Health & Fitness

Coronavirus Stay Updates: Testing Outcomes Take Too Lengthy, U.S. Official Concedes

The U.S. testing czar admits test results take too long, as some state officials worry about backlogs.

Federal, state and local officials on Sunday appeared to agree on one thing: Test results are taking too long.

But they gave conflicting assessments of the U.S. response to recent spikes in coronavirus cases, which have severely strained testing nationwide and led to renewed shortages of supplies and weeklong backlogs at major labs.

Adm. Brett Giroir, the assistant health secretary overseeing the national coronavirus testing response, said the country was performing enough testing to “achieve the goals we need to achieve.”

Speaking on CNN’s “State of the Union,” Mr. Giroir acknowledged that turnaround times were too long. But he asserted that while testing was still not widely available to anyone who wanted it — despite past claims from Mr. Trump that it would be — it was available to those who needed it.

Testing is considered crucial to understanding and stopping the spread of the coronavirus. When turnaround times extend beyond several days, it can render the information useless since those tested may have spread the virus to other people by the time their results are back.

Mark Meadows, President Trump’s chief of staff, skirted questions about the administration’s early missteps by suggesting that medical advancements, not masks, would be the only way to end the pandemic. “Hopefully it is American ingenuity that will allow for therapies and vaccines to ultimately conquer this,” he said on the ABC program “This Week.”

The federal government said Sunday that it would pay the testing company Hologic up to $7.6 million to expand the number of coronavirus tests its machines can run by two million tests a month. The expanded capacity won’t be available until January of next year.

Some state officials voiced apprehensions about the federal response to the pandemic. Gov. Michelle Lujan Grisham of New Mexico, a Democrat, said in an appearance on “This Week” that her state was “at the mercy of what’s going on around the county.”

New Mexico set a single-day record on Thursday, reporting 335 new virus cases.

“There is no national strategy,” Ms. Grisham said. “I still spend most of my days chasing testing supplies for our state. It is the worst abdication of a national response and responsibility to protect Americans I have ever seen in my government career.”

Gov. Larry Hogan of Maryland, a Republican, called for a “robust testing program” for his state in an appearance on “State of the Union.” He urged the administration not to cut funding for testing, much of which is now being carried out by private sector labs “who are becoming overwhelmed because of the massive volume of tests.”

Mr. Hogan said he was concerned that students could not go back to school in the fall without more progress in those areas.

Florida’s total number of reported coronavirus cases has surpassed that of New York, an early epicenter of the pandemic in the United States.

As of Sunday morning, Florida has at least 423,847 reported cases, while there are more than 416,000 reported cases in New York, according to a New York Times database.

Cases have surged in Florida this month. Over the past week, there have been an average of nearly 11,000 cases per day, an increase of about 19 percent from the average two weeks earlier. There have been at least 5,776 deaths in Florida since the beginning of the pandemic.

Last week, California also surpassed New York in the number of known coronavirus cases statewide.

Despite that data, it’s tough to know which state has actually had the most infections. New York and California had significant outbreaks very early on, when testing was limited. The Centers for Disease Control and Prevention has said that huge numbers of infections across the United States have gone undetected, dwarfing the tallies of known cases.

The spread of the virus has escalated in much of the country this month, particularly in Southern states where governors following Mr. Trump’s lead encouraged businesses to reopen.

In Florida, more than a third of the cases reported in the state have been among people age 15 through 34, according to the Florida Department of Health, and there have been outbreaks in jails and nursing homes and on farms. Now there are signs that the age of Floridians getting the virus is shifting, with some retirement communities seeing more cases than they did last month.

In parts of the South and Midwest where the number of cases is surging, it could be last call all over again for bars.

During a visit to Kentucky on Sunday, Dr. Deborah L. Birx, the Trump administration’s coronavirus response coordinator, urged states in the region to reinstate bar closures and restrictions on public gatherings to quell the rise of infections.

“We do believe that there are states that do need to close their bars, to decrease indoor gatherings to less than 10 and to decrease social gatherings to less than 10 to really make it possible to control the pandemic before it gets worse,” Dr. Birx said.

She cited Kentucky, Indiana, Ohio, Tennessee and Virginia as areas of concern and said that federal health authorities were concerned about the percentage of people testing positive for the virus, as well as the total number of cases.

Dr. Birx said that the federal government had designated areas where the positivity rate was 10 percent or greater as Covid red zones and those areas where the positivity rate was 5 to 10 percent as Covid yellow zones.

“I think there’s been a real cry to be able see what were seeing on the federal government level,” she said.

Dr. Birx appeared with Gov. Andy Beshear of Kentucky, a Democrat, who said that the state would announce new guidelines on Monday to address the uptick.

“I want you to know that the White House and Kentucky state government are in complete agreement that the escalation of cases is going to require us to take some new steps,” Mr. Beshear said.

Elsewhere in the United States:

With Hurricane Douglas bearing down on the Hawaiian Islands from the east, officials are opening emergency shelters and bracing for what the National Weather Service warned would be “a triple threat of hazards” including “damaging winds, flooding rainfall and dangerously high surf.” But officials are warning that the coronavirus may sharply constrict how many people those shelters can accommodate.

Top Trump administration officials proposed on Sunday that free-ranging stimulus talks with Democrats be paused in order to rush through a much narrower bill prioritizing an extension of a $600 federal unemployment benefit expiring for millions of Americans. Democrats, who passed their own proposal in May, have already made clear they are not interested.

Four states set single-day case records — Louisiana, Tennessee, Oklahoma and Alaska.

The pandemic is taking an immense toll on the nonprofit groups that Americans rely on for social services, medical care, cultural and spiritual needs. Tens of thousands are likely to close without some kind of rescue package, the research group Candid has concluded from an analysis of tax filings. The sector is the nation’s third-largest private employer, with 1.3 million nonprofits employing roughly 12.5 million people, about 10 percent of the total in the private sector. A Johns Hopkins University study estimated that 1.6 million nonprofit jobs were lost from February to May.

A physical therapist brought the virus to rowers who were training to make the U.S. Olympic team, and more than one-third was infected in March and April. One gold medalist said it “knocked us down pretty hard.”

A Sept. 11 tribute bows to safety and will replace the live recitation of victims’ names with a recording.

Year after year, relatives of those killed in the Sept. 11 terrorist attacks have gathered at ground zero in Manhattan to recite the names of their loved ones as part of a somber tribute that has marked families’ shared pain for nearly two decades.

But even the most hallowed rituals are now affected by the coronavirus.

Alice M. Greenwald, the chief executive of the National September 11 Memorial & Museum, wrote in a letter to family members that they would not read the names of the victims onstage, “out of an abundance of caution and in line with the guidance regarding social distancing.”

Instead, the tribute will feature a recording of the victims’ names being read.

“We are closely monitoring the evolving situation presented by Covid-19 and are planning accordingly to ensure safety while maintaining our mission to honor the victims and those who risked their lives to save others,” Ms. Greenwald wrote.

The ceremony is still scheduled to take place, and the hope is to have relatives gather in the plaza while maintaining social distance and other public health precautions, she added.

As in years past, there will be six moments of silence to mark the moments when the two planes hit the twin towers of the World Trade Center, the time each tower fell, and the moments when one plane hit the Pentagon and another crashed in Shanksville, Pa., after passengers onboard fought against the hijackers.

“Around the world, people are responding to the Covid-19 crisis with compassion, generosity, and a sense of community, much like they did in the aftermath of 9/11,” Ms. Greenwald wrote. “These expressions of connection and empathy give us a sense of hope, even in the face of shared grief.”

Global roundup

Britain’s abrupt rule that travelers from Spain isolate for 14 days surprised even the transport minister.

Often criticized for a slow response to the coronavirus, the British government moved quickly this weekend to impose a quarantine on anyone arriving from Spain, after a spike in Covid-19 cases there.

The move was so rapid that the order brought disarray to thousands of Britons, blindsiding many already traveling and embarrassing Britain’s transportation secretary, Grant Shapps, who is responsible for aviation policy but learned of the quarantine while on vacation. In Spain.

Mr. Shapps, like others who left Britain assuming that they could return without having to go into isolation, will now be required to do so for 14 days.

Many who were about to depart for Spain have been forced to rethink their vacation plans. Some flights to Spain were canceled. And those planning to head elsewhere have been reminded of the risk that quarantine rules can change overnight.

Britain’s foreign secretary, Dominic Raab, said the decision, reversing a recent relaxation of restrictions, had been made after a review of data received on Friday that showed a large jump in the number of Spanish cases.

“We took the decision as swiftly as we could,” Mr. Raab told Sky News.

The Scottish government, which lifted its quarantine rules for Spain just a few days ago, said it would reimpose them, too.

Britain’s biggest tour operator, Tui, said it was canceling all its vacations to mainland Spain until Aug. 9, though several airlines, including British Airways, were still offering flights. Airline officials expressed the frustration of a devastated sector.

“​This is, sadly, yet another blow for British holidaymakers and cannot fail to have an impact on an already troubled aviation industry,” British Airways said in a statement, adding that the change was “throwing thousands of Britons’ travel plans into chaos.”

In other news from around the globe:

North Korea said on Sunday that it had locked down Kaesong, a city near its border with South Korea, and declared a “maximum” national emergency after finding what its leader, Kim Jong-un, said could be the country’s first case of Covid-19 there.It issued the high alert after a North Korean who had defected to South Korea three years ago but secretly crossed back into Kaesong a week ago was “suspected to have been infected with the vicious virus,” the North’s official Korean Central News Agency said. Until now, North Korea, one of the world’s most isolated countries, has repeatedly said that it had no cases of Covid-19, although outside experts questioned the claim.

South Korea reported 58 new infections on Sunday, including 46 from abroad, a sharp drop from a day earlier. On Saturday, the country had reported 113 new infections, its highest daily total since March. Those cases included 36 South Korean construction workers who had returned from Iraq, and 32 Russian sailors from a fishing vessel docked for repair.

Also in South Korea, the office of President Moon Jae-in said that he had received a letter from Bill Gates, the Microsoft co-founder and philanthropist, expressing hope for greater cooperation between South Korea and his foundation in efforts to fight the virus. In the July 20 letter, Mr. Gates praised the country’s pandemic response and said that if the South Korean company SK Bioscience succeeded in developing a vaccine, it would be able to produce 200 million doses a year starting next June. The company has received $3.6 million in research funding from the Bill & Melinda Gates Foundation to develop a coronavirus vaccine.

Australia on Sunday reported its highest one-day death toll — 10 people, all in the state of Victoria. Also, the New South Wales Supreme Court prohibited a Black Lives Matter rally set for Sydney on Tuesday, citing the risk of virus transmission. Organizers say they plan to appeal.

President Jair Bolsonaro of Brazil said on Saturday that he had been cured of Covid-19 after apparently having only mild symptoms from a disease he has repeatedly played down while it has killed more than 85,000 people in his country. “GOOD MORNING EVERYONE,” Mr. Bolsonaro, 65, posted in a message on Twitter Saturday morning, smiling and brandishing a box of hydroxychloroquine pills, the anti-malaria medicine. Mr. Bolsonaro has hailed the drug as a miracle cure, despite a growing scientific consensus that it is not effective to treat Covid-19.

Vietnam, which has recorded zero deaths from the coronavirus and had gone 100 days without a single case of local transmission, reported two positive cases over the weekend in the central city of Danang: a 57-year-old man and a 61-year-old man. In both cases, the source of the infection was unclear. Officials said that the second man’s condition was deteriorating rapidly and that he had been placed on a ventilator.

Brazil, famed for its revelry, sees a much tamer year ahead.

Brazil is known for massive street parties like Carnival and its New Year’s Eve celebrations — but not this year.

Unable to contain the spread of the virus, Brazilian cities are postponing, drastically altering or just plain canceling some of their signature festivities.

On Sunday, the city of Rio de Janeiro announced that it would not host the New Year’s Eve fireworks and music extravaganza that each year draws over two million people to Copacabana beach. City officials said a celebration of some sort would still take place, but what it may look like is still under study.

Rio officials have yet to reveal their plans for Carnival, which traditionally takes place between February and March and fills the city’s streets with many millions of revelers for parties that last for days. But the mayors of São Paulo and Salvador have already announced they would postpone Carnival festivities for several months.

Even with case numbers improving, there is no choice, said Bruno Covas, the mayor of São Paulo. “We are still facing the pandemic,” he said in statement.

Mr. Covas also announced changes to two other events that draw millions: the March for Jesus and the LGBTQI+ parade. The first was postponed, and the second cancelled.

In the city of Salvador, in northeastern Brazil, no official announcement has been made yet, but the mayor, Antônio Carlos Magalhães Neto, said in an interview with the GloboNews broadcaster that his office was studying the possibility of postponing Carnival to July 2021.

“We have to be realistic,” he said, promising to make a final decision by November.

Brazil has so far reported more than 2.3 million cases of Covid-19, and more than 86,000 deaths, making it second only to the United States.

Drugmaker to get up to $472 million for late-stage vaccine trial.

The vaccine maker Moderna said Sunday that it will receive up to $472 million in additional funding from the federal government to help pay for a late-stage clinical trial of the company’s coronavirus vaccine, which is expected to begin enrolling patients Monday.

Moderna said that it had nearly doubled the size of its contract with a division of the Department of Health and Human Services to help it run a trial of 30,000 patients that will evaluate whether the vaccine is effective in preventing infections.

The company’s vaccine was developed with researchers at the National Institute of Allergy and Infectious Diseases and was the first coronavirus vaccine to be tested in humans. Moderna said earlier this month that its vaccine provoked an immune response against the virus and appeared safe in the first 45 people who received it.

In the late-stage trial, half of the participants will receive a placebo, and half will receive the vaccine. If the vaccine is successful, Moderna has said it will be able to produce about 500 million doses per year — and as many as one billion — beginning in 2021.

Hundreds of vaccines are being tested for the coronavirus, and 27 are in human trials. The federal government has been promising billions of dollars to companies to quickly develop and manufacture vaccines as part of Operation Warp Speed.

The drug maker Pfizer recently received a federal promise of nearly $2 billion to develop its vaccine and another company, Novavax, has entered into a $1.6 billion deal. Other companies that have also received significant federal money include AstraZeneca and Johnson & Johnson. The total value of Moderna’s award is now $955 million, the company said.

The limits of antibody testing add to the immunity mystery.

One of the great mysteries of the coronavirus pandemic has been the fact that many stricken people have later discovered that they don’t seem to have antibodies, the protective proteins generated in response to an infection.

This has led to concerns that people may be susceptible to repeat infections.

The problem, writes The Times’s Apoorva Mandavilli, lies in the antibody tests.

Most commercial antibody tests offer crude yes-no answers. The tests are notorious for delivering false positives — results indicating that someone has antibodies when they do not.

But the volume of coronavirus antibodies is known to drop sharply once the acute illness ends, and it has become increasingly clear that tests may miss antibodies that are present at low levels.

Moreover, some tests — including those made by Abbott and Roche and offered by Quest Labs and LabCorp — are designed to detect a subtype of antibodies that doesn’t confer immunity and may wane even faster than the kind that can destroy the virus.

But the declining antibodies indicated by commercial tests don’t necessarily mean declining immunity, several experts said.

“Whatever your level is today, if you get infected, your antibody titers are going to go way up,” said Dr. Michael Mina, an immunologist at Harvard University, referring to the levels of antibodies in the blood. “The virus will never even have a chance the second time around.”

A small number of people may not produce any antibodies to the coronavirus. But even then, they will have “cellular immunity,” which includes T cells that learn to identify and destroy the virus. Virtually everyone infected with the coronavirus seems to develop T-cell responses, according to several recent studies.

For now, many experts urge caution. While it appears extremely unlikely that people can be reinfected, without more information about what antibody testing results mean, they said, people should act as though they do not have immunity.

Editors and account managers at the Time & Life Building in Midtown Manhattan could once walk out through the modernist lobby and into a thriving ecosystem that existed in support of the offices above. They could shop for designer shirts or shoes, slide into a steakhouse corner booth for lunch and then return to their desks without ever crossing the street.

To approach this block today is like visiting a relative in the hospital. The building, rebranded a few years ago and renovated to fit 8,000 workers, now has just 500 a day showing up. The steakhouse dining rooms are dark.

While other neighborhoods are rushing to reopen, Midtown Manhattan — the muscular power center of New York City for a century — remains stuck in a purgatorial Phase Zero, offering a sign of what may lie in store for business districts across the country.

Ahmed Ahmed, a hot dog vendor looking over what should be prime real estate outside Radio City Music Hall at West 50th Street, said he used to sell 400 hot dogs a day. Now? “Maybe 10,” he said.

Subway data tells a story just as stark.

Consider the area’s Rockefeller Center station, a major stop for four train lines. Last year on June 24, a Monday, there were 62,312 MetroCard turnstile swipes as riders entered the station. On the comparable Monday this year, June 22, the number of swipes was 8,032, a staggering 87 percent decrease.

Robert A.M. Stern, the modern traditionalist architect whose firm has executed many prominent projects in Manhattan and around the globe, said the past was a hopeful indicator in this uncertain time.

“New York survived the late ’70s, and everybody thought the city was over, rampant crime, near bankruptcy,” he said. “It survives the market crashes of ’87 and ’89, it survives the dot-com crash of 2000 or so. It survived 2008. So it will survive. But each time, each one of those moments probably can be traced in relationship to new ideas on how to occupy existing buildings or how to occupy new buildings.”

Elaine Roberts, a bagger at a supermarket, tried to be careful. She put on gloves and stopped riding the bus to work, instead relying on her father to drive her. She wore masks — in space-themed fabrics stitched by her sister — as she stacked products on shelves, helped people to their cars and retrieved carts from the parking lot.

But many customers at the Randalls store in a Houston suburb did not wear them, she noticed, even as coronavirus cases began rising in early June. Gov. Greg Abbott, who had pushed to reopen businesses in Texas, was refusing to make masks mandatory and blocked local officials from enforcing mask requirements.

Ms. Roberts, 35, who has autism and lives with her parents, got sick first. Then her father, Paul, and mother, Sheryl, were hospitalized. While no one can be certain how Elaine Roberts was infected, her older sister, Sidra Roman, blamed grocery customers who she felt had put her family in danger.

“Wearing a piece of cloth, it’s a little uncomfortable,” she said. “It’s a lot less uncomfortable than ventilators, dialysis lines, all of those things that have had to happen to my father. And it’s not necessarily you that’s going to get sick and get hurt.”

What happened to the Robertses is in many ways the story of Texas, one of the nation’s hot spots. For weeks, politicians were divided over keeping the economy open, citizens were polarized about wearing masks, and doctors were warning that careless behavior could imperil others.

In southeast Texas, communities already battered by the pandemic faced a new but no less frightening foe on Saturday, as Hurricane Hanna slammed the coast with heavy rains and winds.

Hanna’s eye made landfall on Padre Island, about 60 miles north of the U.S.-Mexico border, around 5 p.m. Saturday, with winds of 90 m.p.h. The National Weather Service warned of floods and of gales that could peel roofs from homes, mangle trees and cause power failures.

Many cities and counties in the path of Hanna have been experiencing spikes in Covid-19 cases and hospitalizations.

Steering a course through the ethics of the coronavirus.

Covid-19 has created a whole new set of moral quandaries. Here are a few ways to consider those issues.

Reporting was contributed by Fahim Abed, Stephen Castle, Melina Delkic, Nicholas Fandos, Marie Fazio, Sheri Fink, Jacey Fortin, Rebecca Halleck, Jennifer Jett, Nicholas Kulish, Ernesto Londoño, Juliet Macur, Apoorva Mandavilli, Raphael Minder, Christina Morales, Adam Nagourney, Bryan Pietsch, Alan Rappeport, Katie Rogers, Jordan Salama, Choe Sang-Hun, Katie Thomas, Michael Wilson and Mihir Zaveri.

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