The Wall Street Journal - 14.03.2020 - 15.03.2020

A6| Saturday/Sunday, March 14 - 15, 2020 **** THE WALL STREET JOURNAL.

three to four days to find out if

a patient had coronavirus, phy-

sicians said. Test results typi-

cally take 8 hours, a university

spokeswoman said.

In the past week, testing has

increased after the CDC relaxed

its criteria, allowing any person

with symptoms who is high

risk, who recently traveled to a

hot spot or who came into con-

tact with an infected person to

get tested.

But the volume of patients

with symptoms and the need

for enough personal protective

equipment, called PPE’s, to

treat them remained a concern.

Dr. Tu thought the medical

clinics he oversaw at Everett

were adequately stocked with

30,000 of the surgical masks.

But the rate of use jumped to

3,000 a day from the 1,000 that

is typical in flu season.

On the verge of running out

last week, he had to reach out to

the Strategic National Stockpile,

the nation’s emergency reserve

of critical drugs and medical

EVAN VUCCI/ASSOCIATED PRESS

Treasury SecretaryStevenMnuchin spoke with reporters Friday at the White House about the economic impact of the coronavirus.

The Trump administration

said it would increase access to

coronavirus testing even as a

fresh potential problem looms:

The U.S. is facing a dwindling

supply of the products and

chemicals needed to run the

tests.

Top administration officials

have told lawmakers they are

aware the supplies are short

and are researching the issue.

Some congressional and state

lawmakers, as well as public-

health leaders, are pressing the

White House to do more, say-

ing they are already having

problems getting certain mate-

rials and a deepening shortage

could hobble testing nation-

wide, even as millions of tests

are deployed.

The administration took

steps Friday to try to advance

testing with a screening web-

site where people can fill out a

questionnaire, check symptoms

and risk factors, and learn

where drive-through options

are for getting tested.

The goal, officials said, is to

have labs use automated ma-

chines enabling them to pro-

vide results in 24 to 36 hours.

“I understand that a lot of

this behind-the-scenes action

over the last couple of weeks

was invisible to the press and

the American people,” said Am-

bassador Deborah Birx, special

representative for global health

diplomacy, at a news briefing at

the White House.

the new coronavirus.

At times, communication be-

came so siloed that the mayor

of Kirkland, at the outbreak’s

epicenter, resorted to calling

every elected official she

could—including her husband,

a state legislator—to get fed-

eral officials to move faster.

“We need to have something

happen. You need to understand

what is happening. People are

dying,” Mayor Penny Sweet re-

called telling Washington Gov.

Jay Inslee’s chief of staff.

Tim Dellit, UW Medicine’s

chief medical officer, and other

Seattle hospital leaders on

March 2 urged state officials to

persuade the Centers for Dis-

ease Control and Prevention to

adopt the World Health Organi-

zation’s guidelines for medical

staff’s protective gear, which

allow for less-specialized masks

to fight coronavirus than those

recommended by the CDC.

“We cannot manage the in-

creasing numbers of patients

presenting with possible

Covid-19 and creating more risk

for our health care workers

given the complexities of the

current CDC recommenda-

tions,” Dr. Dellit’s letter said.

At first, John Lynch, head of

infection prevention and con-

trol at Seattle’s Harborview

Medical Center, had anticipated

clusters of coronavirus cases

would pop up and spread—sim-

ilar to the flu.

When state officials an-

nounced on Feb. 29 the first re-

ported coronavirus death in the

U.S. occurred at Evergreen-

Health, and that sick patients

from there had been at Life Care,

it jogged the memory of a nurse

at Dr. Lynch’s hospital. The nurse

recalled a patient had died at

Harborview on Feb. 26, after be-

ing transferred from Life Care.

The county medical exam-

iner’s office subsequently con-

firmed the Harborview patient

tested positive for coronavirus,

meaning the first death from

Covid-19 happened earlier than

previously known.

“You’re going to need to call

everyone on staff,” Dr. Lynch

told a hospital fellow assigned

to his team.

On those first few days, the

CDC’s testing protocols for the

illness were both too narrow,

focused on travel to known

global hot spots, and took too

long to get results, physicians

said. While waiting, hospital

leaders had to isolate patients

who mightn’t have been in-

fected and burn through dwin-

dling protective equipment.

“It was incredibly frustrat-

ing,” Dr. Lynch said.

The University of Washing-

ton lab got so swamped that

doctors were having to wait

equipment, as well as to Ever-

ett’s parent, UnitedHealth Group,

to arrange emergency shipments.

Realizing he was also about

to run out of the special N

respirators used by staff to

treat coronavirus, Dr. Tu began

digging through Everett’s stor-

age facility until he found alter-

native respirators. But they

didn’t fit snugly enough so staff

jury-rigged the remaining N

devices to last longer.

The Trump administration

has requested more supplies be

added to the national stockpile.

Washington state has asked

federal officials for respirators

and masks twice.

As it became clear that the vi-

rus was tearing through Life

Care, Kirkland officials struggled

to get clear guidance from county

and federal health officials.

The mayor and her staff be-

gan asking for a specialized

federal disaster medical-assis-

tance team to take over the fa-

cility. It took several days of

frustrating back and forth, and

Ms. Sweet calling elected offi-

cials, to find out when the team

would arrive, she said.

By the middle of this past

week, coronavirus had spread

to 10 other Seattle-area elder-

care facilities, which reported

at least three more deaths.

—Melanie Evans

contributed to this article.

Washington were among the
first in the nation to face the cri-
sis, as well as the lumbering re-
sponse from federal health offi-
cials and equipment shortages
that they say have slowed their
ability to contain the virus.
Despite the disaster training
that the region’s medical care
systems have undergone, the
coronavirus crisis exposed crit-
ical gaps. Those on the front
lines in the Seattle area have
had to plead for more re-
sources, demand changes to re-
strictive infectious-disease pro-
tocols, and create their own
rules on the fly.
“There’s a great military
term: ‘No battle plan survives
first contact with the enemy,’ ”
said Jeff Tomlin, a former Ma-
rine Corps pilot who is now
chief executive of Evergreen-
Health, near the Life Care Cen-
ter of Kirkland, a long-term-
care facility where nearly two
dozen deaths are linked to
Covid-19, the illness caused by

ContinuedfromPageOne

Shortages

Slow Down

Hospitals

THE CORONAVIRUS PANDEMIC

businesses with fewer than 50

employees could win an ex-

emption from paying emer-

gency sick leave if they could

prove hardship.

Mr. Trump also wrote on

Twitter that he had instructed

Mr. Mnuchin and Labor Secre-

tary Eugene Scalia to propose

regulations to ensure the leg-

islation doesn’t hurt small

businesses. He didn’t offer de-

tails on the regulations.

Congress last week passed

an $8.3 billion measure to help

the government develop a vac-

cine and provide money for

states to expand their lab test-

ing capacity and attempt to

limit the damage from the vi-

rus. Efforts to put together a

new package came together

only this week—as the number

of cases in the U.S. exceeded

1,000, stock prices plunged,

and sports and cultural events

were canceled nationwide

The package would provide

free coronavirus testing to any-

one whose doctor says they

need a test and allow for as

much as 14 days of paid sick

leave and as much as three

months of paid family and med-

ical leave. It would also provide

more funding for state Medicaid

programs, although less than

what Democrats had proposed

in their original legislation.

Should it pass the House,

the measure would go to the

Senate. Majority Leader Mitch

McConnell (R., Ky.) has can-

celed next week’s recess to be

available to work on a corona-

virus response.

Republicans were especially

concerned about small busi-

nesses, which they warned

could face disruptions with so

many out-of-work employees,

as well as cash-flow problems

even if they were later reim-

bursed for their costs through

a tax credit. In a last-minute

deal, negotiators agreed that

date that requires companies

with fewer than 500 workers

to pay up to 14 days of emer-

gency sick leave to certain

workers who were exposed to

coronavirus, as well as people

whose family members were

exposed or who faced child-

care problems because of the

coronavirus crisis.

met at the White House Friday

night to go over the final details

of the bill and he eventually

signed off, according to a White

House official. Mr. Mnuchin also

spoke with Mrs. Pelosi during

Mr. Trump’s Friday afternoon

news conference.

Negotiations bogged down

late Friday over a new man-

sury Secretary Steven

Mnuchin, who stayed in close

contact with the House

speaker throughout the week.

The president signaled ear-

lier in the day that he wasn’t

ready to reach an agreement on

the legislation, saying Demo-

crats weren’t giving him enough.

But Mr. Trump and Mr. Mnuchin

WASHINGTON—Demo-
crats and the White House
reached an agreement on leg-
islation that would make coro-
navirus testing free and pro-
vide paid sick leave to many of
those affected by the pan-
demic as it continues to
spread across the country.
President Trump endorsed
the legislation in a Friday night
tweet, ending hours of confu-
sion about whether he would
back the bill amid a last-minute
disagreement about the text.
“I encourage all Republi-
cans and Democrats to come
together and VOTE YES! I will
always put the health and
well-being of American fami-
lies FIRST. Look forward to
signing the final Bill, ASAP!”
Mr. Trump wrote in a series of
tweets shortly before 9 p.m.
House Speaker Nancy Pelosi
was expected to hold a vote on
the bill Friday night. She had
announced a deal earlier Fri-
day in a letter to lawmakers.
“This legislation is about
testing, testing, testing,” Mrs.
Pelosi said. “To stop the
spread of the virus, we have
secured free coronavirus test-
ing for everyone who needs a
test, including the uninsured.”
Mr. Trump’s tweets gave
House Republicans confidence
to back the spending legisla-
tion, knowing that the presi-
dent would sign it and ended
days of intense negotiations
between Mrs. Pelosi and Trea-

But the scarcity of some of

the testing materials and prod-

ucts could undermine President

Trump’s efforts to fend off crit-

icism over the government’s re-

sponse to the virus. About

1,600 people in the U.S. have

tested positive for coronavirus,

businesses have told workers to

stay home and many schools

have closed in an effort to slow

the spread.

Administration officials in-

cluding Vice President Mike

Pence said millions of tests

would be available, and Mr.

Trump said last week that

“anyone who wants a test can

get a test.”

But labs and some states say

that hasn’t been the case. Spe-

cific agents that allow the virus

to be extracted for the tests are

running low, they say, as are

supplies of chemicals for test-

ing.

Labs also said there are con-

cerns about collection supplies

at locations where people are

tested, including swabs, respi-

rators and media to transport

the virus as well as masks and

gloves.

“We’ve shared our concerns

with the administration and the

CDC about possible shortages

of supplies,” a spokeswoman

for the American Clinical Labo-

ratory Association said, refer-

ring to the Centers for Disease

Control and Prevention. “We’re

concerned there could be chal-

lenges as we step up increased

demand and screen more speci-

mens.”

Adriane Casalotti, chief of

government of public affairs at

the National Association of

County and City Health Offi-

cials, said the problems will

worsen if more people develop

symptoms and need testing.

“Even if labs don’t have

shortages now, there are only a

handful of suppliers. It’s going

to be a national problem,” said

Ms. Casalotti, whose organiza-

tion represents the country’s

nearly 3,000 local health de-

partments “When you’re think-

ing of testing thousands of

thousands of thousands of peo-

ple, it puts all these materials

at risk.”

The American Society for

Microbiology, whose member-

ship includes thousands of pub-

lic-health and clinical labora-

tory microbiologists, also

sounded a warning.

“We are deeply concerned

that as the number of tests in-

creases dramatically over the

coming weeks, clinical labs will

be unable to deploy them with-

out these critical components,”

the organization said in a state-

ment.

Private labs that are per-

forming coronavirus tests are

closely watching the supply of

materials needed for testing.

Quest Diagnostics Inc., which

launched coronavirus testing,

said it uses some of the same

chemicals as used in tests from

the CDC.

“We are managing supply

and believe we have adequate

supply at least for the time be-

ing,” said Rachel Carr, a spokes-

woman for the company.

Democrats are raising the

alarm: California Gov. Gavin

Newsom said Thursday that

test kits received from the CDC

didn’t include the ingredients

that are in short supply, and Il-

linois Sens. Dick Durbin and

Tammy Duckworth have pushed

the agency for more informa-

tion.

“This is imperative that the

federal government and labs

across the United States—not

the state of California—get the

benefit of all the ingredients

that are components of the

test,” Mr. Newsom said.

On Thursday, Dr. Anthony

Fauci, director of the National

Institute of Allergy and Infec-

tious Diseases, said in congres-

sional testimony that the na-

tion’s system for disease

testing has failed during the

coronavirus crisis because peo-

ple typically need a doctor’s

permission to be tested.

“The system is not really

geared to what we need right

now,” Dr. Fauci said. “That is a

failing. It is a failing. Let’s ad-

mit it.”

—Denise Roland

and Peter Loftus

contributed to this article.

BYSTEPHANIEARMOUR

ANDTHOMASM.BURTON

Supply of Products, Materials Used for Testing Falls

Specific agents that

allow the virus to be

extracted for the

tests are running low.

Under 10

10–

20–

30–

40–

50–

60–

70–

80+

0.0%

0.

0.

0.

0.

1.

3.

8.

14.

Cardiovascular disease

10.5%

Diabetes

7.

Chronic respiratory disease

6.

Hypertension

6.

Cancer

5.

None

0.

Overalldeathrate:2.3%

Who’s Vulnerable?

Among a large group of early patients in China, the death rate

was highest for people over 60 or with underlying illnesses.

Initial cases in the U.S. and South Korea show similar patterns.

Death rate among patients in China diagnosed with the new

coronavirus through Feb. 11

By age group

Deaths in the U.S. and South Korea, by age group

As of March 11

By underlying condition

Under 10

AGE U.S. deaths* South Korea

10-

20-

30-

40-

50-

60-

70-

80+

*Does not include two deaths where the age was not reported.

Sources: Chinese Center for Disease Control and Prevention (death rates); local health officials

(U.S. deaths); Sang Woo Park, Princeton University (South Korea deaths)

Lindsay Huth/THE WALL STREET JOURNAL

1

1

6

14

21

17

1

none

none

none

none

none

none

none

2

5

9

18

BYNATALIEANDREWS
ANDLINDSAYWISE

Trump, Democrats Reach Deal on Virus Bill

Nurses tested UW Medicine staff Tuesday, at a makeshift site in

a Seattle parking garage.

JOVELLE TAMAYO FOR THE WALL STREET JOURNAL