.So Mr. Steiner decided the hospital had no choice but to develop the capacity to test on its own. He and his staff considered buying a testing machine from Abbott Laboratories, a company that had been praised by Mr. Trump, but worried about competing with the federal government over scarce supplies.
Finally, they decided to buy $400,000 worth of equipment from Cepheid, a diagnostic company based in California.Finally, they decided to buy $400,000 worth of equipment from Cepheid, a diagnostic company based in California.
Now, the hospital tests every patient who is admitted, even those coming in for unrelated procedures, as well as outpatients who have symptoms. The number of cases has fallen, as has the percentage of patients testing positive, to 25 percent in April from about 40 percent in March.Now, the hospital tests every patient who is admitted, even those coming in for unrelated procedures, as well as outpatients who have symptoms. The number of cases has fallen, as has the percentage of patients testing positive, to 25 percent in April from about 40 percent in March.
But doctors cannot run as many tests as they would like. Mr. Steiner said he requested enough materials from Cepheid for 1,500 tests a week, but the company has sent enough to do only 400 to 900.But doctors cannot run as many tests as they would like. Mr. Steiner said he requested enough materials from Cepheid for 1,500 tests a week, but the company has sent enough to do only 400 to 900.
“We didn’t get any last week,” he said. “We heard that there were other government agencies that took the supply.”“We didn’t get any last week,” he said. “We heard that there were other government agencies that took the supply.”
So far he has been unable to get tests for antibodies, which help show how many people have already contracted the virus, and the county health department’s efforts to conduct contact tracing are at a very early stage.So far he has been unable to get tests for antibodies, which help show how many people have already contracted the virus, and the county health department’s efforts to conduct contact tracing are at a very early stage.
Mr. Steiner has seen both the devastation of the virus and also the increasing risks of the shutdown for patients who have had to delay surgeries, including breast cancer patients awaiting mastectomies. The hospital, which gets most of its income from elective surgeries, could resume those procedures in a few weeks.Mr. Steiner has seen both the devastation of the virus and also the increasing risks of the shutdown for patients who have had to delay surgeries, including breast cancer patients awaiting mastectomies. The hospital, which gets most of its income from elective surgeries, could resume those procedures in a few weeks.
But nearly 100 Covid-positive patients remain in the hospital. And on a single day this week, eight more patients were admitted.But nearly 100 Covid-positive patients remain in the hospital. And on a single day this week, eight more patients were admitted.
“It’s not gone,” Mr. Steiner said.“It’s not gone,” Mr. Steiner said.
Although Mr. DeWine, a Republican, has been one of the most aggressive governors in addressing the crisis, testing has been a concern from the start.Although Mr. DeWine, a Republican, has been one of the most aggressive governors in addressing the crisis, testing has been a concern from the start.
On April 1, the state’s health director, Amy Acton, ordered hospitals to stop sending coronavirus tests to private laboratories because a huge backlog had created delays of up to 10 days in processing. (This week, Mr. DeWine lifted the order, saying the labs had caught up.)On April 1, the state’s health director, Amy Acton, ordered hospitals to stop sending coronavirus tests to private laboratories because a huge backlog had created delays of up to 10 days in processing. (This week, Mr. DeWine lifted the order, saying the labs had caught up.)
But by March 31, Ohio State University’s Wexner Medical Center and Battelle, a nonprofit research institute, had developed their own test that produced results within five hours. Ohio State now processes slightly more than 1,000 tests a day, with a capacity of 4,500 per day, said Harold L. Paz, the chief executive of Wexner Medical Center.But by March 31, Ohio State University’s Wexner Medical Center and Battelle, a nonprofit research institute, had developed their own test that produced results within five hours. Ohio State now processes slightly more than 1,000 tests a day, with a capacity of 4,500 per day, said Harold L. Paz, the chief executive of Wexner Medical Center.
Facing a shortage of nasal swabs, the medical center teamed up with a plastics maker to produce swabs on 3-D printers; it has received 15,000 swabs, with another 100,000 expected soon.Facing a shortage of nasal swabs, the medical center teamed up with a plastics maker to produce swabs on 3-D printers; it has received 15,000 swabs, with another 100,000 expected soon.
Yet the health commissioner in Columbus, Dr. Roberts, was struggling to keep up with the demand. While she supervises a staff of 450 people with a budget of $45 million, she said she and her team probably spent 20 percent of their time searching for necessary test kits and supplies.Yet the health commissioner in Columbus, Dr. Roberts, was struggling to keep up with the demand. While she supervises a staff of 450 people with a budget of $45 million, she said she and her team probably spent 20 percent of their time searching for necessary test kits and supplies.
A little over a week ago, the state shipped her 1,000 test kits. She will distribute them judiciously, she said, focusing on nursing homes and other hot spots or high-risk groups.A little over a week ago, the state shipped her 1,000 test kits. She will distribute them judiciously, she said, focusing on nursing homes and other hot spots or high-risk groups.
“I worry, are we testing enough people?” she said. “And how do we get the tests to the right people and make sure that we don’t have something brewing that we failed to pay enough attention to and it becomes a huge fire.”“I worry, are we testing enough people?” she said. “And how do we get the tests to the right people and make sure that we don’t have something brewing that we failed to pay enough attention to and it becomes a huge fire.”
Ohio’s testing capacity has been limited by a shortage of reagents, the compounds needed to process the tests. Mr. DeWine complained privately to Vice President Mike Pence that the Food and Drug Administration was moving too slowly to approve a new reagent made by Thermo Fisher Scientific. Last Sunday, Mr. DeWine repeated his plea for faster action on NBC’s “Meet the Press.”Ohio’s testing capacity has been limited by a shortage of reagents, the compounds needed to process the tests. Mr. DeWine complained privately to Vice President Mike Pence that the Food and Drug Administration was moving too slowly to approve a new reagent made by Thermo Fisher Scientific. Last Sunday, Mr. DeWine repeated his plea for faster action on NBC’s “Meet the Press.”
The pressure campaign worked; on Tuesday, Mr. DeWine announced the F.D.A. had granted approval, clearing the way for his announcement on Friday about expanded testing.The pressure campaign worked; on Tuesday, Mr. DeWine announced the F.D.A. had granted approval, clearing the way for his announcement on Friday about expanded testing.
Mr. DeWine said Ohio would now have enough capacity to do intensive testing in hot spots and to test the contacts of those infected, helping guide him through “gut-wrenching decisions” about the balance between getting the economy going again and keeping people from spreading the virus.Mr. DeWine said Ohio would now have enough capacity to do intensive testing in hot spots and to test the contacts of those infected, helping guide him through “gut-wrenching decisions” about the balance between getting the economy going again and keeping people from spreading the virus.
“Frankly,” he said, “I feel a lot better than a few days ago when I didn’t have this.”“Frankly,” he said, “I feel a lot better than a few days ago when I didn’t have this.”
Sheryl Gay Stolberg and Sharon LaFraniere reported from Washington, and Farah Stockman from Cambridge, Mass. Kitty Bennett contributed research.Sheryl Gay Stolberg and Sharon LaFraniere reported from Washington, and Farah Stockman from Cambridge, Mass. Kitty Bennett contributed research.