WASHINGTON -- Guidelines urging Americans to stay at home, practice social distancing, and take other steps to prevent coronavirus from spreading will need to be extended until April 30, the Trump administration said.
"Nothing would be worse than declaring victory before the victory is won," President Trump said at a press conference early Sunday evening in the White House Rose Garden. Therefore, although the White House originally suggested that the guidelines could be relaxed beginning Monday, "we will be extending our guidelines to April 30 to slow the spread," he said. The administration's urge Americans to work from home whenever possible, avoid social gatherings of more than 10 people, avoid discretionary travel, and practice good hygiene, including frequent handwashing.
On Tuesday, "we will be finalizing these plans and providing a summary of our findings, supporting data, and strategy to the American people," Trump added. By extending the guidelines, "we can expect that by June 1st, we will be well on our way to recovery."
The extension became necessary when the White House's coronavirus task force looked at the projections for COVID-19 deaths and illnesses. "All of the flu models predicted anywhere between 1.6 and 2.2 million fatalities if we didn't mitigate," explained Ambassador at Large and task force member Deborah Birx, MD. "Some of them predicted half the U.S. would get infected and have that level of mortality. So we worked very hard together to really look at all of the impacts of the different mitigations utilized around the world and used that evidence base to really bring that data and evidence to the president to consider."
"It's not a simple situation when you ask people to stay home for another 30 days, and so they have to know that we really built this on scientific evidence and the potential to save hundreds of thousands of American lives," she added. "We know that's a huge sacrifice for everyone ... but it's all to protect not only Americans but the healthcare providers that are on the front lines."
By extending the guidelines to April 30, the task force's model puts the estimated number of deaths at 100,000 to 200,000, said Trump. If the death comes in at that level, "we altogether have done a very good job," he said.
Trump was asked about the April 30th date in relation to his earlier statements in which he said he hoped to have life back to normal by Easter. "Easter was just an aspiration," he said. "On Easter, that could be the peak number of deaths before it starts coming down."
Asked about the idea of relaxing the guidelines on a region-by-region basis based on which areas of the country seemed to be improving faster, Trump responded, "I don't think so," adding that his healthcare advisors weren't in favor of the idea.
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, addressed that idea further. "This can happen anywhere and that's one of issues we're concerned about," he said. "That's why we were so reluctant to pull back at a time when we need to put our foot on the gas as opposed to on the brake."
"There are a number of communities, cities, and states in which they're trickling along ... Don't get complacent about that, because that's exactly the way the virus works," Fauci said, describing a situation in which the number of cases starts small but then increases exponentially. "That's what we're trying to avoid in multiple locations throughout the country. We shouldn't take any solace when we see low levels in different states, different cities, different areas, because they're very vulnerable to an explosion."
"We're hoping the models are not completely right, that we can do better than what predictions are," Birx said.
"You can see from the recent data about young people are being impacted here," she continued. "We didn't see that the same way in Europe but our population is 8 or 9 years younger. We have to be attentive to all aspects of this."
Trump also praised health insurers and for agreeing to waive all of their enrollees' out-of-pocket costs -- including deductibles, copays, and coinsurance -- for COVID-19 diagnosis and testing (Humana is also waiving out-of-pocket costs for treatment, while CIGNA says "out-of-pocket costs may apply" for that). "Copays in particular, that's a big deal -- Humana and CIGNA should be getting a lot of credit for that," he said. "It's a lot of money they're waiving."
Also on Sunday, Vice President Pence requesting that hospitals report daily to the Federal Emergency Management Agency (FEMA) all results of COVID-19 tests performed at their institutions (tests that hospitals send out to major commercial labs are already being reported by those labs). In addition, Pence asked the hospitals to report data on COVID-19 patient illness and death to the CDC's . "The data will help us better understand disease patterns and develop policies for prevention and control of health problems related to COVID-19," he wrote.