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Credit…Johnny Milano for The New York Times
America’s lost month: How the U.S. fell behind on coronavirus testing.
As the deadly coronavirus spread across the United States between late January and early March, large-scale testing of people who might have been infected did not happen because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels.
The three federal health agencies responsible for detecting and combating pandemic threats failed to prepare quickly enough, a Times investigation found. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.
Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, trusted the agency’s veteran scientists to develop a test for the coronavirus. But when test turned out to have a flaw, it took the C.D.C. much of February to settle on a solution. In the meantime, the virus was spreading undetected.
Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, was supposed to help build national testing capacity by approving diagnostic tests developed by the private sector. Yet he enforced regulations that paradoxically made it tougher for hospitals and laboratories to deploy such tests in an emergency.
Alex M. Azar II, the health and human services commissioner, oversaw the two other agencies and coordinated the government’s public health response to the pandemic. Yet he did not manage to push the C.D.C. or F.D.A. to speed up or change course.
Together, the challenges resulted in a lost month, when the United States squandered its best chance of containing the coronavirus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.
C.D.C. issues a travel advisory for the New York region, after Trump backs off his quarantine threat.
President Trump said Saturday night that he will not impose a quarantine on New York, New Jersey and Connecticut but would instead issue a “strong” travel advisory to be implemented by the governors of the three states.
Mr. Trump made the announcement on Twitter just hours after telling reporters that he was considering a quarantine of the three states in an effort to limit the spread of the coronavirus to Florida and other states.
Later Saturday night, the C.D.C. issued a formal advisory urging the residents of the three states to “refrain from non-essential domestic travel for 14 days effective immediately.” The advisory, which was posted to the agency’s website and its Twitter account, does not apply to “employees of critical infrastructure industries,” the agency said. That includes trucking, public health professionals, financial services and food supply workers.
Mr. Trump, when he said he was considering a quarantine for the region, offered no details about how his administration would enforce it. Speaking to CNN, Gov. Andrew Cuomo of New York criticized the idea, calling it “a declaration of war on states.”
He also questioned the logistical challenges, as well as the message, such an order would present. “If you start walling off areas all across the country it would just be totally bizarre, counterproductive, anti-American, antisocial,” he said.
Mr. Trump’s public airing of his deliberations came one day after he signed a $2 trillion economic stimulus package and as cases in the tristate area continued to climb. The specter of a federal quarantine followed a wave of governors who, fearful about the virus spreading further through their states, ordered people who had traveled from New York to isolate themselves for two weeks after their arrivals.
Gov. Gina Raimondo of Rhode Island said Friday that state troopers would begin stopping drivers with New York license plates so that National Guard officials could collect contact information and inform anyone coming from the state that they were subject to a mandatory, 14-day quarantine.
Texas, Florida, Maryland and South Carolina are among the other states that have ordered people arriving from New York to self-quarantine. In Texas, for instance, the authorities said Friday that Department of Public Safety agents would make surprise visits to see whether travelers were adhering to the state’s mandate, and they warned that violators could be fined $1,000 and jailed for 180 days.
Mr. Lamont, the Connecticut governor, this week urged all travelers from New York City to self-quarantine for two weeks upon entering the state, but he stopped short of issuing an order requiring it.
Coronavirus Map: Tracking the Global Outbreak
The virus has infected more than 651,600 people in at least 171 countries.
A sudden lockdown in India leaves hundreds of thousands of migrants homeless and jobless.
In one of the biggest migrations in India’s modern history, hundreds of thousands of migrant laborers have begun long journeys on foot to get home, having been rendered homeless and jobless by Prime Minister Narendra Modi’s nationwide lockdown to contain the spread of the coronavirus.
In the capital, Delhi, thousands of migrants, including whole families, packed their pots, pans and blankets into rucksacks, some balancing small children on their shoulders as they walked along interstate highways. Some planned to walk hundreds of miles. But as they reached the Delhi border, many were beaten back by police.
“You fear the disease, living on the streets. But I fear hunger more, not corona,” said Papu, 32, who came to Delhi three weeks ago for work and was trying to get to his home in Saharanpur in the state of Uttar Pradesh, 125 miles away.
So far, 980 people have tested positive for the coronavirus in India, with 24 dead, according to officials.
India already had one of the world’s largest homeless populations, and the lockdown may have tripled it overnight, workers for nongovernmental organizations say. A 2011 government census put the number of homeless at 1.7 million, almost certainly a vast underestimate in this country of 1.3 billion.
The lockdown, which includes a ban on interstate travel, was announced with just four hours’ notice on Tuesday, leaving India’s enormous migrant population stranded in big cities, where jobs lure them in vast numbers from the countryside.
Illinois reports first known U.S. death of an infant with the coronavirus.
An infant who tested positive for the coronavirus has died in Chicago, the authorities said on Saturday. It was the first known death of a child younger than a year old with the virus in the United States, although the authorities in some states do not release details about people who die.
Newborns and babies have so far seemed to be largely unaffected by the coronavirus, but three new studies suggest that the virus may reach the fetus in utero.
“There has never before been a death associated with Covid-19 in an infant,” said Dr. Ngozi Ezike, the director of the Illinois Department of Public Health. “A full investigation is underway to determine the cause of death.” Older adults, especially those in their 80s and 90s, have been viewed as the most vulnerable in the outbreak, but younger people have also died.
By Saturday night, deaths in the United States had surpassed 2,000, at least 50 of them in Illinois. More than 3,500 known cases of the virus have been identified in Illinois.
Interview with a W.H.O. official revives criticism over China’s influence.
A World Health Organization official ducked questions about Taiwan’s response to the coronavirus pandemic, reviving criticism that China exercises undue influence over what should be an apolitical body concerned with global health.
China considers self-governed Taiwan to be part of its territory, and it has sought to limit its international recognition and participation in multinational bodies like the W.H.O. In its coronavirus situation reports, the W.H.O. has listed Taiwan as part of China and referred to it as “Taipei,” its capital city, and later “Taipei and environs.”
In an interview broadcast Saturday by RTHK, the Hong Kong public broadcaster, the journalist Yvonne Tong asked Dr. Bruce Aylward, a senior adviser at the W.H.O., whether Taiwan should be reconsidered for membership in the organization.
At first, Dr. Aylward, who led a W.H.O team to China in February, said he had not heard the question over the video call. But when pushed again, he asked that Ms. Tong move on to a new question. When she tried again, the video was disconnected. RTHK then called back and asked about Taiwan’s performance in containing the virus.
“We’ve already talked about China, and you know, when you look across all the different areas of China, they’ve actually all done quite a good job,” Dr. Aylward responded.
Joseph Wu, Taiwan’s foreign minister, criticized Dr. Aylward’s comments. “Wow, can’t even utter ‘Taiwan’ in the W.H.O.?” Mr. Wu wrote on Twitter. “You should set politics aside in dealing with a pandemic.”
Taiwan has been widely credited for containing the spread of the coronavirus within its borders, despite its proximity to mainland China and the large number of people who regularly travel across the Taiwan Strait. Taiwan has recorded 283 confirmed coronavirus cases and just two deaths.
Taiwan last week accused the W.H.O. of not passing along a warning it sent in December, which cautioned governments about the outbreak in Wuhan, the city in China where the coronavirus emerged last year.
Ambulances in New York haven’t been this busy since 9/11.
Even as hospitals across New York become inundated with coronavirus cases, some patients are being left behind in their homes because the health care system cannot handle them all, according to dozens of interviews with paramedics, New York Fire Department officials and union representatives, as well as city data.
In a matter of days, the city’s 911 system has been overwhelmed by calls for medical distress apparently related to the virus. Typically, the system sees about 4,000 Emergency Medical Services calls a day.
On Thursday, dispatchers took more than 7,000 calls — a volume not seen since the Sept. 11 attacks. The record for amount of calls in a day was broken three times in the last week.
Because of the volume, emergency medical workers are making life-or-death decisions about who is sick enough to take to crowded emergency rooms and who appears well enough to leave behind. They are assessing on scene which patients should receive time-consuming measures like CPR and intubation, and which patients are too far gone to save.
And, they are doing it, in most cases they say, without appropriate equipment to protect themselves from infection.
The paramedics described grim scenes as New York City has become the epicenter of the coronavirus pandemic in the United States, with more than 29,000 cases as of Saturday, and 517 deaths.
Reporting and research was contributed by Neil MacFarquhar, Alan Blinder, Michael D. Shear, Jesse McKinley, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas, Noah Weiland, Maria Abi-Habib and Austin Ramzy.