WASHINGTON - Trump administration health officials urged the public Tuesday to prepare for the "inevitable" spread of the coronavirus within the United States, escalating warnings about a growing threat from the virus to Americans' everyday lives.
The warnings from officials with the Centers for Disease Control and Prevention, the National Institutes of Health and other agencies, contrasted sharply with assessments from President Donald Trump and other White House officials, who have largely dismissed concerns about the virus. The mixed messages continued Tuesday as dire warnings issued to senators and reporters early in the day gave way to a more positive assessment, after the Dow Jones industrial average plunged 3.4 percent, bringing the two-day loss to more than 1,900 points - the worst in two years.
"We believe the immediate risk here in the United States remains low, and we're working hard to keep that risk low," Anne Schuchat, the CDC's principal deputy director, said during a hastily convened afternoon news briefing.
Earlier in the day, CDC officials and others expressed greater urgency.
"Ultimately, we expect we will see community spread in the United States. It's not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses," Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at the CDC, said during the morning briefing with reporters.
Messonnier said the rapid surge in cases outside mainland China in the past several days prompted the change in official warnings.
There is growing evidence that efforts to contain the spread of the virus outside China have failed. There are now more than 1,100 cases in South Korea, at least 15 people have died in Iran, and new cases were reported for the first time in Switzerland, Austria and a luxury resort in Spain. In the United States, 57 people have the virus, all but 14 of them evacuees from the Diamond Princess cruise ship, which had been quarantined in Yokohama, Japan.
Messonnier noted the emergence of cases in multiple nations without a known source of exposure. Evidence of what is called "community spread," she said, is triggering strategies to confront the respiratory virus, including urging businesses, health-care facilities and even schools to plan now for ways to limit the impact of the illness when it spreads.
Health leaders voiced similar warnings in a closed-door briefing Tuesday morning for senators. Sen. Patty Murray, D-Wash., said officials had cautioned them that there was a "very strong chance of an extremely serious outbreak of the coronavirus here in the United States."
Not long after, though, National Economic Council Director Larry Kudlow tried to assuage concerns over the coronavirus and its impact on the U.S. economy, telling CNBC's Kelly Evans on "The Exchange," "We have contained this. I won't say [it's] airtight, but it's pretty close to airtight."
Even top GOP lawmakers struggled to explain the inconsistent messages coming from the government.
"I can't comment on what the White House has been saying on this because the people who work for the White House are not saying that," said Sen. Roy Blunt, R-Mo.
The confused messaging threatened to obscure urgent public health advice coming from the CDC early Tuesday, when officials said the agency would be focusing on containing the spread of the virus in the United States, as well as warning people to prepare.
"Disruptions to everyday life may be severe, but people might want to start thinking about that now," said the CDC's Messonnier. She said parents may want to call their school offices to see what plans they have in place and consider options for child care. Messonnier added that she called the office of her children's schools superintendent to find out about the school system's plans.
Businesses need to consider replacing in-person meetings with telework, Messonnier said. School authorities should consider ways to limit face-to-face contact, such as dividing students into smaller groups, using Internet-based learning or even closing schools. Local officials should consider modifying, postponing or canceling large gatherings. Hospitals should consider ways to triage patients who do not need urgent care and recommend that patients delay surgery that isn't absolutely necessary.
Some senators who attended Tuesday's closed-door briefing played down any alarmist tone from health officials. However, Sen. Lamar Alexander, R-Tenn., said senators were told that the number of cases in the United States would inevitably grow.
"What we heard was that it's inevitable that we'll have more than 14 cases as time goes on," Alexander said. "And what we'll have to try to do is the same thing we've already done through quarantining and monitoring through our public health system to limit that as much as possible."
Sen. John Neely Kennedy, R-La., criticized the briefing for lawmakers, saying officials could not answer his basic questions while they issued dire warnings.
"I thought a lot of the briefing was bulls---," Kennedy said. "They would answer the question but dodge, bob and weave. I understand there's a lot they don't know. I get that. But they need to answer the questions straight up. They all talk about a task force, a committee - a committee's not going to solve this problem."
Blunt, Kennedy and Sen. Mitt Romney, R-Utah, were among GOP senators who told health officials about concerns during the closed-door briefing, including the level of spending the administration is prepared to commit, the adequacy of preparations and the length of time for development of a vaccine.
"I'm very disappointed in the preparation that's been done over the last few years anticipating the potential of an outbreak of substance," Romney said later.
Traveling in India this week, Trump said the United States was "very close to a vaccine." While top health officials have praised the record speed with which they expect to get a coronavirus vaccine into early clinical safety tests, it is likely to be a year or 18 months before the vaccine is widely available, said Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. Fauci said Tuesday that he expected phase-one testing of the vaccine to begin within six weeks if there are no glitches.
"It will still be an important tool for the future," Fauci said.
Testifying before a Senate appropriations subcommittee, Health and Human Services Secretary Alex Azar defended the administration's overall response and its $1.8 billion emergency spending plan for the virus, which includes $1.25 billion in new money and transfers of other funds from Ebola research. The total the administration proposes to spend to fight the virus is at least $2.5 billion, according to the plan released late Monday.
Democrats slammed the request as woefully inadequate and excoriated the administration for cutting public health budgets for years. Even some Republicans wondered whether it was enough.
"If you lowball something like this, you'll pay for it later," Senate Appropriations Committee Chairman Richard Shelby, R-Ala., told Azar. "You're not only dealing with the crisis, you're dealing with the perception of the American people," Shelby said, adding that the coronavirus could be an "existential threat" for many Americans.
"The steps the president has taken are the most aggressive containment measures ever taken," Azar said. "Our country is preparing every day."
Azar pushed back against senators' complaints. He pointed to the use of the first federal quarantine authority in more than 50 years to contain the virus and efforts to restrict travel from China. He said the administration's supplemental request focused on expanding surveillance for coronavirus in the United States, support for state and local governments, procuring and supporting research and development of vaccines and therapeutics, and acquiring additional personal protective equipment such as masks and ventilators.
Even before this week’s developments, most Americans - 55 percent - said they were concerned there would be a major coronavirus outbreak in the United States, with 57 percent voicing fears that the outbreak would hurt the economy, according to a Kaiser Family Foundation poll released Tuesday. The poll was conducted Feb. 13-18.