Health & Fitness

Covid-19 Dwell Updates: C.D.C. Director, Going through Criticism, Clarifies That Testing ‘Might Be Thought-about’ for Anybody Uncovered

Redfield issues a statement after a storm of criticism over the new C.D.C. guidelines involving potentially asymptomatic people.

The director of the Centers for Disease Control and Prevention tried to clarify the agency’s recommendation advising some people not to get tested after exposure to the novel coronavirus, now saying “testing may be considered for all close contacts of confirmed or probable Covid-19 patients.”

The statement by Dr. Robert R. Redfield was issued to some news outlets late Wednesday, and more broadly Thursday morning, after a storm of criticism over the new C.D.C. guidelines — involving potentially asymptomatic people — which were the product of the White House Coronavirus task force and not the C.D.C.’s own scientists. Dr. Redfield made the statement in an effort to clarify the new policy, an official said. However, the guidelines issued earlier this week remained on the C.D.C.’s website as of Thursday morning, and it appears unlikely that the agency will change them.

“Testing is meant to drive actions and achieve specific public health objectives,” Dr. Redfield wrote. “Everyone who needs a Covid-19 test, can get a test. Everyone who wants a test does not necessarily need a test; the key is to engage the needed public health community in the decision with the appropriate follow-up action.”

The clarification is unusual. Public health experts say clear, consistent communications are essential to fighting an infectious disease outbreak, and Dr. Redfield’s comments may further confuse things.

In guidelines posted on Monday, the agency said close contacts of Covid-19 patients “do not necessarily need a test” unless they are vulnerable or their doctor or a state or local public heath official recommended it. On a conference call with reporters Wednesday, Admiral Brett M. Giroir, the administration’s coronavirus testing czar, said the new policy mirrored the existing recommendation for health care and other frontline workers, and the task force had simply decided to extend it to the general population.

But the guidance was met with protest from public health experts, who said the nation needs more testing, not less, and that it made no sense to advise anyone exposed not to get a test, particularly because the virus is transmitted by asymptomatic people.

The chief scientific officer of the Association of American Medical College, Dr. Ross McKinney Jr., slammed it as “irresponsible,” saying the guidelines released Monday “go against the best interests of the American people and are a step backward in fighting the pandemic.”

President Trump has suggested that the nation should do less testing, arguing that administering more tests was driving up case numbers and making the United States look bad. But experts say the true measure of the pandemic is not case numbers but test positivity rates — the percentage of tests coming back positive.

In an interview on Wednesday, Dr. Anthony S. Fauci, a member of the task force and the government’s top infectious disease expert, said he was concerned that it could be misinterpreted. Dr. Fauci had signed off on an early iteration of the rule but was undergoing surgery for removal of a polyp on his vocal cord when it was finalized last Thursday.

In the statement, Dr. Redfield said the agency is “placing an emphasis on testing individuals with symptomatic illness, individuals with a significant exposure, vulnerable populations including nursing homes or long-term care facilities, critical infrastructure workers, health care workers and first responders, or those individuals who may be asymptomatic when prioritized by medical and public health officials.”

Dr. Redfield also said that anyone — even people who test negative — exposed to someone who is or may be infected should “strictly adhere” to public health guidelines, like social distancing, wearing a mask, avoiding crowded indoor spaces and frequently washing their hands.

Pelosi and Meadows speak for the first time since stimulus discussions stalled.

Speaker Nancy Pelosi of California and Mark Meadows, the White House chief of staff, spoke on Thursday afternoon for the first time since talks on an economic recovery package collapsed earlier this month, raising the possibility of jump-starting negotiations on another round of pandemic stimulus.

Since the discussions broke down weeks ago, top Democrats and administration officials have barely been in contact, even as the toll of the virus continued to mount on families, small businesses and schools.

House Democrats passed a $3.4 trillion relief measure in May and then scaled back their request this month, asking Mr. Trump’s team to raise their opening offer to a $2 trillion plan — a notion they also rejected.

In the 25-minute call on Thursday, Ms. Pelosi said, she told Mr. Meadows that Democrats would lower their opening bid from $3.4 trillion to $2.2 trillion.

“This conversation made clear that the White House continues to disregard the needs of the American people as the coronavirus crisis devastates lives and livelihoods,” Ms. Pelosi said in a statement after the call. “The administration’s continued failure to acknowledge the funding levels that experts, scientists and the American people know is needed leaves our nation at a tragic impasse.”

Ms. Pelosi later told reporters that she would agree to speak again when the White House agreed to a $2.2 trillion threshold for the stimulus.

After negotiations stalled, Mr. Trump took a series of executive actions this month that he said would deliver relief across the country, though officials acknowledged that the moves would be small in scope and impact without new funds allocated by lawmakers. His plan to use a FEMA disaster fund to pay for aid to laid-off workers is also facing fresh scrutiny as Hurricane Laura bears down on the Gulf Coast with another storm in tow, raising the possibility that the money will be needed for a major recovery effort.

With the impasse persisting into the annual August recess, many lawmakers and aides have concluded that any additional pandemic relief would have to be tied to a stopgap spending bill to fund the entire federal government. That measure must pass by the end of September to avert a shutdown.

Louisiana and Texas are facing a convergence of two public health disasters as Hurricane Laura, one of the most powerful storms to ever strike the United States, pelts down on the two states — which are among the states most ravaged by the pandemic.

The hurricane was preceded by tough decisions about evacuating and an urgent push to get people out of harm’s way, with more than 500,000 residents in Louisiana and Texas urged to leave their homes.

Although large shelters have been set up throughout the hurricane zone, Gov. Greg Abbott of Texas had encouraged evacuees to consider forgoing shelters and instead booking rooms in hotels or motels, a safer way to isolate themselves from others who might be infected with the virus.

Gov. John Bel Edwards of Louisiana employed a different message that has become familiar during the pandemic: Stay home.

In parts of Louisiana, virus testing sites were closed, and families fleeing the storm piled onto buses, most wearing masks.

With more than 145,000 known cases, Louisiana has had the most confirmed cases per capita in the nation since the virus reached the state earlier this year, according to a New York Times database. The virus was particularly brutal early on in New Orleans, where Mardi Gras celebrations helped fuel an eruption in cases. But it has also more recently been moving through other parts of the state, including Baton Rouge and the Shreveport area.

In Texas, traditional shelters like gymnasiums and convention centers that have hosted hundreds of evacuees in past disasters were to be set up with “layers of separation” between the occupants, Mr. Abbott said. The shelters and buses have hand sanitizer and personal protective equipment like face masks, and state officials plan to dispatch testing teams to the larger shelters.

“The state and local governments are fully aware that they are dealing with a pandemic while they are responding to Hurricane Laura,” Mr. Abbott said.

Seven months into the coronavirus crisis, with more than 30 vaccines rapidly advancing through the rigorous stages of clinical trials, a surprising number of research groups are placing bets on some that have not yet been given to a single person.

The New York Times has confirmed that at least 88 vaccine candidates are under active preclinical investigation in laboratories across the world, with 67 of them slated to begin clinical trials before the end of 2021.

Those trials may begin after millions of people have already received the first wave of vaccines. It will take months to see if any of them are safe and effective.

Nevertheless, the scientists developing them say their designs may be able to prompt more powerful immune responses, or be much cheaper to produce, or both — making them the slow and steady winners of the race against the virus.

“The first vaccines may not be the most effective,” said Ted Ross, the director of the Center for Vaccines and Immunology at the University of Georgia, who is working on an experimental vaccine he hopes to put into clinical trials in 2021.

Many of the vaccines at the front of the pack today try to teach the body the same basic lesson. They deliver a protein that covers the surface of the coronavirus, called spike, which appears to prompt the immune system to make antibodies to fight it off.

But some researchers worry that we may be pinning too many hopes on a strategy that has not been proved to work. “It would be a shame to put all our eggs in the same basket,” said David Veesler, a virologist at the University of Washington.

Just over one million Americans filed new claims for state jobless benefits last week, the latest sign that the economy is losing momentum just as federal aid to the unemployed has been pulled away.

Weekly claims briefly dipped below the one million mark earlier this month, offering a glimmer of hope in an otherwise gloomy job market. But filings jumped back above one million the following week, and stayed there last week, the Labor Department said Thursday.

Another 608,000 people filed for benefits under the federal Pandemic Unemployment Assistance program, which offers aid to independent contractors, self-employed workers and others not covered by regular state programs. That number, unlike the figures for state claims, is not seasonally adjusted.

Other recent indicators also suggest that the recovery is faltering. Job growth slowed in July, and real-time data from private-sector sources suggests that hiring has slumped further in August. On Tuesday, American Airlines said it would furlough 19,000 workers on Oct. 1, the latest in a string of such announcements from major corporations.

Unemployment filings have fallen sharply since early April, when 6.6 million applied for benefits in a single week. But even after that decline, weekly filings far exceed any previous period. Roughly 30 million Americans are receiving benefits under various state and federal programs.

The continued high rate of job losses comes as government support for the unemployed is waning. The $600-a-week federal supplement to state unemployment benefits expired at the end of July, and efforts to replace it have stalled in Congress. Mr. Trump announced this month that he was using his executive authority to give jobless workers an additional $300 or $400 a week, but few states have begun paying out the new benefit, and the $44 billion allocated to the program is expected to last only a few weeks.

Economists warn that the loss of federal support could act as a brake on the recovery. Nancy Vanden Houten, lead economist for the forecasting firm Oxford Economics, estimated that the lapse in extra unemployment benefits would reduce household income by $45 billion in August. That could lead to a drop in consumer spending and further layoffs, she said.

A three-day extension of a lockdown in the Gaza Strip went into effect on Thursday after the densely populated territory — which had not recorded a single case of community transmission of the virus before this week — saw two virus-related deaths since Monday, according to the Hamas-run Health Ministry.

The ministry on Thursday reported a total of 80 new cases of community transmission. Yousef Abu al-Rish, the deputy health minister, told a news conference in Gaza City on Wednesday that he expected the coming days would see “more and more” infections, but emphasized that there was still an opportunity to contain the pandemic.

Until Monday, authorities had found infections only at quarantine facilities, where all returning travelers were required to isolate for three weeks and pass two tests before being permitted to leave.

In other developments around the world:

Over the past six months, about 1.5 billion children around the world have been told to stay home from school because of the coronavirus. But more than 30 percent of them — around 463 million — were unable to gain access to remote learning opportunities, according to a report on Wednesday by UNICEF. Schoolchildren in sub-Saharan Africa have been the most affected, the report said, as education systems there have failed to reach about half of all students through television, radio, internet or other forms of remote learning. Forty percent of students in the Middle East and North Africa, 38 percent in South Asia and 34 percent in Eastern Europe and Central Asia have also been unable to learn remotely.

In Britain, the government said it would start to pay people in low-income areas with high numbers of coronavirus cases who have to quarantine and cannot work from home. Payments of up to 182 pounds (about $240) will be made to people who have tested positive for Covid-19 as well as to their contacts if they meet certain criteria. A trial will start on Tuesday.

In Germany, demonstrations by far-right groups against virus restrictions scheduled for the weekend in Berlin were canceled after city authorities said that they would likely break social-distancing rules. Critics said a ban could energize those who already think the state is overreaching on virus rules, and ultimately lead to more dangerous illegal demonstrations.

Doctors in the public hospitals in Nairobi, the capital of Kenya, have ended their weeklong strike over shoddy protective gear, lack of insurance coverage and delayed salaries. The return to work announcement came after the Nairobi county government and the doctors’ union struck a deal that saw the resolution of most of the health workers’ concerns.

South Korea reported 441 new cases on Thursday, its highest daily total since early March, as the government criticized what it called two great obstacles in fighting the virus: doctors on strike and churches obstructing epidemiological efforts. The country has reported three-digit daily jumps in infections since Aug. 14.

Face masks will be required in all public places in Paris starting Friday morning, Prime Minister Jean Castex announced. The country has seen a surge in cases, and Mr. Castex warned against complacency, adding that the local authorities could tighten restrictions if needed.

Flu vaccines are available now, and doctors urge everyone to get one to avoid a ‘twindemic.’

Most major drugstores have influenza vaccine in stock as of this week. Public health officials, fearing that the confluence of Covid-19 and influenza cases could result in a “twindemic” that will further overburden hospitals and testing locations, are urging vaccination for nearly everyone.

“Everyone above the age of 6 months should be getting the flu vaccine,” said Dr. Uchenna Ikediobi, an assistant professor of general internal medicine and infectious diseases at Yale University.

The Centers for Disease Control and Prevention recommends that you get the vaccination no later than September or October, before the start of the season. Healthy adults can get one now, but adults over 65 and those with compromised immune systems should wait until at least mid-September, so that the vaccine’s protection lasts the entire season, experts said. A special vaccine for older adults protects against multiple virus strains, and there are egg-free and nasal versions available.

Coronavirus is not the only issue that teachers, students, parents and staff will have to worry about as some schools attempt to reopen this fall. Legionella could lurk in the water supplies of school buildings.

Last week in Ohio, officials found Legionella at five schools. On Friday, a district in Pennsylvania also announced it had found Legionella at four of its schools.

“It is unusual to hear about nine schools in a one-week period having a detection of Legionella,” said Andrew Whelton, an associate professor at Purdue University in Indiana who has been studying the effects of lockdown on water systems. He said that more schools may be testing for the bacteria than in a typical year.

Legionella can form in stagnant water and then disperse through the air and be inhaled when, for example, a shower or tap is turned on. It can be fatal in one in 10 cases, according to the Centers for Disease Control and Prevention.

Many school buildings have been unoccupied since March. Experts worry that water was left to stagnate, and that schools don’t have effective guidance for dealing with the effects of prolonged shutdowns.

The C.D.C. has issued guidelines for business and building reopenings after coronavirus lockdowns that are applicable to schools, a spokeswoman said. But the vagueness of many of the guidelines, according to Dr. Whelton, means that schools that do the minimum of general preventive steps can claim to be compliant.

A string of announcements by prominent Hungarian political figures Thursday indicated a recent spike in confirmed cases in the country has reached the upper echelons of the government. Four prominent politicians, including two ministers, have gone into quarantine, with one ranking party official announcing he had tested positive for the virus.

The Hungarian government, which is led by Prime Minister Viktor Orban, drew significant criticism from the international community earlier this year following a decision by the parliament, which Mr. Orban’s party controls, to allow the prime minister to rule by decree in an effort to control the outbreak.

On Thursday, the prime minister’s office released a statement to Hungary’s state-run news service announcing that the minister overseeing the office of the prime minister, Gergely Gulyas, and a state secretary, Balazs Orban, had gone into quarantine after coming into contact with a person who had tested positive for the virus.

Shortly after the announcement, István Hollik, a lawmaker and communications director for Mr. Orban’s party, announced on Facebook that he had tested positive. The justice minister, Judit Varga, also announced on Facebook that she had gone into quarantine after being exposed to the virus.

According to government data, new case levels have risen sharply over the past week, with 91 new cases registered Thursday — the highest number of recorded daily infections since April. Hungary has recorded more than 600 deaths from the virus.

The virus has infiltrated vulnerable, protected tribes living on islands in the Bay of Bengal.

The authorities in Andaman and Nicobar Islands in the Bay of Bengal say they have recorded at least 10 cases of the virus in the endangered Greater Andamanese tribe, one of five vulnerable tribes living on the remote islands.

The islands are territories of India, and the country’s health officials said after six members of the Greater Andamanese tribe tested positive this month that medical workers tested nearly all 53 members of the aboriginal tribe.

Four more tribe members tested positive and were hospitalized in Port Blair, the capital. Dr. Avijit Roy, a health official, said the infection may have spread after the tribe came in contact with other islanders.

“They are very health conscious and are cooperating with doctors,” Dr. Roy said.

The Andaman and Nicobar Islands have recorded 2,985 cases of the virus and 41 deaths since the first infection was detected in early June.

India strictly monitors access to the tribes, and the groups living on the islands of Andaman and Nicobar are some of the most carefully guarded. The authorities now say their priority is to mass test other tribes in coming days.

India on Thursday recorded 75,760 cases in the past 24 hours, taking the country’s total number of cases above 3.3 million, out of a population of 1.3 billion. The country has recorded at least 60,000 deaths, and is now testing nearly a million people a day, according to the health ministry.

Reporting was contributed by Katie Benner, Alan Blinder, Chelsea Brasted, Aurelien Breeden, Alexander Burns, Ben Casselman, Emily Cochrane, Choe Sang-Hun, Nick Cumming-Bruce, Abdi Latif Dahir, Concepción de León, Reid J. Epstein, Hari Kumar, Alex Marshall, Jonathan Martin, Jesse McKinley, Sarah Mervosh, Claire Moses, Heather Murphy, Ben Novak, Richard C. Paddock, Adam Rasgon, Campbell Robertson, Rick Rojas, Amanda Rosa, Dana Rubinstein, Christopher F. Schuetze, Dera Menra Sijabat, Jenna Smialek, Sheryl Gay Stolberg, Eileen Sullivan, Sameer Yasir and Carl Zimmer.

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