Coronavirus Live Updates: Firm Helping Run Federal Database Refuses Senators’ Questions

The manager of the Trump administration’s new virus database refuses Senate questioning, citing a nondisclosure agreement.

The private health care technology vendor that is helping to manage the Trump administration’s new coronavirus database has refused to answer questions from top Senate Democrats about its $10.2 million contract, saying it signed a nondisclosure agreement with the federal Department of Health and Human Services.

In a letter obtained by The New York Times, dated Aug. 3, a lawyer for the Pittsburgh-based TeleTracking Technologies cited the nondisclosure agreement in refusing to provide information about its process for collecting and sharing data; its proposal to the government; communications with White House staff or other officials; and any other information related to the award.

A spokeswoman for Department of Health and Human Services said members of Congress should direct their inquiries to the government, not the company. But Senator Patty Murray of Washington, the top Democrat on the Senate Health Committee, sent a letter to the agency in June seeking similar information and has not received a reply, her office said.

The arrangement was unusual, Jessica Tillipman, an assistant dean at George Washington University Law School who teaches about government contracts and anti-corruption, said in an interview.

“One of the cornerstones of the federal procurement system is transparency, so it strikes me as odd,” she said.

TeleTracking was responding to a July 22 letter from two top Democrats: Senator Chuck Schumer of New York, the minority leader, and Ms. Murray. The two recently introduced legislation aimed at protecting data transparency — an issue Mr. Schumer addressed during recent talks with Mark Meadows, the White House chief of staff, and Treasury Secretary Steven Mnuchin, according to a person familiar with their discussion.

“The Trump administration’s decision to hire a private vendor and then cloak that vendor in a nondisclosure agreement raises numerous questions about their motivations and risks the ability of our public health experts to understand and effectively fight this virus,” Mr. Schumer said in a statement Friday.

The controversy over the contract stems from the administration’s abrupt order in July for hospitals to stop reporting coronavirus information to the C.D.C.’s National Healthcare Safety Network — a longstanding government data system — and instead send it to TeleTracking for inclusion in a coronavirus database overseen by H.H.S. officials in Washington. H.H.S. has said the switch was necessary because the C.D.C.’s system was slow and incomplete; the government uses the hospital data to make critical decisions about how to allocate scarce supplies, like ventilators and the drug Remdesivir.

The contract — and in particular the sudden switch in reporting from C.D.C. to TeleTracking — generated objections from public health experts and outside advisers to the health agency, who say that the new system is burdening hospitals and endangering scientific integrity by sidelining government experts.

TeleTracking is majority owned by its chairman and chief executive, Michael Zamagias, a Pittsburgh real estate developer.

The manner in which the contract was awarded has also generated confusion. A government website initially listed it as a “sole source” contract, but H.H.S. officials later said there were six bidders, though they refused to name the others, saying they were, saying they were “prohibited from sharing that information by federal regulations and statutes.”

Ms. Tillipman said it is also unusual for the government to keep the names of bidders a secret.

The Centers for Disease Control and Prevention updated their guidance recently to suggest that people who have recovered from the virus can safely mingle with others for three months.

It was a remarkable addition to the body of guidance from the agency, and its first indication that immunity to the virus may persist for at least three months. Scientists have said that it could last even longer but no definitive evidence exists yet. Even so, the C.D.C. still recommends physical distancing, mask-wearing and other precautions.

“People who have tested positive for Covid-19 do not need to quarantine or get tested again for up to three months as long as they do not develop symptoms again,” the guidance, which was tucked into public recommendations about who needs to quarantine, said. “People who develop symptoms again within three months of their first bout of Covid-19 may need to be tested again if there is no other cause identified for their symptoms.”

Doctors have reported some cases of people who seemed to be infected a second time after recovery, but experts have said those are more likely to represent a re-emergence of symptoms from the initial bout.

“There is no evidence to date of any reinfection within 90 days of the initial diagnosis,” said a C.D.C. spokesman.

Clinical trials for some of the most promising experimental drugs are taking longer than expected, even as the pandemic continues to wreak havoc in the United States and treatments are needed more than ever.

Researchers at a dozen clinical trial sites said that testing delays, staffing shortages, space constraints and reluctant patients were complicating their efforts to test monoclonal antibodies — man-made drugs that mimic the molecular soldiers made by the immune system.

As a result, once-ambitious deadlines are slipping. The drug maker Regeneron, which previously said it could have emergency doses of its antibody cocktail ready by the end of summer, has shifted to talking about how “initial data” could be available by the end of September.

And Eli Lilly’s chief scientific officer, who had said in June that its antibody treatment might be ready in September, said this week that he now hopes for something before the end of the year.

“Of course, I wish we could go faster — there’s no question about that,” said the executive, Dr. Daniel Skovronsky. “I guess in my hopes and dreams, we enroll the patients in a week or two, but it’s taking longer than that.”

One major hurdle has been testing. According to the rules of the Regeneron trial, a patient must be treated with the antibodies within seven days of the onset of symptoms. Both the Regeneron and Eli Lilly trials require giving the drug within three days of taking a test that comes back positive, but with turnaround times in some areas lagging for five days or more, keeping within those time frames has proved difficult.

A study by researchers in South Korea last month suggested that children ages 10 to 19 spread the coronavirus more frequently than adults — a widely reported finding that influenced the debate about reopening schools.

But additional data from the research team now calls that conclusion into question; it’s not clear who was infecting whom. Some of the household members who appeared in the initial report to have been infected by older children in fact were exposed to the virus at the same time as the children.

The incident — just the latest example of science about the virus unfolding in front of our eyes — underscores the need to consider the preponderance of evidence, rather than any single study, when making decisions about children’s health or education, scientists said.

The disclosure does not negate the overall message of that study: Children under 10 do not spread the virus as much as adults do, and the ability to transmit seems to increase with age.

“It’s indisputable that the highest risk of becoming infected and being detected as being infected is in older age groups,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “I think you have to be really careful before you decide to open high schools.”

The earlier study was not intended to demonstrate transmission from children to adults, only to describe contact-tracing efforts in South Korea, said Dr. Young June Choe, assistant professor of social and preventive medicine at Hallym University College of Medicine and an author of both studies.

The first study from South Korea grouped children in 10-year ranges. Tracing the contacts of 29 children ages 9 or younger, it found that the children were about half as likely as adults to spread the virus to others, consistent with other research.

But Dr. Choe and his colleagues reported an odd finding in the group of 124 children aged 10 to 19: They appeared significantly more likely than adults to spread the coronavirus. Experts told The Times at the time that the finding was likely to be a fluke.

In the latest study, the researchers found only one undebatable case of transmission among older children, from a 16-year-old girl, who had returned from Britain, to her 14-year-old sister. The remaining infected contacts of the older children could all be explained by a shared exposure.

A group of Democratic senators said Friday that they were worried about the military’s ability to handle a coronavirus outbreak at the wartime prison at Guantánamo Bay, Cuba, after the Pentagon told Congress that it could maintain just four of the 40 detainees on ventilators and offered no details of how it might care for the 1,500 troops there.

“The Pentagon’s response leaves doubts about the Guantánamo prison’s capacity to protect military personnel and detainees from Covid-19,” the 11 senators, led by Elizabeth Warren of Massachusetts and Jack Reed of Rhode Island, the ranking member of the Senate Armed Services Committee, said in a statement.

One key concern is that, by law, prisoners at Guantánamo must receive all their medical care there, while any of the other 6,000 residents could be medically evacuated to mainland hospitals if needed.

In detailing the base’s health capabilities, Matthew P. Donovan, an under secretary of defense, said the detention operation had acquired the ability do rapid on-site testing in addition to airlifting samples to U.S. military labs.

The military acknowledged two cases of the virus on the base, in March and April, before the Pentagon ordered installations to stop disclosing any new cases for “operational security” reasons.

The prison has the capacity to isolate each of the 40 prisoners, including with space for four in regular inpatient rooms, two in intensive care and two more in rooms that have negative pressure and can control the flow of infectious particles.

Doctors who looked at the capabilities noted that the prison’s Covid-19 Care Team lists only four I.C.U. nurses, far below a standard of care that requires one such nurse per ventilated patient around the clock.

This article was produced in partnership with the Pulitzer Center on Crisis Reporting.

U.S. Roundup

Obesity alone, apart from accompanying health problems, adds to Covid-19 risks for men.

Various factors are known to increase the risk of severe Covid-19, including older age and chronic health conditions like high blood pressure and heart disease. The Centers for Disease Control and Prevention also lists extreme obesity as a high risk.

But is the excess weight to blame? Or is it the health problems that accompany obesity, like metabolic disorders and breathing problems?

A new study points to obesity itself as a culprit. An analysis of thousands of patients treated in Southern California identified extreme obesity as an independent risk factor for dying among Covid-19 patients — most strikingly among adults 60 and younger, and particularly among men.

Among female Covid-19 patients, body mass index — a measure of body fat based on height and weight — does not appear to be independently associated with an increased risk of dying at any age, the authors said, possibly because women carry weight differently than do men, who tend to have more visceral and abdominal fat. The study was published in Annals of Internal Medicine.

“Body mass index is a really important, strong independent risk factor for death among those who are diagnosed with Covid-19,” said Sara Tartof, the study’s first author, a research scientist at Kaiser Permanente of Southern California.

In other news from around the United States:

  • Georgia Gov. Brian Kemp is expected to sign an executive order on Saturday allowing local governments to issue mask ordinances, according to The Associated Press, which cited the Atlanta Journal-Constitution. The governor has staunchly opposed issuing a statewide mask ordinance — even suing Mayor Keisha Lance Bottoms for signing a mask order in Atlanta. Mr. Kemp’s executive order is expected to give businesses the option of enforcing local mandates and comes after a “strong recommendation” from the White House coronavirus task force. Officials announced 3,319 new cases in Georgia today, according to a New York Times database.

  • The five metropolitan areas that have the highest rate of new coronavirus cases relative to their population are all in South Texas, according to data compiled by The Times.

  • The Department of Homeland Security announced an extension of the U.S. agreement with Canada and Mexico to limit nonessential travel through Sept. 21. It was the fifth extension since the measure was put in place in March.

  • A federal judge dismissed a lawsuit by an Arizona woman who claimed New York’s 14-day quarantine requirement for travelers from hotspot coronavirus states infringed on her “fundamental right to travel.” This was the second challenge to Gov. Andrew Cuomo’s quarantine order to be thrown out by a federal judge, the Associated Press reported.

  • Gov. Gretchen Whitmer of Michigan said that the state would give four million free face masks to homeless shelters, tribal organizations, community health centers, schools and grocery stores. The effort, which targets people particularly vulnerable to the virus, includes one million masks provided by the Federal Emergency Management Agency and 1.5 million masks donated by Ford Motor.

  • At least 22 workers at a remote mining camp in Alaska have been infected with the virus, forcing a temporary stoppage to underground work. The Kensington Mine, about 45 miles north of Juneau, has about 200 to 250 workers on site at a time, said a spokeswoman for its owner, Coeur Alaska. The state has embraced a broad reopening but implemented protocols to keep infections in check, and though Alaska has had a spike in reported infections this summer, its numbers remain low compared with other states’.

More than 8,500 people have signed a petition asking the health plan of SAG-AFTRA, the American union for professional film and television actors, to reverse changes that will result in at least several hundred members no longer qualifying for health insurance.

The health plan said in an email sent to members on Wednesday that it would raise the floor for eligibility from those earning $18,040 a year to $25,950, effective Jan. 1. Premiums will also increase.

“The Trustees of the SAG-AFTRA Health Plan have taken a difficult but necessary action to address financial deficits facing the plan,” the Screen Actors Guild-American Federation of Television and Radio Artists (SAG-AFTRA) Health Plan said in a statement.

At a time when film jobs are scarce and live theater is almost completely shut down because of the pandemic, many actors have seen their income slow to a trickle or disappear entirely.

SAG-AFTRA represents approximately 160,000 actors, singers, journalists and other media professionals in film and television. Membership is considered a rite of passage that can lead to more prestigious work.

According to the email, the changes are in response to projected deficits of $141 million this year and $83 million in 2021. The health plan estimated that, without the changes, it would run out of reserves by 2024.

In other U.S. cultural news:

  • As New York maintains its hard-won progress against the coronavirus, New York City’s museums and other cultural institutions will be allowed to open their doors again on Aug. 24, Gov. Andrew M. Cuomo said.

  • The National September 11 Memorial & Museum canceled its annual light display on the anniversary of the 2001 terrorist attacks because of the coronavirus. The decision was made “after concluding the health risks during the pandemic were far too great for the large crew,” a spokesman said.

Whatever one calls them — learning pods, pandemic pods or microschools — small groups that hire teachers to supplement or even replace the virtual instruction offered by public schools have become an obsession among many parents of means.

A virtual cottage industry of companies and consultants has emerged to help families organize these small-group, in-home instruction pods and pair them with instructors, many of whom are marketing themselves on Facebook pages and neighborhood email lists.

But the cost — often from $30 an hour per child to $100 or more — has put them out of reach for most families, generating concerns that the trend could make public education even more segregated and unequal.

In Washington, D.C., one parent started a GoFundMe page to raise money to subsidize learning pods for low-income students in the district.

Education experts say fund-raising efforts and “pod scholarships,” however well meaning, are no solution for millions of low-income parents juggling the educational, child care and economic challenges of the pandemic.

More useful, they say, would be if school districts or city governments created their own version of learning pods, especially for at-risk students or children of essential workers.

In other education news:

  • Barnard College and Columbia University said that all undergraduate classes would be held remotely for the fall semester and that student housing would be mostly closed. The announcement came days before students were to move into dormitories.

  • The president of Villanova University in Pennsylvania has warned students that they will be sent home if they are caught disregarding the school’s coronavirus protocols, which include wearing a mask “at all times” and social distancing. Videos that appear to show a gathering of dozens of new Villanova students recently drew backlash on social media.

France on Friday declared Paris and the Marseille region in its southeast to be high-risk zones, granting the local authorities powers to restrict the movements of people and vehicles, limit access to public transportation and public buildings and close restaurants and bars.

France’s seven-day average is now above 2,000 cases, according to a Times database, a level the country reached in late March during a sharp rise in its outbreak.

Britain added France to its list of countries that visitors arriving from must quarantine for two weeks. Britain also added the Netherlands, where cases have doubled every two weeks since early July, along with Aruba, Malta, Monaco and Turks and Caicos.

Authorities in Britain unveiled the expanded list with little more than a day’s notice, prompting an instant scramble from vacationers to return there before the quarantine is imposed at 4 a.m. on Saturday.

France’s rising caseload reflected not only an increase in the number of tests, which stand at more than 600,000 per week, but also a higher infection rate, especially among young people, the health authorities said. The country’s total caseload has risen to 209,365, with 30,388 deaths, according to the Times database.

In other news from around the world:

  • North Korea lifted a lockdown it had imposed last month on the city of Kaesong, near its border with South Korea, on government suspicions that a runaway from South Korea had brought the virus with him. The North said the reversal was “based on the scientific verification and guarantee by a professional anti-epidemic organization” but without saying whether the nation has a coronavirus outbreak. Its leader, Kim Jong-un, has said it is facing “twin perils” — the virus and flooding from an unusually long monsoon season.

  • South Korea reported 103 new cases, mostly in Seoul, the country’s biggest daily jump in three weeks. The daily caseload has remained in double digits since July 25. Last month’s spike was primarily attributed to workers returning home with the virus from Iraq, but 85 of the 103 new cases reported on Friday were local transmissions.

  • Spain ordered bars and clubs to close by 1 a.m. and banned drinking on the street on Friday, according to Reuters. Virus cases have risen steadily since July when the country emerged from a strict lockdown that only allowed residents to leave their home to walk their dog or grocery shop. Spain reported more than 5,400 new cases on Friday, according to a New York Times database.

  • President Rodrigo Duterte of the Philippines has delayed opening schools until Oct. 5, his chief aide said. The Philippines has the highest number of infections in Southeast Asia, with 153,660 confirmed cases and 2,442 deaths, according to the Times database.

  • Health officials in Toronto said that about 550 people may have been exposed to the coronavirus at a strip club bar after an employee tested positive for the virus. The occupation of the infected employee was not disclosed.

  • Vietnam’s health ministry announced that it had registered to buy Russia’s coronavirus vaccine, despite experts’ concerns that the Kremlin is distributing it before the last phase of human trials have even begun. The ministry said it had also registered to buy a vaccine from the United Kingdom. It cautioned that using the vaccines would depend on the progress of clinical trials and compliance with Vietnam’s “strict regulations.

Long-term financial damage to states may be greater than that of the last recession, economists say.

As Congress leaves Washington on a recess, Democrats and the Trump administration remain far apart on the stimulus, including how much to spend and where the money would go. The Democratic-controlled House passed a $3 trillion dollar aid package in May. Republicans, who control the Senate, want to stay in the $1 trillion range.

A major sticking point, beyond how much more to help unemployed Americans, was providing more aid to state and local governments. With tax revenues plummeting, states could face a cumulative budget gap of at least $555 billion through the next two years, according to one estimate. Economists warn that, unless Congress intervenes, the long-term financial damage might be greater than after the recession of 2007-9.

The Trump administration and many Republican lawmakers have largely brushed off state financial woes, insisting that governors and other local leaders foot part of the pandemic aid bill and refusing to “bail out” Democratic-led states struggling with huge shortfalls in their public pension plans.

Democrats insist that states need more money and have proposed as much as $1 trillion, saying it would support needed services and help the economy recover more quickly.

Nearly all states are required to balance their budgets, meaning officials will need to plug shortfalls by tapping rainy-day funds, raising taxes or cutting costs, including by eliminating jobs.

With unemployment high and many businesses expected to close, states are bracing also for more safety net costs on top of the public health expenses they are already incurring. They spend a large chunk of their budgets on Medicaid payments and services for low-income residents.

Even as coronavirus infections spread, school reopenings were scrapped and near-historic unemployment levels persisted Americans kept shopping in July, reflecting a rare bright spot in the battered economy.

Retail sales rose 1.2 percent from June, the Commerce Department reported. Though smaller than increases in the previous two months, the jump in sales showed that the bounceback in spending to pre-pandemic levels was not a fluke. Sales have returned to their February level, a sign that consumerism, buoyed by government support, remains resilient even as many other facets of American life are increasingly bleak.

“It shows there is a willingness and a desire to spend,” said Michelle Meyer, chief U.S. economist at Bank of America. “There is no doubt the recovery in consumer spending has been robust.”

Retail sales in June rose 8.4 percent. That followed a May jump, 18.2 percent, which was the largest monthly surge on record. But that had followed two months of record declines.

But some of the recovery was helped by the $600 a week in unemployment assistance that expired at the end of July, and Congress’ failure so far to extend the emergency benefit could derail the retail rebound in coming months. And certain sectors of the industry may not truly bounce back until a vaccine is approved and widely distributed, allowing people to shop and dine indoors again without fear.

How do people learn to be more resilient?

If you feel as if you can barely cope, while others are doing just fine, remember that the very earliest days of our lives, and our closest relationships, can offer clues about how we deal with adversity.

Reporting was contributed by Sarah Bahr, Mike Baker, Damien Cave, Choe Sang-Hun, Emily Cochrane, Michael Corkery, James Dobbins, Thomas Erdbrink, Manny Fernandez, Abby Goodnough, Jason Gutierrez, Rebecca Halleck, Sapna Maheshwari, Apoorva Mandavilli, Constant Méheut, Claire Moses, Colin Moynih, an, Richard C. Paddock, Alan Rappeport, Rick Rojas, Carol Rosenberg, Anna Schaverien, Jeanna Smialek, Mitch Smith, Paula Span, Eileen Sullivan, Sheryl Gay Stolberg, Katie Thomas, Billy Witz and Katherine J. Wu.

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