Coronavirus US live: US now has more cases than any other country – as it happened

Live reporting on the coronavirus in the US continues on Friday’s blog:

• The US has surpassed China and Italy, with more than 82,000 cases per Johns Hopkins’ tally. A lack of early action and setbacks in testing could be to blame. During a Coronavirus Task Force briefing, Donald Trump expressed skepticism at the news that the US was worst hit by the pandemic, accusing China of sharing false data.
• Trump continued to push the idea that the US could revise physical distancing guidelines within two weeks, despite warnings from public health experts that doing so would have disastrous consequences. He said more guidance would come next week, but for now, he told Americans to “stay home, just relax, stay home.”
• During the briefing, Dr. Deborah Birx — who is leading the US response to the coronavirus pandemic. — said reports that hospitals were running out of beds and ventilators, and considering “do not resuscitate” protocols were irresponsible. She provided an optimistic assessment of the crisis and indicated that predictions that 20 to 60 or 70% of Americans would contract the virus did not match. conditions “on the ground”. But her rosy outlook was somewhat at odds with what public health experts and hospitals have been reporting so far.
• The US labor department announced that a record 3.3 million people filed claims for unemployment. The Fed Chair, Jerome Powell, said the US may very well be headed into a recession. Lawmakers said the emergency economic relief package that passed the Senate last night will help.
• Nancy Pelosi is “certain” that the House will pass the $2tn stimulus package that was approved by the Senate last night. With 435 members, there are some logistical challenges to ensuring the vote is carried out in adherence to social distancing guidelines.
  

The Guardian’s Vivian Ho reports:

California’s homeless census was already troubled. Covid-19 is making it impossible.

For the past year and a half, local county census committees and homeless service providers throughout California have been conducting their own outreach for the 2020 census, knowing that only an accurate count of the state’s growing homeless population will guarantee the federal funding needed to get people off the streets and into stability.

Because even before the US coronavirus crisis prompted shelter-in-place orders and the suspension of 2020 census field operations nationwide, casting doubt on the operations for the once-in-a-decade count, they were preparing for the federal Census Bureau to significantly undercount the homeless population.

While homelessness has soared, particularly in California, census staffers said plans in place to count the population were insufficient and disorganized. The federal bureau had limited the hours of targeted counting to between midnight and 7am. There was little or varied communication around cultural facilitation led by service providers or homeless representatives who act as a guide for enumerators, to smooth the process. Two weeks from 1 April, census day, when thousands of enumerators were set to flood the streets to conduct the count, some field offices were still not fully staffed.

26 Mar 202019.42 EDT

Experts say economic relief package is a start - but not enough

Lois Beckett

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Advocates for American workers praised a “historic” increase in unemployment benefits included in an emergency $2tn relief package approved by the US Senate, which will offer special “pandemic unemployment” to gig workers, self-employed workers, and some people forced to leave their jobs because of the coronavirus crisis.

But although the unemployment payments will offer months of support to many vulnerable Americans, advocates said that the bill threatens to leave too many people out. Even $2tn in emergency aid, experts said, is probably too little for the size of the crisis.

As part of the unprecedented relief package approved by the Senate on Wednesday night, millions of Americans would get an individual, $1,200 check to help them weather the economic crisis caused by the pandemic. The bill would also create a $500bn lending program for businesses, cities and states and a $367bn fund for small businesses, which would focus on helping small businesses to pay their employees’ salaries through the next weeks of pandemic-related shutdowns, rather than laying them off.

The bill’s major benefit to American workers is not that single cash payment, but the sweeping expansion of unemployment benefits, labor experts said. The bill offers laid-off workers an additional $600 a week for four months and extends unemployment benefits to gig workers, independent contractors, and others who have not previously been eligible for unemployment, including people forced to leave their jobs to care for family members with coronavirus, or to care for children whose schools have closed.

The Guardian’s Sam Levine reports:

Two Florida poll workers tested positive for coronavirus after the state’s March 17 primary, the Broward County supervisor of elections announced Thursday.

The announcement came after Florida faced criticism for moving ahead in-person voting despite concerns over coronavirus. Around 20% of the state is age 65 or older, a demographic extremely vulnerable to the virus.

The two poll workers worked at separate locations in Hollywood, Florida. One was at the Martin Luther King Community Center and the other at the David Park Community Center. One of the poll workers also worked at a location in Weston during early voting.”

County staff as well as other poll workers at those locations have been notified of the situation and have been advised to take appropriate steps,” the Broward County supervisor of elections said in a statement. “Voters who voted in person on March 17th at either of those locations or who voted early at the Weston early voting location may wish to take appropriate steps and seek medical advice.”

Fact check:

Dr. Birx also commented that because 19 out of 50 states had had fewer than 200 cases, “that’s almost 40% of the country with extraordinarily low numbers”, she said. Of course, 19 states with low population density don’t account for 40% of the US population.

About 103,200 tests have been conducted in the US, according to the Centers for Disease Control and Prevention. But tests are normally administered to people who are already showing symptoms or are at high risk of complications from the disease.

Fact check:

Dr. Birx also said that with some “creative” thinking, hospitals could find beds for coronavirus patients.

But communities across the country have expressed that they do not have the capacity to treat a surge of coronavirus patients. California officials have said the state may need up to 50,000 more beds, and New York hospitals have been transferring patients without coronavirus to other hospitals and medical facilities, as their resources are stretched.

Projections from Harvard found that even if 50% of all currently occupied hospital beds were emptied, the country would need at least three times more beds to care for everyone.

Of course, as we discussed earlier, projections are tough to make, since we don’t know how many Americans have already been infected.

Fact check:

The Guardian’s Nina Lakhani reports.

Dr. Birx also implied that contrary to reports, there are enough ventilators to go around. “We don’t have evidence” that Americans who need a hospital bed or ventilator won’t have access to one, Birx said.

However, an article in the New England Journal of Medicine published on Wednesday 25 March categorically concluded that the US does not have enough ventilators to treat patients with Covid-19 in the coming months.

The authors, American public health experts, wrote: ‘There is a broad range of estimates of the number of ventilators we will need to care for U.S. patients with Covid-19, from several hundred thousand to as many as a million. The estimates vary depending on the number, speed, and severity of infections, of course, but even the availability of testing affects the number of ventilators needed.... current estimates of the number of ventilators in the United States range from 60,000 to 160,000, depending on whether those that have only partial functionality are included. The national strategic reserve of ventilators is small and far from sufficient for the projected gap. No matter which estimate we use, there are not enough ventilators for patients with Covid-19 in the upcoming months.”

Fact check:

Dr. Birx said that predictions that huge swaths of the population will inevitably contract Covid-19 are misleading.

Marc Lipsitch, the head of the Harvard TH Chan School of Public Health’s Center for Communicable Disease Dynamics, predicted that between 20% and 60% of adults worldwide will ultimately get infected before a vaccine becomes widely available.

But it’s difficult to predict how many people will get the infection, because it’s nearly impossible to ascertain the actual number of cases. Many Americans with mild or no symptoms have not been tested for the coronavirus. A shortage of tests and the logistical difficulty of testing millions of people make that sort of widespread testing right now untenable.

Amping up testing even more will be key to not only understanding the conditions “on the ground” as Birx said but also to developing more accurate predictions.

As World Health Organization director-general Tedros Adhanom Ghebreyesus said this week, “You cannot fight a fire blindfolded, and we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: Test, test, test.”

Now that Donald Trump has exited the briefing room, health officials Anthony Fauci and Deborah Birx, along with vice-president Mike Pence, are addressing reporters.

Dr. Birx said that the current predictions of the models do not match the conditions on the ground. Predictions that 60% or 70% will get infected in the next 8-12 weeks, or even that 20% of a population will get infected, are “very scary”, she said. “But we don’t have data to match that.” The only countries with especially high rates of infection are very small, she said.

Reports today that hospitals were considering issuing “do not resuscitate” orders for Covid-19 patients were irresponsible, Birx said.

“There is no situation in the US right now that warrants that kind of discussion,” she said “To say that to the American people - to make the implication that when they need a hospital bed, it may not be there, when they need a ventilator, it may not be there.”

Birx said that she believes there are enough ventilators — though they not be at the hospitals that need them most. “We can get creative,” she said, to ensure all hospitals have access.

Fact check:

The Guardian’s Nina Lakhani reports.

Trump said that “the mortality rate, in my opinion, is way down”.

But globally, there are 521,086 confirmed cases worldwide, with 23,567 deaths, which is a mortality rate of 4.5% And while currently in the US, the mortality rate currently stands at 1.4% (79,708 confirmed cases and 1123 deaths) but, the country is several weeks behind Asia and Europe regarding infection rates, and there is widespread agreement among medical and public health experts that things (cases and deaths) are going to get much much worse in coming weeks.

Donald Trump said that the things there are likely hundreds of thousands of more cases, because many people have few or minor symptoms, even as he fixated on the idea of having Americans get back to work as soon as possible.

“Many people have it. I just spoke to two people that had it,” he said. “They never went to a doctor, they didn’t report it,” he added, but likely were infected. He used the idea that many cases are mild, and therefore undetected, to justify his wish to scale back distancing measures and reopen closed businesses.

“The people that actually die, that percentage is much lower than I actually thought,” he said.

So far, more than 1,000 Americans have died from Covid-19.

Fact check:

The Guardian’s Nina Lakhani reports

“Nobody would have ever thought a thing like this could have happened,” Trump said.

In fact, the US intelligence community, public health experts and officials in Trump’s own administration had warned for years that the country was at risk from a pandemic, including specific warnings about a coronavirus outbreak.

When this strain of coronavirus, SARS-CoV-2, was identified in Wuhan, China in early January, health experts immediately cautioned that it could turn into a global health crisis.

“This was foreseeable and foreseen, weeks and months ago, and only now is the White House coming out of denial and heading straight into saying it could not have been foreseen,” Marc Lipsitch, director of Harvard’s Center for Communicable Disease Dynamics, told CNN on Sunday.

Asked about the number of shuttered restaurants, the president responded: “It may not be the same restaurant. It may not be the same ownership. But they’ll all be back.”

He also addressed why he’s backed off using the term “Chinese virus” to refer to the coronavirus.

“I think it was time,” he said. He said that the president of China didn’t ask him to stop, but said that Chinese official may have reached out to American officials. “I don’t have to say it if they feel so strongly about it,” Trump said, even as he doubled down on his right to use the term.