Trump Extends Social Distancing Guidelines Through End of April

https://www.nytimes.com/2020/03/29/us/politics/trump-coronavirus-guidelines.html

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WASHINGTON — President Trump retreated Sunday from his desire to relax coronavirus guidelines by Easter, announcing instead that all Americans must continue to avoid nonessential travel, going to work, eating at bars and restaurants, or gathering in groups of more than 10 for at least another month and perhaps until June.

The grim recommendation, which the president made in the White House Rose Garden, came just a day before the end of a two-week period in which the world’s largest economy has largely shut down with staggering consequences: businesses shuttered, schools and colleges emptied, and social life all but suspended.

Mr. Trump said repeatedly last week that he wanted to reverse such drastic measures soon, perhaps by Easter, on April 12, in the hopes of restarting the economy. But public health experts — including the president’s own advisers — had warned that trying to return to normal life too quickly risked allowing the virus to rage, increasing the likelihood of more infections and raising the number of deaths.

The president finally appeared on Sunday to acknowledge the possibility of deaths on a large scale and back down from weeks of insisting that the threat from the virus might be overblown. In the past month, Mr. Trump has vacillated between accepting the need for aggressive action to limit the pandemic and complaining that such moves will harm the economy.

But on Sunday, his mood seemed somber as he conceded the need for another month of collective pain. Citing figures from his advisers that showed that as many as 200,000 people could die from the virus even if the country took aggressive action to slow its spread, Mr. Trump said the restrictions must continue, even if it meant more sacrifice in the days ahead.

“During this period, it’s very important that everyone strongly follow the guidelines. Have to follow the guidelines,” Mr. Trump told reporters, with members of the government’s coronavirus task force nearby. “Therefore, we will be extending our guidelines to April 30 to slow the spread.”

“We can expect that by June 1, we will be well on our way to recovery,” Mr. Trump said. “We think by June 1. A lot of great things will be happening.”

Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said he and other public health officials had urged Mr. Trump not to relax the guidelines too soon. Dr. Fauci — who in television appearances earlier in the day had offered the estimate of 200,000 dead — said Mr. Trump was affected by those predictions.

“The idea that we may have these many cases played a role in our decision in trying to make sure that we don’t do something prematurely and pull back when we should be pushing,” Dr. Fauci said. He said extending the guidelines until April 30 was a “wise and prudent decision” that Mr. Trump reached after discussions over several days with Dr. Deborah L. Birx, the coordinator of the effort to fight the virus, and other health officials.

“Dr. Birx and I spent a considerable amount of time going over all the data, why we felt this was a best choice for us, and the president accepted it,” Dr. Fauci said.

Aides said that Mr. Trump was muted during the task force meeting before Sunday’s news conference, his mind almost entirely made up to extend the guidelines. One adviser said the president recognized that the data about the potential impact of the virus in the United States was bad, and could not be bent to his will.

For weeks, Mr. Trump had compared the coronavirus to the flu, repeatedly suggesting that many more people die of the flu each year than would succumb to the virus. But on Sunday, he repeatedly cited predictions that up to 2.2 million Americans could die from the virus if nothing were done to stop its spread. He talked about “the viciousness” of the virus and revealed that it had sent a friend to the hospital.

“He’s a little older and he’s heavy. But he’s a tough person, and we went to the hospital and a day later he’s in a coma,” Mr. Trump said. “How is he doing? ‘Sir, he’s in a coma. He’s unconscious. He’s not doing well.’ The speed and the viciousness, especially if it gets the right person, it is horrible.”

The president also expressed horror at the grim scenes playing out at the hospitals in New York City, where he spent much of his adult life. He cited the situation at Elmhurst Hospital Center — “I know it very well,” he said — which has been inundated in recent days with people ill from the virus.

“I’ve been watching that for the last week on television, body bags all over in hallways,” Mr. Trump said. “I have been watching them bringing in trailer trucks, freezer trucks because they can’t handle the bodies. There are so many of them. This is in essentially my community in Queens, New York. I have seen things that I have never seen before.”

The president’s turnabout came as state and local officials across the country confronted rapidly rising numbers of infections that threatened to overwhelm their hospitals amid shortages of protective equipment and fears that there would not be enough doctors and nurses to tend to those who get sick.

Several of the nation’s governors said on Sunday that they anticipated surges of cases during the next several weeks, and they urged their residents to continue to follow social distancing guidelines that would slow the spread of the pandemic.

“If we don’t flatten the curve, we’re on a trajectory currently to exceed our capacity in the New Orleans area for ventilators by about April the 4th, and all beds available in hospitals by about April the 10th,” Gov. John Bel Edwards, Democrat of Louisiana, said on NBC’s “Meet the Press” program Sunday morning. “So we’re doing everything we can to surge capacity. It’s very difficult.”

Gov. Jay Inslee, Democrat of Washington, who has frequently clashed with Mr. Trump, said before the president’s announcement that his state would not be ready to lift social distancing guidelines any time soon.

“Boy, I would not want to be responsible for opening the door to this virus to ravage our places that seem OK today, but, within 10 weeks, within 10 days, can be at full-scale burning through our hospital system,” Mr. Inslee said on CNN’s “State of the Union” program. “And we have seen this happen. We have got to be ahead of this curve.”

Over the last several days, Mr. Trump has lashed out at the governors, suggesting that some of them do not appreciate the help that they are getting from him and from others in the federal government.

Mr. Edwards and several other governors largely steered clear of responding to those criticisms by Mr. Trump. Instead, several of them stressed that they were working with the Federal Emergency Management Agency and other federal agencies even as they pleaded for more help getting ventilators, surgical masks and other medical equipment they need.

“You know, I don’t have energy to respond to every slight,” Gov. Gretchen Whitmer, Democrat of Michigan, said on “State of the Union.” “What I’m trying to do is work well with the federal government. And I will tell you this. There are people from the White House on down who are working 24/7, just like we are at the states. We’re all stressed, because we have people that are dying right now.”

Still, on Sunday, Mr. Trump repeated a complaint that Democratic governors had insulted him and said he would delegate calls with those officials to other people in the White House.

Updated June 12, 2020

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.

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.

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.

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.)

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.

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.

“I don’t have to call because I’m probably better off not,” Mr. Trump said, describing Mr. Inslee as “a nasty person” and raising his failed candidacy for the Democratic presidential nomination. “I don’t like the governor of Washington, so you know who calls? I get Mike Pence to call. I get the head of FEMA to call. I get the admiral to call.”

“Because when they disrespect me, they’re disrespecting our government,” he said.

And Mr. Trump once again targeted officials in New York for scorn, appearing to suggest that New York hospitals are hoarding — or doing something else improper — with protective gear like their surgical masks. He said that he did not believe they really need the increases in protective equipment they claim are necessary to protect doctors and nurses treating coronavirus patients.

Mr. Trump said he was told that demand for masks at a New York hospital jumped from 10,000 to 20,000 per week before the virus arrived to nearly 300,000 a week now.

“Something’s going on. And you ought to look into it as reporters. Where are the masks going — are they going out the back door?” Mr. Trump said. “Somebody should probably look into that because I just don’t see from a practical standpoint how that’s possible to go from that to that, and we have that happening in numerous places.”

The president seemed to be suggesting that New York hospitals were lying about how many masks they needed. Mr. Trump said he was given the information about the increased demand for masks at the hospital from an executive of a company that makes them who was sitting in the audience.

In fact, hospitals throughout the country have said the surge in coronavirus patients requires that doctors and nurses change masks repeatedly throughout the day to protect themselves from getting infected. That has created a huge shortage of masks.

Mr. Trump again clashed with reporters, chiding Yamiche Alcindor, a PBS reporter, and later Jeremy Diamond, a CNN reporter, who made a point of giving his question to Ms. Alcindor, whom the president cut off earlier in the news conference. He instructed Ms. Alcindor to be nice and not “threatening,” while Mr. Diamond’s question prompted him to declare: “CNN is not trusted anymore. They are fake news.”

Before facing reporters, he attacked the “the Lamestream Media” on Twitter, even as he repeatedly trumpeted the high ratings for his coronavirus briefings, which have rivaled “Monday Night Football” and the season finale of “The Bachelor.”

Mr. Trump also denied on Sunday that he had threatened to quarantine New York, New Jersey and Connecticut on Saturday, despite suggesting 24 hours earlier that he was seriously considering doing just that.

“I didn’t do that at all. Read the statement. Read the statement. Read what I said,” Mr. Trump told a reporter. “I said we’re going to look into possibly quarantine. I didn’t say we’re going to quarantine. I looked at it as a possibility, because a lot of our professionals suggested quarantine. I said we’re going to look at it.”

The president’s musings about a ban on travel in and out of New York and the other states prompted hours of confusion and some fear as residents of the three states considered rushing to leave before the quarantine was put in place. On Saturday evening, Mr. Trump announced a travel advisory urging people against nonessential travel but stopping short of a quarantine.

Emily Cochrane contributed reporting from Washington, and Maggie Haberman from New York.