A fatal flaw in the plan to reopen the economy: not enough coronavirus testing

President Donald Trump cannot wait until medical science says it is reasonably safe to begin opening up the economy. He announced on Thursday a plan to reopen the economy (below) as early as today if some irresponsible red states wish.

There is a fatal flaw in Trump’s reckless plan to reopen the economy: there has not been nearly enough coronavirus testing to assure businesses and the public that it is reasonably safe to risk reopening and returning to a new normal. Trump’s attempt to enlist businesses in reopening push gets off to rocky start: Some business leaders complained the effort was haphazard and warning that more testing needs to be in place before restrictions are lifted.

In fact, Coronavirus testing is plateauing this week:

The number of coronavirus diagnostic tests being completed every day has plateaued over the last week — at a number that falls far short of what experts say is needed.

Some states are testing more than others, but we’ve got a long way to go before we’re ready to safely resume normal life. Otherwise, the virus will easily be able to spread undetected.

Data: The COVID Tracking Project; Chart: Andrew Witherspoon/Axios

Ashish Jha, director of the Harvard Global Health Institute, said he thinks we need to be doing 500,000 tests a day for the foreseeable future.

Nationwide testing capacity steadily increased for weeks, but has appeared to hit a wall around only 145,000 tests a day. Several factors are holding it back:

• • • Supply shortages for key test ingredients, swabs, test kits, and personal protective equipment.
    • Poor coordination: Some labs have excess testing capacity, but aren’t being sent samples from the providers collecting them.
    • Rules about who gets tested: Many states have limited testing to the sickest patients, and caseloads are dropping overall. But clinicians often have discretion as to who they test.
    • States are competing for resources, and some have better existing infrastructure than others.
    • “Every state has come up with its own policy for testing, and most states are relying on a mix of different factors for how to do testing,” Jha said.

On March 6, Trump asserted that “Anybody that wants a test (for the coronavirus) can get a test.” It was a lie then, and it is still a lie today.

The single greatest failure of the Trump administration is its failure to adopt a “Manhattan Project” or “Apollo Project” level of commitment to the manufacturing of key coronavirus test ingredients, swabs, test kits, and personal protective equipment to ensure such widespread testing. Trump has still not invoked the Defense Production Act to this day to ramp up production of these critical test components, or to use the power of the federal government to manage the logistics of the production and distribution of these critical test components, despite his fanciful claim that he is a “wartime president.”

The Washington Post adds (excerpts):

There is no national testing strategy, but rather a patchwork of programs administered by states with limited federal guidance.

There also is no single administration official working on testing.

The government has been unable to compel test manufacturers to dramatically increase the number of tests produced, and Trump has been unwilling to invoke the Defense Production Act for that purpose. States are also still struggling with acute supply shortages for tests, including swabs and reagents, that Washington has not addressed.

Governors have said one of the most important factors in making these determinations is testing data, but Trump’s plan does not contain a national testing strategy. As testing outcry mounts, Trump cedes to states in announcing guidelines for slow reopening:

Senior administration officials said that although the federal government will try to facilitate access to tests, states and localities will be responsible for developing and administering their own testing programs.

Leaders across sectors, from elected officials to business executives to public-health experts, have amplified warnings this week that the nation is not ready to reopen in part because its testing system is woefully inadequate.

So far, about 3.3 million people have been tested in the United States, according to the Covid Tracking Project, at a rate over the past week of roughly 146,000 people per day. While that is a significant improvement from early testing stumbles, it is still far short of the millions of tests per day experts say is needed to begin safely reopening the economy in a nation of some 330 million.

Trump falsely claimed that the United States has “the most advanced and robust testing anywhere in the world,” but the data show other countries, including Germany and South Korea, tested far more people per capita early in the outbreak, which helped them contain cases and deaths. Germany, with about a quarter of the U.S. population, has been testing 350,000 people per week, one reason Chancellor Angela Merkel decided to begin gradually reopening her country next week.

“It is the single best tool to inform decisions and to calibrate all of this,” New York Gov. Andrew M. Cuomo (D) said Thursday of testing. “This has to be figured out. I understand that this is a problematic area and the federal government’s not eager to get involved in testing. I get that, but the plain reality here is we have to do it in partnership with the federal government.”

This is simply inexcusable in a country where we are constantly told by Republicans that “we have the finest medical system in the world.” The coronavirus pandemic has laid bare this lie.

Nevertheless, President Trump is forging ahead with his reckless plan to reopen the economy too soon on the randomly selected date of May 1:

President Trump released federal guidelines Thursday night for a slow and staggered return to normal in places with minimal cases of the novel coronavirus, moving to try to resume economic activity even amid an outcry from political and health leaders about the nation’s testing capacity.

Despite Trump’s desire for a May 1 reopening, his plan does not contain a date for implementation and is a vague set of recommendations for a three-phased reopening of businesses, schools and other gathering places in jurisdictions that satisfy broad criteria on symptoms, cases and hospital loads.

“America wants to be open and Americans want to be open,” Trump said. “A national shutdown is not a sustainable long-term solution. To preserve the health of our citizens, we must also preserve the health and functioning of our economy.”

The plan effectively reverses Trump’s claim earlier this week that he had “total authority” to declare the nation reopened. The federal guidelines shift accountability to governors and mayors, placing the onus on them to make decisions for their own states and localities based on their own assessments of the coronavirus’s spread and risk of resurgence.

“You’re going to call your own shots,” Trump told governors on a conference call Thursday, a recording of which was obtained by The Washington Post.

Trump’s the-buck-stops-with-the-states posture is largely designed to shield himself from blame should there be new outbreaks after states reopen or for other problems, according to several current and former senior administration officials involved in the response who spoke on the condition of anonymity to discuss internal deliberations.

The key factor for Trump was that he got to fire the starter’s pistol, Axios‘ Jonathan Swan reports. Trump’s coronavirus self-protection plan: Spread responsibility to the states: Even though he’s delegating to governors, Trump didn’t want them to call the reopening first. And if he waited until next week he would’ve been trailing in several red-state governors’ wake.

Trump is green-lighting reckless Republican governors to reopen their economies before it is reasonably safe to do so. This will lead to a second wave of coronavirus infections and deaths. And a “false start” reopening of the economy that leads to a second wave and rapid lockdown for social distancing again will have a negative impact on the economy. (Keep an eye on the most irresponsible red states, Texas and Florida).

The guidelines Trump unveiled Thursday suggest that, before reopening, states should first have a “robust testing system in place for at-risk health care workers,” see a decrease in confirmed covid-19 cases over a 14-day period, and hospitals should be able to “treat all patients without crisis care” before proceeding to a phased reopening.

Trump has been advised by a number of political allies, as well as medical experts, that there needs to be significantly more testing before the country reopens.

“The key to opening up the economy is mass testing,” Sen. Lindsey “Stonewall” Graham (R-S.C.), a Trump confidant. “There are parts you could safely begin to reopen the economy, but the real key is mass testing. You have to have mass testing. It has to be science-based.”

Yet Trump routinely brags about how many tests already have been completed and complains about dire economic projections. The president is “determined to reopen the country. Testing is just not his primary thought,” according to one of his advisers, who spoke on the condition of anonymity to be candid.

On the conference call Thursday with governors, Trump played down the significance of testing.

“Testing is very interesting,” Trump said, according to the audio recording obtained by The Post. “There are some states where I think you can do with a lot less testing than other people are suggesting.” He told the governors that they have “a lot of leeway” in determining how many tests they conduct.

Trump has heralded a new rapid-response test from Abbott Laboratories that can deliver results in as few as five minutes, and has taken pride in his administration’s role helping distribute the machines nationwide. But when Montana Gov. Steve Bullock (D) said they got the “great Abbott machines” two weeks ago but still don’t have testing kits required to use them, Trump replied that the states are “going to lead the testing.”

“Cadet Bone Spurs” leading from behind, deflecting blame and passing the buck for failure to the governors: a coward’s personal survival strategy.

Only a fraction of the Abbott tests are being used right now because there are not enough skilled technicians around the country to operate them — a challenge officials know will continue to persist as testing ramps up — according to a senior administration official involved in the response.

A draft national strategy to reopen the country in phases, developed by the Federal Emergency Management Agency and the Centers for Disease Control and Prevention, emphasizes that even a cautious and phased approach “will entail a significant risk of resurgence of the virus.” Leaked CDC and FEMA plan warns of ‘significant risk of resurgence of the virus’ with phased reopening:

The internal document, obtained by The Washington Post, warns of a “large rebound curve” of novel coronavirus cases if mitigation efforts are relaxed too quickly before vaccines are developed and distributed or broad community immunity is achieved.

The framework lays out criteria that should be in place before a region can responsibly ease guidelines related to public gatherings: a “genuinely low” number of cases; a “well functioning” monitoring system capable of “promptly detecting” spikes of infections; a public health system able to react robustly to new cases and local health systems that have enough inpatient beds to rapidly scale up in the event of a surge in cases.

This would seem to necessitate ramping up testing and production of personal protective equipment at levels not currently being done.

But none of this matters to the sociopath-in-chief:

“Impatient with the economic devastation wrought by social distancing and other mitigation measures — and fearful of the potential damage to his reelection chances — Trump has been adamant in private discussions with advisers about reopening the country next month. Yet within Trump’s circle, officials say, there is acknowledgment that it will not be possible for the president to simply flip a switch,” per Phil Rucker, Bob Costa and Ashley Parker. “Inside the White House, it has been clear to officials since last week that there is no longer much of a debate — at least with the president — about starting the reopening process May 1 … Rather, the debate this week has been over how to implement the return, what data could be used to justify the decision, and how to build public support for it to provide the president maximum political cover …

I will reiterate what I have said before: Trump lied, people died — he must be held accountable (and all of his enablers too). The personality cult of Donald Trump is a death cult.