By The Washington Post · Shane Harris, Felicia Sonmez, Mike DeBonis · NATIONAL, WORLD, HEALTH
Public health experts say testing on a larger scale is a crucial step before resuming normal social and economic activity in the country. But Trump defended the administration's approach of leaving testing largely to states.
"Testing is a local thing," Trump said at a White House briefing. He said too many governors were relying on state government labs and should turn to commercial labs to help them process more tests. He didn't name any particular states or officials.
But earlier Sunday, Republican and Democratic governors were unanimous in putting the onus on the federal government to help secure vital testing components, including swabs and reagents, the chemical solutions required to run the tests, which the governors said have been in short supply.
"To try to push this off to say that the governors have plenty of testing, and they should just get to work on testing, somehow we aren't doing our job, is just absolutely false," Republican Gov. Larry Hogan of Maryland told CNN's "State of the Union." "Every governor in America has been pushing and fighting and clawing to get more tests, not only from the federal government, but from every private lab in America and from all across the world."
Democratic Gov. Ralph Northam of Virginia, which is working closely with officials in neighboring Maryland and the District of Columbia, called Trump administration claims of sufficient testing "delusional."
"We've been fighting for testing," Northam, a physician, told CNN. "It's not a straightforward test. We don't even have enough swabs, believe it or not. And we're ramping that up."
Trump, displaying a nasal swab to reporters, said the federal government was procuring millions more swabs, and then claimed some states had lost the ones they were already sent.
"We also are going to be using, and we're preparing to use the Defense Production Act to increase swab production in one U.S. facility by over 20 million additional swabs per month," Trump said. "We've had a little difficulty with one. So we're going to call in - as we have in the past, as you know, we're calling in the Defense Production Act, and we'll be getting swabs very easily. Swabs are easy."
The pushback from governors came on a day that the total number of confirmed deaths from covid-19, the disease caused by the new coronavirus, passed 35,000. Although some states have reported a leveling off in the number of deaths and new infections, nationally those figures are still rising. More than 749,000 confirmed infections have been reported as of Sunday night.
Experts say the number of tests has not kept pace with the severity of the infection. Nationally, the number of tests has plateaued to an average of about 146,000 per day. But some state officials, business leaders and public health experts say that is woefully short of the several hundred thousands or perhaps even millions of daily tests it might take to safely restart the economy.
Some governors said only the federal government had the authority to make decisions that could speed up the deployment of testing kits.
Ohio's Republican governor, Mike DeWine, said his state's "big problem" is that the federal Food and Drug Administration has not prioritized companies that are "putting a slightly different formula together" for their testing kits. "I could probably double, maybe even triple testing in Ohio virtually overnight" if the FDA would do that, DeWine told NBC News' "Meet the Press."
Michigan Gov. Gretchen Whitmer, a Democrat, said on NBC that her state has "the capacity to double or triple the number of tests that we are doing, but we need some of these supplies."
"The reagents and the swabs are absolutely essential," she said. "You can't process all these tests if you can't take the sample and protect it and move forward through testing. And so while our capabilities are there, these important supplies are not."
In Massachusetts, which is now seeing a surge in infections of covid-19, Republican Gov. Charlie Baker emphasized that states need "guidance" from federal agencies, including the FDA and Centers for Disease Control and Prevention, "especially the ability to put the foot on the accelerator with respect to advancements in testing."
"Everything associated with testing ultimately has to be approved by the CDC and the FDA," he said on CBS News' "Face the Nation."
Trump defended his administration's performance, tweeting on Sunday afternoon: "Just like I was right on Ventilators (our Country is now the 'King of Ventilators', other countries are calling asking for help-we will!), I am right on testing. Governors must be able to step up and get the job done. We will be with you ALL THE WAY!"
For all the bipartisan agreement that testing must increase, there were signs that the public's patience was fraying with restrictive orders to remain at home and stop working.
In Washington state, more than 2,000 protesters showed up at the Capitol in Olympia calling on Gov. Jay Inslee, a Democrat, to lift a stay-home order meant to slow the spread of the virus, according to the Washington State Patrol.
Smaller protests have erupted across the country in response to state stay-home orders. Trump has signaled his support for some, tweeting that residents of Michigan, Minnesota and Virginia should "liberate" their states after demonstrations last week.
On Saturday, a few dozen protesters gathered outside the Utah Capitol, demanding that officials allow people to return to work.
Protests were planned for Monday in California and Pennsylvania, and for later this week in Missouri and Wisconsin.
Vice President Mike Pence, when asked on Sunday talk shows whether Trump was inciting citizens to rise up against their state governments, defended Trump's comments and pledged to work with governors to safely reopen the economy.
A former head of the FDA, who served under Trump, agreed with governors who were critical of the administration and said that the federal government must do more to safely resume normal activity.
The administration has pursued a "loose strategy" and needs to focus more closely on obtaining supplies, Scott Gottlieb said on CBS News' "Face the Nation."
"I think states are largely on their own trying to get testing resources into their states," he said, noting that the shortage of swabs and reagents is a more urgent matter than lack of lab capacity.
"If you have the government more engaged in trying to manage that supply chain, getting supplies to the states that need it most, and trying to look for ways to increase manufacturing at a national level, that could help the states get the supplies they need," he added.
Democratic New York Gov. Andrew Cuomo, whose state has seen by far the largest numbers of infections and deaths from covid-19, said states also must begin wide testing for antibodies, which could indicate who was already infected with the virus and may be immune. He pledged at a news conference that New York would pursue antibody testing "in the most aggressive way in the nation."
The FDA has authorized four antibody tests on an emergency basis, but dozens more have been put on the market without any review by the federal agency. Some experts, including at the FDA, are concerned that those unvetted tests may be of dubious quality and yield unreliable results.
Since the first case of covid-19 was confirmed in the U.S., public health officials have called for more testing, both as a means of understanding how many people were infected and isolating people with the virus before they can infect others.
Deborah Birx, the Trump administration's coronavirus response coordinator, shifted the emphasis of the debate slightly, telling CBS that mass testing in areas that do not have known outbreaks of the virus could be counterproductive.
"Testing needs to be focused critically where you start to see early evidence [of transmission] because no test is 100% specific and 100% sensitive," she said. "And so if you test and overtest in areas where there isn't virus, you can end up with false positives and false negatives."
Experts agree that future testing will need to focus aggressively on outbreaks and be accompanied by tracing contact of the people who may have been exposed to the infected patient. But before that can occur, health officials say they need much more testing to develop baselines that will indicate when a new outbreak is happening.
Birx said the White House task force was "working with every laboratory director across the country . . . to really understand and find solutions for them on their issues related to supplies."
She questioned whether nearly a million tests a day were necessary and emphasized that outbreaks have to be addressed on a case-by-case basis, rather than with a single national approach.
"This has to be looked at as a community by community," she said, resisting questions about when the country would know that it was safe to begin a return to normal life. "It needs to be down to the communities so the communities can see what happens in their communities and make decisions with the local and health officials and the state officials, what can be opened and what needs to remain closed."
Some communities have decided that time is now.
In Florida, local officials allowed the public back onto some beaches, after Republican Gov. Ron DeSantis on Friday said beachfront governments could make those decisions on their own.
Despite admonitions to maintain social distancing, local news showed photos and videos of shoreline dotted with people closer than six feet apart.