Dr. Andre Kalil, of the University of Nebraska Medical Center, will oversee a clinical trial of a potential coronavirus treatment.

Dr. Andre Kalil, of the University of Nebraska Medical Center, will oversee a clinical trial of a potential coronavirus treatment. Nati Harnik / AP

Trump Administration Prepares for Rapid Growth of U.S. Coronavirus Cases

Agencies acknowledge some bumps in the road as they prepare for inevitable domestic outbreak.

The Trump administration is moving rapidly to ramp up its response to the novel coronavirus, saying the virus' recent spread around the globe has increased the concern that the number of cases in the United States will soon climb rapidly. 

The White House sent a supplemental budget request to Congress for $1.25 billion for prevention and response efforts, as well as permission to reallocate another $1.25 billion from previously distributed funding. While lawmakers had urged the request, members of both parties quickly criticized the administration’s proposal. 

“It seems to me at the outset this request for the money, the supplemental is lowballing it potentially, and you can’t afford to do that,” Sen. Richard Shelby, R-Ala., chairman of the Senate Appropriations Committee, told Health and Human Services Secretary Alex Azar on Tuesday. “If you lowball something like this, you’ll pay for it later.”

Sen. Patrick Leahy, D-Vt., the top Democrat on the panel, said the administration should not shortchange other programs—such as its ongoing Ebola response—to fund the novel coronavirus efforts. 

“President Trump’s instinct of robbing Peter to pay Paul is once again on full display, demonstrating a dangerous level of incompetence within his administration to confront the global spread of the novel coronavirus,” Leahy said. “This is on top of the obscene cuts to the very programs meant to combat infectious diseases that President Trump proposed for next year in his budget released just two weeks ago.”

The Centers for Disease Control and Prevention is spearheading the administration’s response efforts. A top official said on Tuesday cases in the United States will inevitably skyrocket in the near future. 

“It’s not so much of a question of if this will happen in this country any more but a question of when this will happen and how many people in this country will have severe illness,” said Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases. 

CDC is working with the Food and Drug Administration to rush out the door new test kits to enable state and local facilities to diagnose COVID-19, the disease that results from the new coronavirus. The agency has encountered problems with the kits, Messonnier said, and only 12 jurisdictions can currently conduct tests on their own. Even in those cases, positive tests must be sent to CDC for verification. The agency has deployed teams to ports of entry around the country and with the World Health Organization to conduct research and testing. 

Homeland Security Department acting Secretary Chad Wolf also faced tough questions from lawmakers on Tuesday about the agency’s response efforts, including whether the country had enough supplies to protect all of its citizens. Wolf demurred, noting HHS was leading efforts and he could only confirm his own personnel were sufficiently protected. Frontline DHS employees, especially those at Customs and Border Protection, are playing a key role in conducting initial screenings of Americans for potential signs of respiratory illness. Despite the rapid spread of the virus, CDC is only testing individuals who have returned to the United States from mainland China, the epicenter of the outbreak. 

The State Department, in consultation with CDC, has worked to bring home Americans stranded in at-risk areas due to travel restrictions. 

The Defense Department has begun housing individuals in quarantine on some of its bases and is prepared to expand that operation significantly as needed. The Pentagon has maintained none of its own personnel will come in contact with infected patients. It is also taking precautions with its personnel overseas. As an outbreak has developed in South Korea, U.S. Forces Korea has limited travel, closed some facilities and opened the possibility of cutting off training with its host country to mitigate risks. The virus’ spread comes at a perilous time in U.S.-South Korea relations, as the Trump administration has demanded its counterparts incur a significantly higher portion of the American military’s costs there. 

There is still no vaccine or treatment for COVID-19, though the National Institutes of Health and FDA are working on developing them. While a vaccine is likely at least months away, NIH on Tuesday announced a new trial to treat the disease with its National Institute of Allergy and Infectious Diseases serving as regulator sponsor. An American infected on the Diamond Princess cruise ship that docked in Japan and saw the virus spread quickly among passengers will be the first trial patient. 

The U.S. containment strategy has been largely successful to date, Messonnier said, but those efforts are becoming “harder and harder” as the situation evolves into an expanding global crisis. During her 25 years at CDC, she said, any public health official asked what he or she fears the most would describe “something exactly like this.”