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Trump Names Mike Pence to Lead Coronavirus Response https://nyti.ms/391M7tj

The president’s budget request for the fiscal year that begins in October would slash the C.D.C.’s budget by almost 16 percent, and the Health and Human Services Department’s by almost 10 percent. Tens of millions of dollars would come from the department’s Office of Public Health Preparedness and Response and its Hospital Preparedness Program, which helps hospitals handle surges of patients during disease outbreaks." I'm sure it seemed like a great idea at the time."

TRUMP NAMES MIKE PENCE TO LEAD CORONAVIRUS RESPONSE

President Trump sought to reassure the country that his government was controlling the spread of the coronavirus after his administration weathered days of criticism.

By Michael D. Shear, Noah Weiland and Katie Roger's | Published Feb. 26, 2020 Updated 9:54 p.m. ET | New York Times | Posted February 26, 2020 |

WASHINGTON — President Trump named Vice President Mike Pence on Wednesday to coordinate the government’s response to the coronavirus, even as he repeatedly played down the danger to the United States of a widespread domestic outbreak.

Mr. Trump’s announcement, at a White House news conference, followed mounting bipartisan criticism that the administration’s response had been sluggish and came after two days of contradictory messages about the virus, which has infected more than 81,000 people globally, killing nearly 3,000.

“The risk to the American people remains very low,” said Mr. Trump, flanked by top health officials from several government agencies. “We have the greatest experts, really in the world, right here.”

The president said he would accept whatever amount of money congressional Democrats wanted to give for the virus response, adding, “We’re ready to adapt and we’re ready to do whatever we have to as the disease spreads, if it spreads.”

“We’ll spend whatever is appropriate,” he said.

Several top health care experts at the news conference echoed Mr. Trump’s optimism but also offered a more sober assessment of the future risks. Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention, warned Americans that there would be more infections.

“Our aggressive containment strategy here in the United States has been working and is responsible for the low levels of cases that we have so far. However, we do expect more cases,” she said as the president stood behind her. “The trajectory of what we’re looking at over the weeks and months ahead is very uncertain.”

About a half-hour later, Mr. Trump contradicted Ms. Schuchat’s assessment, telling reporters that “I don’t think it’s inevitable.” He left the door open to travel restrictions beyond China, to other hard-hit countries such as South Korea and Italy and said his early decision to stop flights from China had held the virus at bay.

But the C.D.C. confirmed minutes later that a new infection in California was contracted by a person who did not appear to have traveled to countries hard hit by the virus or been exposed to a known coronavirus patient. That raised the prospect that the virus was spreading through unknown means.

Health experts have questioned the C.D.C.’s decision to limit testing for the virus to people who have traveled in China or have come into contact with someone who has. Other countries are testing more broadly for the coronavirus among people from countries where outbreaks have been growing, including Italy, Iran and South Korea.

“We’re testing everybody that we need to test,” Mr. Trump insisted, “and we’re finding very little problem, very little problem.”

Earlier in the day, Mr. Trump had accused journalists of making the situation “look as bad as possible” even as government health experts warned that the coronavirus threat in the United States is only beginning. Without offering any details on transmission, Alex M. Azar II, the health and human services secretary, confirmed the new case on Wednesday afternoon, bringing to 60 the total number of infections that have been counted in the United States. Mr. Azar said that health officials were still figuring out how the new person became infected.

The politics of coronavirus shifted drastically on Tuesday when Dr. Nancy Messonnier, the director of the C.D.C.’s National Center for Immunization and Respiratory Diseases, told reporters that “it’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen.” She said that hospitals and schools should begin preparing for an outbreak, and that she had even spoken to her own family about “significant disruption of our lives.”

Mr. Trump sought on Wednesday to counter that message with a much less dire one, holding up a Johns Hopkins University study that he said showed the United States as the most prepared country in the world to confront a virus. He said he was “amazed” that tens of thousands of people died from the flu each year, contrasting that number with the several dozen currently infected with coronavirus.

“We’re very, very ready for this, for anything, whether it’s going to be a breakout of larger proportions or whether or not we’re, you know, we’re at that very low level,” Mr. Trump said.

The president, who is a well-known germophobe, urged Americans to be vigilant about covering their coughs and washing their hands, and he told the story of a man who recently came up to him and hugged him.

“I said are you well? He says no,” Mr. Trump said. “He said, ‘I have the worst fever, and the worst flu.’ He’s hugging and kissing me. I said, ‘Excuse me,’ I went and started washing my hands.”

Mr. Trump has been reluctant to give in to what he considers an “alarmist” view about the virus, an administration official said. The president has repeatedly said that, like the flu, the new coronavirus will dissipate with warmer, more humid weather even though officials have warned him that relatively little is known about the virus, and it may not behave as others do.

The possibility of the virus spreading in the United States comes as the administration grapples with budget cuts and personnel moves that critics say have weakened the system for dealing with such health crises. The White House in 2018 eliminated a dedicated position on the National Security Council to coordinate pandemic response, the same year that the Trump administration narrowed its epidemiological work to 10 countries from 49.

In November, a task force at the Center for Strategic and International Studies, which included five current and former Republican senators and House members, warned that “the United States remains woefully ill prepared to respond to global health security threats” and recommended the reinstatement of an N.S.C. coordinator and a recommitment of funding and attention to global health programs.

Instead, the president’s budget request this month for the fiscal year that begins in October would cut the C.D.C.’s budget by almost 16 percent, and the Health and Human Services Department’s by almost 10 percent. The proposal’s $3 billion in cuts to global health programs included a 53 percent cut to the World Health Organization and a 75 percent cut to the Pan American Health Organization.

And his naming of Mr. Pence as his point person immediately drew partisan fire even as he vowed to ensure that the “full resources of the American government” were deployed to protect Americans from the coronavirus.

The Democratic National Committee immediately pointed out that as governor of Indiana, Mr. Pence was blamed for aggravating a severe AIDS outbreak among intravenous drug users in a rural Indiana county when he opposed calls for a clean needle exchange program on the grounds it would encourage more drug use.

It has fallen to Mr. Azar to make the case that the government is up to the task of containing the virus as anxiety grew around the world about vulnerability to a still-mysterious affliction that does not respect international borders.

New cases popped up across Europe, dozens of infections in Iran raised fears of an unbridled spread through the Middle East, and the first confirmed case was reported in Latin America — a Brazilian man who had returned from Italy just as Brazil is in the midst of its Carnival celebrations.

For the first time, more new cases were reported outside China — where the outbreak began two months ago — than inside, according to figures from the World Health Organization.

The Chinese authorities cautioned that the falling infection rate might be only temporary, while South Korean officials scrambled to contain the largest outbreak of cases outside China — including an American soldier deployed in South Korea. Across the United States, universities began bringing students home from abroad and canceling overseas study programs.

Mr. Trump has privately expressed frustration to numerous officials about his administration’s efforts confront the virus, according to someone familiar with his comments.

[ VIDEO 01:12‘Someone Needs to Be in Charge’: Alex Azar Grilled in Coronavirus Hearing

The secretary of health and human services, Alex M. Azar II, testified to lawmakers about efforts to respond to the coronavirus outbreak.Feb. 26, 2020Image by T.J. Kirkpatrick for The New York Times]

As recently as last weekend, the president grew furious that he had been sidelined from a decision to return some Americans infected with the virus to the United States, and he made his anger to Mr. Azar known. Officials in the White House have since wrestled with how best to present Mr. Trump with information during a fast-moving situation, one aide said.

The White House’s muscular internal messaging efforts kicked in on Wednesday. Supporters were pelted with multiple emails assuring them that Mr. Trump was overseeing an “aggressive coronavirus response,” and that the “full weight of the U.S. government” was working to safeguard Americans from illness, according to one message.

Mr. Trump’s attempts to calm the American public have also occasionally been laced with a degree of alarm, with Mr. Trump telling reporters at a news conference in India on Tuesday that “there’s a very good chance you’re not going to die.”

Some of Mr. Trump’s political allies tried to question the motivation of some of his top health officials for warning the public about the spread of the virus.

Rush Limbaugh, the conservative talk radio host, on Wednesday argued without foundation that Dr. Messonnier was being purposely alarmist to undermine Mr. Trump because she is the sister of Rod Rosenstein, the former deputy attorney general who was a frequent target of Mr. Trump’s ire.

“In that town, I’m telling you, everything is incestuous,” Mr. Limbaugh said on his show. “Most of that town is establishment oriented or rooted, which means they despise Trump.”

Mr. Trump’s reassurances to the public appear at least in part aimed at calming global markets. On Tuesday, a day after its worst one-day slide in two years, the S&P 500 closed down 3 percent. The S&P 500 ended Wednesday down about 0.4 percent, bringing its losses for the week to close to more than 6 percent.

Moody’s Analytics predicted a 40 percent chance that the virus would grow into a global pandemic that would push the United States and the world into a recession. On Wednesday, Mr. Trump said he believed that “the stock market will recover. The economy is very strong.”

For a second day, Mr. Azar was on Capitol Hill Wednesday defending his work, telling lawmakers that he was overseeing “the smoothest interagency process I’ve experienced in my 20 years of dealing with public health emergencies.”

Mr. Azar said that the C.D.C. had already exhausted the $105 million rapid response fund that the federal government had been using in its initial response efforts. He has proposed shifting $136 million from other health programs to the coronavirus to replenish the government’s efforts.

A day earlier, he told a Senate panel that medical supplies were badly needed for the nation’s emergency stockpile, including 300 million masks for health care workers alone.

But on Wednesday, he faced bipartisan concern about the administration’s $2.5 billion request. Lawmakers from both parties have said the White House request is far short of what is needed and relies on the transfer of existing funds — including $535 million intended to counter the spread of the Ebola virus.

“These cuts are shameful,” Representative Anna G. Eshoo, Democrat of California, said Wednesday evening at a separate House hearing with Mr. Azar.

Senator Chuck Schumer of New York, the Democratic leader, proposed on Wednesday to increase the president’s emergency request drastically, to $8.5 billion in new funds, including$3 billion for a public health emergency fund, $1.5 billion for the C.D.C., $1 billion for vaccine development and $2 billion for reimbursing states and cities for efforts they have so far made to monitor and prepare for potential cases of the virus.

Mr. Trump said he would gladly accept the additional funds.

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Reporting was contributed by Emily Cochrane, Maggie Haberman, Jim Tankersley, Sheryl Gay Stolberg, Catie Edmondson, Eileen Sullivan and Carl Hulse.

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"The problem with the president speaking up now is that no matter what he says -- from expecting the worst pandemic the world has ever seen to the best administration response to what is really no health issue at all -- who is going to believe him? When Nancy Messonnier speaks, I will believe her. But Trump has proven that he never tells the truth. Why should he change now? Anything coming from Trump and his administration I will totally disregard as propaganda meant to salvage Trump's reelection campaign and the failing stock market. Nothing more. Nothing less." AVRDS, MONTANA

"Here's the actual Trump record on protecting its citizens and public health: In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure. In May 2018, Trump ordered the National Security Council’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40%, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced. Trump - and his GOP aiders and abetters - are singlehandledly responsible for 'small government' incompetence, negligence and abandonment of the American people. Americans will die because Donald Trump and the GOP hate the government." SOCRATES, VERONA NJ

"This is a potential event of a magnitude of impact we haven't seen since World War II. At this point, the bombers are headed toward Pearl Harbor, and it's unlikely our radar will find them before it's too late. We are sitting ducks and the current administration has already eliminated much of the infrastructure we need to address this. As a retired physician, I worry greatly about the coming impact on our health care system, the "soldiers" in this response. When health workers get sick, and they will because of the contagiousness no matter how well they try to protect themselves, then the system will be even more severely stressed. Patients with seemingly benign presentations will be infectious. Those who in "normal times" need advanced care in hospitals will be impacted. Supplies of protective gear are inadequate at this time. Every facet of life - work, school, public transit, food distribution, social events - may see profound impacts. And at the top of the heap, our president is the worst possible person to be in charge at this time. We need truth, transparency, and compassion from this man, and he is incapable of delivering those things. We need competent leadership (Jared can't be the czar of this too!) and a huge amount of resources - not borrowing from other important programs. We're in trouble." JOE, LAFAYETTE CA

"So how is Trump going to blame the media when the virus does get here? The progression of the disease is just beginning. It's early, very early. So far, it appears the virus can be carried and passed around for a week or two before any symptoms develop. That is a sure fire mechanism for widespread infection. In the US and other free societies, we don't lock people up just to prevent the spread of disease. We do quarantine people after they get sick, but by then the disease would have been passed on to others. With international travel commonplace, especially in the business world, there will be no way to stop the spread of the disease short of locking down borders. That would cripple the global economy. Won't happen. Besides, the virus is already widespread. The proverbial genie is already out of the bottle. Keep in mind that for most people, the symptoms are mild, like a cold. So now everyone who sniffles gets quarantined? That won't happen either. So far, the death rate is about 3% which is slightly greater than the death rate of the flu pandemic of 1918-19. The potential for deaths ranges in the many tens of millions. This is the real deal. This is not a time for political spin and disinformation from government officials, especially from the President of the United States."BRUCE, KANSAS CITY MO

"First and foremost, we need to have a reliable testing kit. The CDC tests are barely working. Not all states have the test kit. Therefore, a large reason we are not seeing the virus in the US is because we are NOT testing for it! The infection is most likely brewing at a low level in some cities already. Oh yea, we also need masks, ventilators, antibiotics (for superimposed bacterial infections), classes online, social distancing, and a different president." MIDWEST DOC, CLEVELAND

"Our lack of universal health care and social safety net can only exacerbate the spread and the damage the virus causes. When workers don't have paid sick leave, can't afford the loss of income, and fear the loss of their job, they will come to work when they're sick. When a sick person fears destitution from lack of health insurance, or from copays, deductibles, and/or surprise bills, they will avoid or delay medical care. When the emergency room is the only available access to health care, crowded waiting rooms will offer the virus an ideal place to propagate. When American health care corporations outsource manufacturing of pharmaceuticals and raw ingredients to China and rely on just-in-time supply chains, all in the name of maximizing short-term shareholder value, shortages of critical drugs and supplies will compromise treatment and result in needless deaths. When vaccines and antivirals are eventually developed, the manufacturers will gouge Americans with exorbitant unregulated prices. By limiting availability to the wealthy and those with the best insurance, an opportunity to curb the spread of infection will be sacrificed in the name of shareholder value. But maybe some good may ultimately come from this virus. By exposing the indefensible failures of a system focused on wealth care for Wall Street rather than health care for people, it may be what finally forces the US to join the rest of the civilized world and adopt universal health care." TED, CALIFORNIA

"“A great job?!” Most states don’t even have testing kits yet." SUMMER, SEATTLE WA

"@Joe As a retired Microbiologist (virology) I couldn't agree with you more. We have the people who are experts at CDC. and they need to be totally supported in every way. We have capacity in terms of providing the resources as well. What we need is is a big, broad-based, organized education program since we are seeing a lot of mis-information being spread already. Despite what Rush Limbaugh says it is more than the common cold. What Trump says is true, in that it eventually will die out, but that will be when the supply of potential victims disappears. That will be quite a while." GSS, AUGUSTA GA

"When I was a kid half the city of Chicago were quarantined in their homes----especially in the summer when polio raged, but also for an array of other diseases--it was one of the few weapons we had. Walking to school, every other house had a huge "quarantine" sign on it. At the time we had not been blessed by having a president who knows absolutely everything about everything. What we did have was a stable government and a well funded and managed system of public health. Public Health agencies now will march to the anti-science, anti public health tune being boomed by the GOP over the loudspeakers. Hup, two, three." MARY, ARIZONA

"As I prepare to cast my vote on Super Tuesday what is guiding my choice at this moment is which of the current democratic candidates would I most want in office during this type of potential global health crisis."

REDBED, NH

Again POTUS shows more concern on how a crisis affects him and not the country. Instead of being concerned that there are people infected in this country and containing the virus for the sake of the American people, his concern is to whether it will hurt his chances at re-election. Attacking the media again to shift the blame to them instead of on his decision to cut funding to another Dept. that would have been our first line of defense. I think Nancy Pelosi stated correctly, "I don't think the President knows what he is talking about, again!" RUSSELL SMITH, FLORIDA

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C.D.C. CONFIRMS FIRST POSSIBLE COMMUNITY TRANSMISSION OF CORONAVIRUS IN U.S..... A case in California may be the first infection without a known link to travel abroad.

By Roni Caryn Rabin | Published Feb. 26, 2020 Updated 9:03 p.m. ET | New York Times | Posted February 26, 2020

A person in California who was not exposed to anyone known to be infected with the coronavirus, and had not traveled to countries in which the virus is circulating, has tested positive for the infection.

It may be the first case of community spread in the United States, the Centers for Disease Control and Prevention said on Wednesday.

“At this point, the patient’s exposure is unknown,” the C.D.C. statement said. “The case was detected through the U.S. public health system and picked up by astute clinicians.”

The case was announced shortly after President Trump concluded a news briefing in which he said that aggressive public health containment measures and travel entry restrictions had successfully limited the spread of coronavirus in the United States.

It brings the number of cases in the country to 60, including the 45 cases among Americans who were repatriated from Wuhan, China — the epicenter of the outbreak — and the Diamond Princess cruise ship, which was overwhelmed by the virus after it docked in Japan.

Until now, public health officials have been able to trace all of the infections in the country to a recent trip abroad or a known patient, and to identify the sources of exposure.

Though C.D.C. officials said it was possible the patient was exposed to a returning traveler who was infected, the new case appears to be one of community spread — one in which the source of infection is unknown.

“The thing that would immediately make all of us uneasy is if this person has no direct contact with someone who comes from an affected country,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.

“That would suggest there are other undetected cases out there, and we have already started some low-grade transmission.”

Public health officials said the infected individual was a resident of Solano County, Calif., and was receiving medical care in Sacramento County, but they have not disclosed any other information to protect the patient’s privacy.

Doctors in the patient’s community may want to expand testing for the coronavirus among their patients in order to identify other infected individuals there, Dr. Schaffner said.

“Physicians are going to want to start testing everybody with a fever and a cough,” he said. “They’re going to want to do that and the patients are going to want to do that.”

Right now, however, testing capacity is limited in the United States.

The C.D.C. developed a diagnostic test and distributed testing kits to local health departments around the country.

But the kits were flawed, and the agency must manufacture new ones. Although a dozen states are capable of testing for coronavirus infection, confirmatory tests must still be done by the C.D.C., a process that can take days.

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TRUMP HAS A PROBLEM AS THE CORONAVIRUS THREATENS THE U.S.: HIS CREDIBILITY Even his allies worry that Mr. Trump has undermined his ability to appear presidential in a moment of national emergency,

By Annie Karni, Michael Crowley and Maggie Haberman | Published Feb. 26, 2020 Updated 10:10 p.m. ET | New York Times | Posted Feb 26, 2020 |

WASHINGTON — When Hurricane Dorian crashed into the Atlantic Coast in September, President Trump assumed a take-charge role in response. But he undermined his own effectiveness after it became apparent that before displaying a map in front of the television cameras in the Oval Office, he had altered it with a Sharpie pen to match his inaccurate forecast of where the storm was headed.

For years, experts have warned that Mr. Trump has been squandering the credibility he could need in a moment of national emergency, like a terrorist attack or a public health crisis.

Now, as the coronavirus races across the globe and has begun to threaten the United States, Mr. Trump could face a moment of reckoning. Maintaining a calm and orderly response during an epidemic, in which countless lives could be at stake, requires that the president be a reliable public messenger.

“I think the president has a unique opportunity to dispel fears and calm the situation — if people believe he is telling the truth,” said Kathleen Sebelius, who served as secretary of health and human services in the Obama administration. “And I think that’s really where a great disconnect occurs.”

On Wednesday evening, Mr. Trump delivered an almost casual account of the administration’s response to the coronavirus, leaving it to the experts appearing with him to relay the real information and assure a jittery public. Still, he kept trying to suggest the risk was low.

“We will see what happens,” the president said as he addressed the nation. “But we are very, very ready for this, for anything.”

Mr. Trump said that Johns Hopkins University rated the United States “No. 1 for being prepared,” holding up a chart printed on an 8 ½ by 11 sheet of paper.

“This will end,” he said, comparing the coronavirus to the everyday flu. “We really have done a very good job.”

During a crisis, presidents are looked to for direct and honest assessments of threats and for reassurance to the public about their impact.

During the swine flu outbreak of 1976, President Gerald R. Ford announced at a news conference that the government planned to vaccinate “every man, woman and child in the United States.” Mr. Ford himself was photographed receiving the vaccine in the White House as part of a public awareness campaign.

Responding to the Ebola outbreak in West Africa in 2014, President Barack Obama visited the Centers for Disease Control and Prevention in Atlanta to announce that the administration would send as many as 3,000 people to the region.

Mr. Trump, in contrast, contradicted his own health experts in a news conference Wednesday evening, insisting that the spread of the virus was not inevitable, and excoriating two of his favorite foils, Speaker Nancy Pelosi and Senator Chuck Schumer, the minority leader, for “trying to create a panic.”

For three and a half years, Mr. Trump has repeatedly proved an unreliable narrator on a range of subjects.

At times, he has exaggerated threats, like talking up the caravans of migrants he claimed were storming the southern border before the 2018 midterm elections. Other times, he has minimized potentially serious dangers that could be politically damaging, like the renewed nuclear threat posed by North Korea after the failure of his talks with its leader, Kim Jong-un, and now, the global spread of the coronavirus, which he has persistently tried to play down.

In his response to the coronavirus, Mr. Trump has made inaccurate or questionable claims, twice misstating the number of Americans infected with the virus and insisting that it “miraculously goes away” when warmer spring weather arrives — a prediction that health experts have said is premature.

He based that prediction on a comment made at one of his briefings, when an expert noted that temperatures can affect the spread of viruses. Mr. Trump has used that data point as evidence in saying in public and in private to guests at his Mar-a-Lago resort in Palm Beach, Fla., that the global outbreak will be behind him by April.

The president, as he often does, has also focused on coverage of his response, complaining that he is being treated unfairly and blaming the news media. “If the virus disappeared tomorrow, they would say we did a really poor, and even incompetent, job,” he tweeted on Tuesday. “Not fair, but it is what it is. So far, by the way, we have not had one death. Let’s keep it that way!”

Before he took office, Mr. Trump was an outspoken critic of the Obama administration’s handling of the Ebola outbreak, arguing that infected people should not be allowed back into the United States.

Current Trump allies said the fact that the president chose to address the growing public health crisis quickly after returning from a trip to India showed how seriously he was taking the outbreak.

But privately, they say he has been reluctant to give in to what he has called an “alarmist” view of the virus’s potential to cause damage as he warily watches the effect of the outbreak on the stock market. He has been rattled by the Wall Street reaction to the spread of the virus in places like Italy, lashing out at the news media in tweets and accusing journalists of intentionally trying to harm the stock market.

And polls show that Mr. Trump’s credibility with much of the United States is low after an impeachment inquiry in which a majority of voters said they did not believe that he was telling the truth about his actions involving Ukraine.

Federal health officials had been bracing for the arrival of the virus in the country with minimal intervention by the White House.

As Ebola presented both a health and political threat to his administration in 2014, Mr. Obama carefully hewed to proven science, which he repeatedly invoked in his carefully calibrated public messages.

“We have to be guided by the science. We have to remember the basic facts,” he said in an October 2014 radio message.

Mr. Trump, in contrast, has not been focused on scientific detail. The secretary of health and human services, Alex M. Azar II, has told officials they should give the notoriously impatient president simple, paint-by-numbers briefings on coronavirus.

But a larger fear among experts in the field has been that he would contradict scientific experts. “That’s where Trump is most pernicious, potentially,” said Ron Klain, who served as Mr. Obama’s “Ebola czar,” and now is an adviser to the presidential campaign of former Vice President Joseph R. Biden Jr. “When he contradicts those experts, when he suggests they have biases, or when he intimidates them not to be straight, that’s when the risk really grows.”

As Mr. Trump faces this emergency, his history of issuing false claims could make it harder to sell the public on any plans to address coronavirus.

“When you’re trying to build trust in the government’s response, people have to have trust,” said Leslie Dach, a senior counselor at health and human services during the Ebola outbreak.

“Making false promises and them turning out not to be true undermines people’s confidence,” Mr. Dach said. He pointed to Mr. Trump’s claim this month about the virus that, “We did shut it down, yes.”

As recently as this week, the president appeared to simply want to put the coronavirus response in his rearview mirror. “I think that’s a problem that’s going to go away,” he said in remarks on Tuesday to a group of business leaders in New Delhi.

On Wednesday, before Mr. Trump’s news conference, his allies on television and radio appeared to be speaking to the proverbial “audience of one” as they sought to give their unsolicited advice to the president.

Jason Miller, a top adviser to Mr. Trump’s 2016 campaign who hosts a podcast that is currently focused on the coronavirus, tweeted that the president had to “make clear full Administration working around the clock on this, and explain in everyday, layman’s terms what we need to both do and avoid to remain safe.”

On Fox News, daytime hosts noted the news conference presented an “opportunity for him to act presidential.”

Mr. Trump, however, chose to conduct the news conference his own way.

“It is what it is,” he said of the potential for a virus with a higher fatality than the flu to spread through communities. “We’ve got the greatest people in the world.”

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Noah Weiland contributed reporting from Washington, and Donald G. McNeil Jr. from New York.

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WHAT WOULD A CORONAVIRUS OUTBREAK IN THE U.S. MEAN FOR SCHOOLS? Districts have infectious disease protocols. But few have detailed plans to teach online if schools were closed for long periods.

By Dana Goldstein and Julie Bosman | Published Feb. 27, 2020, 5:00 a.m. ET| New York Times | Posted Feb 27, 2020 |

Schools in the United States prepare for all manner of disasters and threats, whether hurricanes, mass shooters, tornadoes, influenza or head lice.

But this week, a stark new order came from the Centers for Disease Control and Prevention: Get ready for the coronavirus.

Around the nation, school officials and parents were flummoxed by the sudden warning that if a coronavirus epidemic hit the United States, school buildings could be shut down for long periods of time, leaving children sequestered at home and schools scrambling to provide remote instruction.

In warning that the coronavirus will almost certainly spread in the United States, Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said she had contacted her own local school superintendent this week and asked if the district was prepared. She advised parents to do the same. And she suggested that a temporary system of “internet-based teleschooling” could replace traditional schools.

It was not clear how such a system would work.

The obstacles to teaching remotely were evident: American children have uneven access to home computers and broadband internet. Schools have limited expertise in providing instruction online on a large scale. And parents would be forced to juggle their own work responsibilities with what could amount to “a vast unplanned experiment in mass home-schooling,” said Kevin Carey, vice president for education policy at New America, a think tank.

Across the country, as federal authorities announced that 60 people in the United States had been infected with the virus, mainly from travel abroad, families were grappling with the new alarm raised over the virus and how a possible outbreak could play out in their own communities.

In Denver, Meg Conley’s 11-year-old daughter, Margaret, interrupted breakfast on Wednesday morning with a worried question. She told her mother that her elementary school classmates were gripped by fears about the coronavirus, and she asked when it was coming and how many people it would kill.

“I had no idea,” Ms. Conley, 35, a freelance writer, said of the children’s anxieties. “Apparently it’s all the kids are talking about on the playground.”

Schools are hastily making their own plans, or updating those drafted during previous scares over viruses like H1N1 and Ebola. The Washington State health department held a webinar for about 250 school superintendents on Tuesday to discuss coronavirus preparations, including plans to close schools and allow students to continue to do schoolwork at home.

Dennis Kosuth, a nurse for Chicago Public Schools, said his district’s ability to handle an outbreak could be compromised by circumstances like families who could not afford child care costs to keep sick children at home. Nursing shortages are a concern, too, he said. Mr. Kosuth said he was responsible for nursing care at four schools.

Some Chicago schools also lack rooms dedicated to health needs, Mr. Kosuth said. In one school where many students and staff members became ill with an ordinary infection last semester, “Patient Zero was sitting in the main office coughing and sneezing all over the place” as the sick child waited to be picked up, he said.

On a more positive note, Mr. Kosuth said that evidence from China suggested that children were more resilient to the coronavirus than adults were.

In Miami-Dade County, Fla., Alberto M. Carvalho, superintendent of one of the nation’s largest school districts, said his system’s preparation for hurricanes put it at an advantage in preparing for the coronavirus. The district has provided laptops, tablets and smartphones for some students to take home, as well as internet connectivity for some low-income students. Teachers would be asked to assign work remotely and could even teach some high school courses live online.

“I was a bit surprised that it took this long to offer national guidance specifically to school districts,” Mr. Carvalho said of the C.D.C. statement this week.

Many districts have already sent home letters about the coronavirus, asking parents to keep sick children away from school and to remember basic prevention measures such as hand washing, cough covering and vaccination against the flu. They have highlighted C.D.C. advice issued early this month, calling for all travelers returning from China to “self-quarantine” for 14 days.

School officials have often tried to ratchet down panic among parents, reminding families that face masks are not broadly recommended and that the overall risk of infection is low.

But few districts have publicly addressed what would happen to classes in the case of widespread infection and school closings like those that have taken place in China, Italy and Bahrain.

The vast majority of districts have access to broadband internet, but they do not necessarily have expertise in how to effectively organize and teach classes online when schools are shuttered. Further complicating matters, not all families have home computers and high-speed internet. While 90 percent of households with children under 18 had broadband access in 2016, according to federal data, gaps remained along the lines of income, race and education level.

Less affluent families were more likely to depend on smartphones but to lack computers or tablets, which are often needed to fully participate in online learning.

While school districts may not be ready for widespread remote learning, many of the larger districts have had plans for the possibility of pandemics for years, according to Chris Dorn, a school safety consultant with the nonprofit Safe Havens International.

Districts without such plans will need to work with local health agencies to come up with protocols, he said. Among the questions to tackle: Should students at risk for coronavirus who show symptoms at school be transported immediately to hospitals or should they be kept on school grounds until a parent or caretaker can pick them up?

In the San José Unified School District in California, Melinda Landau, who manages school nursing, said the district’s response to flu season would also help in the case of a coronavirus outbreak.

It has ordered additional thermometers and hand-washing lesson kits, which allow nurses to sprinkle powder that glows when exposed to ultraviolet light, demonstrating how thoroughly students have washed their hands and how important simple personal-hygiene measures can be.

The district also asks parents who call their children in sick to describe symptoms. Schools with clusters of sick students are cleaned more deeply with disinfecting products.

There have been no confirmed cases of the coronavirus in the district, Ms. Landau said. Two students returned from trips to China in late January. Their parents voluntarily kept them home from school for a time to monitor their health.

Going forward, the district is waiting to see how the coronavirus progresses, Ms. Landau said.

She added, “We don’t quite know where to move yet.”

Closing schools may not be the best option, especially since children appear to be at lower risk of infection, said Amy Acton, the director of Ohio’s health department. Beyond contingency plans for closing, she said, schools need to consider lining up substitute teachers and planning for absences of other staff members, like cafeteria workers. And Dr. Acton said schools can also play another, more traditional, role: science and health education.

“Schools can be telling families what they can be doing to stay healthy, and we can teach about viruses, and what is a zoonotic disease? Why is it important to get a flu vaccine?” Dr. Acton said. “This is a teachable moment.”

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Jack Healy, Amy Harmon and Sarah Mervosh contributed reporting.

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WELCOME TO THE AGE OF PANDEMICS

We need to stop what drives mass epidemics rather than just respond to individual diseases.

By Peter Daszak, Mr. Daszak is a disease ecologist. | Published Feb. 27, 2020, 5:01 a.m. ET | New York Times | Posted February 27, 2020 |

In early 2018, during a meeting at the World Health Organization in Geneva, a group of experts I belong to (the R&D Blueprint) coined the term “Disease X”: We were referring to the next pandemic, which would be caused by an unknown, novel pathogen that hadn’t yet entered the human population. As the world stands today on the edge of the pandemic precipice, it’s worth taking a moment to consider whether Covid-19 is the disease our group was warning about.

Disease X, we said back then, would likely result from a virus originating in animals and would emerge somewhere on the planet where economic development drives people and wildlife together. Disease X would probably be confused with other diseases early in the outbreak and would spread quickly and silently; exploiting networks of human travel and trade, it would reach multiple countries and thwart containment. Disease X would have a mortality rate higher than a seasonal flu but would spread as easily as the flu. It would shake financial markets even before it achieved pandemic status.

IN A NUTSHELL, COVID-19 IS

DISEASE X.

Even as there are signs that the epidemic’s spread might be slowing in China, multiple communities and countries have now reported sustained transmission in their midst. The number of confirmed cases has exploded in South Korea in recent days. In Italy, villages and towns are on lockdown, Fashion Week in Milan has been disrupted and festivals are being canceled while public health authorities search for patient zero to identify who else is likely infected and may spread the disease in Europe. Iran appears to have become a new hub of transmission. The looming pandemic will challenge us in new ways, as people try to evade quarantines, and misinformation campaigns and conspiracy theorists ply their trade in open democracies.

But as the world struggles to respond to Covid-19, we risk missing the really big picture: Pandemics are on the rise, and we need to contain the process that drives them, not just the individual diseases.

Plagues are not only part of our culture; they are caused by it. The Black Death spread into Europe in the mid-14th century with the growth of trade along the Silk Road. New strains of influenza have emerged from livestock farming. Ebola, SARS, MERS and now Covid-19 have been linked to wildlife. Pandemics usually begin as viruses in animals that jump to people when we make contact with them.

These spillovers are increasing exponentially as our ecological footprint brings us closer to wildlife in remote areas and the wildlife trade brings these animals into urban centers. Unprecedented road-building, deforestation, land clearing and agricultural development, as well as globalized travel and trade, make us supremely susceptible to pathogens like coronaviruses.

Yet the world’s strategy for dealing with pandemics is woefully inadequate. Across the board, from politicians to the public, we treat pandemics as a disaster-response issue: We wait for them to happen and hope a vaccine or drug can be developed quickly in their aftermath. But even as Covid-19 rages, there still is no vaccine available for the SARS virus of 2002-3, nor for HIV/AIDS or Zika or a host of emerging pathogens. The problem is that between outbreaks, the will to spend money on prevention wanes, and the market for vaccines and drugs against sporadic viral diseases isn’t enough to drive research and development.

During its World Health Assembly in 2016, the W.H.O. set up the R&D Blueprint to bridge this gap and announced a priority list of pathogens that most threaten global health and for which no vaccines or drugs were in the pipeline. SARS made the list, as did MERS, Nipah, Ebola and other rare but serious diseases caused by epidemic viruses. The Coalition for Epidemic Preparedness Innovations — a global partnership between public, private, philanthropic and civil society organizations launched at Davos in 2017 — stepped up to the plate and sourced funding to develop vaccines and therapeutics against some of these.

To escape from the Age of Pandemics, we’ll need to treat them as a public health issue and start working on prevention in addition to responses. Our first goal should be to broaden our armory against potential mass epidemics. When some of us added “Disease X” to the W.H.O.’s priority list two years ago, we wanted to make the point that it’s not sufficient to develop vaccines and drugs for known agents when the next big one is likely to be a different pathogen — a virus close to SARS, say, but not close enough that the same vaccine can work against both.

As Covid-19 strikes today and a spate of other pathogens are ready to emerge in the future, we continue to butt up against nature. Scientists estimate that there are 1.67 million unknown viruses of the type that have previously emerged in people. Discovering and sequencing them should be a priority — a simple case of “know your enemy.” In the aftermath of SARS, research on coronaviruses originating in bats has discovered more than 50 related viruses, some of which have the potential to infect people; this information can now be used to test for broad-action vaccines and drugs. Scaling up this effort to cover all viral families, as the Global Virome Project proposes to do, is a logical first step toward prevention.

A radical shift is also needed in the way that tests, vaccines and drugs are designed so that entire groups of pathogens are targeted instead of individual pathogens that are already known. The National Institute of Allergy and Infectious Diseases in the United States is working on a universal flu vaccine that would cover all known strains of influenza; a universal coronavirus vaccine, an Ebola-virus vaccine and others will also be needed.

With a smaller investment, we can also try to get ahead of pandemics by working with communities in hot spots of emerging diseases. Disease surveillance should be focused on farmers, rural communities and anyone who has extensive contact with wildlife, to look for unusual illnesses, test for novel pathogens and work with people to develop alternatives to high-risk activities such as the wildlife trade.

Pandemics are like terrorist attacks: We know roughly where they originate and what’s responsible for them, but we don’t know exactly when the next one will happen. They need to be handled the same way — by identifying all possible sources and dismantling those before the next pandemic strikes.

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Peter Daszak is a disease ecologist and the president of EcoHealth Alliance, in New York.

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