Trump confronts most difficult week yet in coronavirus battle

President Trump and his administration are confronting the most difficult week yet of the novel coronavirus outbreak as cases are expected to approach peak levels in some of the hardest-hit areas of the country.

The administration is facing growing pressure to get medical supplies to states where hospitals fear shortages, and critics say a leadership vacuum has hurt the disbursement of critical resources.

The week ahead also will tell the tale of whether the administration’s guidelines for social distancing are working to flatten the curve of infections.

It all comes amid increased signs of fractures on the White House team, including a report of a battle over a controversial coronavirus treatment between economic and health experts in the administration.

Trump has warned the country should prepare for a difficult two-week period that will be filled with death. But he’s also sought to strike an optimistic tone by pointing to a “light at the end of the tunnel” while reviving rhetoric about the need to get the country back to work.

“We’re going to have a rough week,” Trump told reporters at Monday evening’s White House briefing. “But there is tremendous light at the end of the tunnel.”

The novel coronavirus as of Monday afternoon had infected more than 350,000 Americans and resulted in more than 10,000 domestic deaths, according to Johns Hopkins University.

Other experts warn that as sad and difficult as the next two weeks are going to be, the nation faces months of struggle.

“One of the things that is not only disappointing but frankly shocks me is the lack of realism that we have about this situation,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Everyone is living for the next press briefing or the next tweet and not really understanding what the long-term impact is here.” 

The White House is using a model produced by Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington that projects daily deaths across the country will peak on April 16 at more than 3,100, while the domestic use of medical resources will peak on April 15. 

Officials have urged the public to heed social distancing guidelines that call on Americans to avoid public places, nonessential travel and gatherings until the end of April. 

Anthony Fauci, the government’s top infectious disease expert, told reporters Sunday that the country could begin to see a flattening of the curve of infection in the next two weeks but that it was entering a difficult period.

“If we start seeing now is a flattening or a stabilization of cases, what you’re hearing about potential light at the end of the tunnel doesn’t take away from the fact that tomorrow or the next day is going to look really bad,” Fauci said. 

The White House is tracking data at the state and county level in order to monitor increases in cases and medical equipment needs. 

New York Gov. Andrew Cuomo (D) said Monday that the death toll had remained flat for two days and that hospitalizations are down in the state, which is the epicenter of the virus in the U.S.

“Those are all good signs and again would suggest a possible flattening of the curve,” Cuomo said during his daily press conference, though he spoke of an “unsustainable” stress on the state hospital system.

Speaking to reporters Monday, Fauci described the developments out of New York as an encouraging sign the mitigation efforts were working.

Yet other hot spots have emerged in New Jersey, Louisiana, Michigan and Illinois, suggesting a long battle ahead.

A Department of Health and Human Services inspector general report issued Monday said hospitals countrywide reported serious shortages of tests for the coronavirus and protective equipment at the end of March. The president dismissed the report as “wrong” during Monday’s briefing and questioned the background of the inspector general.

Trump has employed the Defense Production Act (DPA) to force companies to ramp up production and to prevent the hoarding of critical supplies, and on Sunday he announced officials would send ventilators to New Jersey, Louisiana, Michigan, Illinois and Massachusetts. The administration is also redistributing ventilators provided by the state of California to other areas in need.

Still, Trump has faced persistent criticism for not using the DPA authority to its full power and calls for the federal government to take on a larger role. 

“You’ve got two problems: One is that we’ve got a shortage of essential medical resources, particularly personal protective equipment for doctors and nurses and, secondly, inefficient distribution and supply chain at the state and local level,” said Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law. 

As the U.S. stares down a grim week ahead, Trump has expressed hope that the U.S. would soon turn a corner and be able to begin opening parts of the country in order to get the economy going again, suggesting keeping the nation shut down for too long could have a worse effect than the virus itself. 

The forced closures caused by the coronavirus have devastated businesses and workers across the country, with an unprecedented 6.6 million Americans filing for unemployment just last week. 

Still, public health experts say that safely reopening the country should require a sustained reduction in cases of COVID-19, widespread testing to monitor for new outbreaks and assurances that hospital systems will not be overwhelmed.  

“We have some surveillance in this country but nothing like the level that looks like will be needed to prevent and contain any future outbreaks — and there is a real risk of future outbreaks,” said Mark McClellan, the former FDA director under the George W. Bush administration, who noted the risk of resurgence of the virus come fall. 

Osterholm criticized the administration for not having a plan to address what is likely to be a months-long problem. He argued that officials need to develop a strategy that allows young people who are less susceptible to the virus and individuals who have already cleared the infection to return to society.  

“We are in the first inning of a nine-inning game, and I hope to hell we’re not going into extra innings,” Osterholm said.