Coronavirus patients in Kansas range in age from 7 to 90

WASHINGTON (AP) — A series of missteps at the nation’s top public health agency caused a critical shortage of reliable laboratory tests for&nbsp;<a href="https://apnews.com/VirusOutbreak">the coronavirus</a>, hobbling the federal response as the pandemic spread across the country like wildfire, an Associated Press review found.

President Donald Trump assured Americans early this month that the COVID-19 test developed by the Centers for Disease Control and Prevention is “perfect” and that “anyone who wants a test can get a test.” But more than two months after the first U.S. case of the new disease was confirmed, many people still cannot get tested.

In the critical month of February, as the virus began taking root in the U.S. population, CDC data shows government labs processed 352 COVID-19 tests — an average of only a dozen per day.

“You cannot fight a fire blindfolded,” Tedros Adhanom Ghebreyesus, head of the World Health Organization, said at a recent briefing. “We cannot stop this pandemic if we don’t know who is infected.”

The Department of Health and Human Services, which includes the CDC, has begun an internal review to assess its own mistakes. But outside observers and federal health officials have pointed to four primary issues that together hampered the national response — the early decision not to use the test adopted by the World Health Organization, flaws with the more complex test developed by the CDC, government guidelines restricting who could be tested and delays in engaging the private sector to ramp up testing capacity.

Combined with&nbsp;<a href="https://apnews.com/67a9a72531ca2e332bea9225cec2fda5">messaging from the White House minimizing the disease</a>, that fueled a lackluster response that missed chances to slow the spread of the virus, they said.

“There were many, many opportunities not to end up where we are,” Dr. Ashish K. Jha, the director of the Global Health Institute at Harvard, told the AP. “Basically, they took this as business as usual. ... And that’s because the messaging from the White House was ‘this is not a big deal, this is no worse than the flu.’ So that message basically created no sense of urgency within the FDA or the CDC to fix it.”

Even as private labs have been cleared by government regulators to process tens of thousands of additional tests in the last two weeks, experts warn that the nation is still falling well short of enough testing capacity to keep ahead of&nbsp;<a href="https://apnews.com/UnderstandingtheOutbreak">the highly contagious virus</a>. And it can often take a week just to get results back.

Trump last week rated his administration’s response to the crisis as a perfect 10. However,&nbsp;<a href="https://apnews.com/432a37435f28015e8b45eeff710cd254">Dr. Anthony Fauci</a>, the director of the National Institute of Allergy and Infectious Diseases, said the CDC’s system wasn’t designed to test for and track a widespread outbreak, which he characterized as “a failing.”

In interviews with the AP, two federal health officials with direct knowledge of the situation said CDC experts don’t know why many of the agency’s test kits failed to reliably detect the virus. The officials spoke on the condition of anonymity because they were not authorized to speak publicly about what went wrong.

J. Stephen Morrison, a health policy expert at the Center for Strategic and International Studies in Washington, called the testing issues a “debacle,” contributing to what he described as a confused and delayed federal response to the crisis.

As a result, he said, the CDC has now been marginalized within the White House — a worrisome development.

“CDC has generally been regarded as the best in the game,” Morrison said. “I don’t think they anticipated the technical difficulty or the speed with which the virus has been moving. The virus was racing out ahead of them.”

On New Year’s Eve, Chinese scientists informed the World Health Organization about a cluster of 27 pneumonia cases of unknown cause in the industrial megalopolis of Wuhan that they linked to the city’s wholesale fish market. Less than two weeks later, the Chinese had sequenced the virus’ genetic makeup and shared it with the world.

Within days, German scientists had developed a test that could identify a unique part of the virus’ DNA. The WHO quickly adopted the German test,&nbsp;<a href="https://www.who.int/docs/default-source/coronaviruse/protocol-v2-1.pdf?sfvrsn=a9ef618c_2" target="_blank">publishing technical guidelines</a>&nbsp;on Jan. 17 and working with private companies to produce testing kits.

As they have done with some past outbreaks, officials at the CDC headquarters in Atlanta decided to develop their own test, focusing on three gene targets distinct from what the WHO used. Over the decades, the headquarters lab had built a track record of being among the first to develop tests for new diseases and quickly making them available for disease tracking.

The CDC published the technical details for its COVID-19 test on Jan. 28, 10 days after the WHO. By then, the virus had already been in the U.S. for at least two weeks.

The 35-year-old man who would become the first American to test positive had arrived in Seattle on Jan. 15, following a trip to Wuhan. After swabs from his nose and throat were flown to the CDC lab, federal officials announced the results Jan. 21.

In&nbsp;<a href="https://www.cnbc.com/2020/01/22/trump-on-coronavirus-from-china-we-have-it-totally-under-control.html" target="_blank">an interview on CNBC</a>&nbsp;the following day, the Republican president was asked about the risk to the nation.

“We have it totally under control,” he said. “It’s one person coming in from China. ... It’s going to be just fine.”

With limited capacity at the CDC lab in Atlanta, the agency placed strict criteria on who could be tested: people with fevers, coughing or difficulty breathing who had also visited Wuhan within the preceding two weeks or who had close contact with someone already confirmed or under investigation for having the virus.

On Jan. 30, the day the WHO declared the outbreak a public health emergency, Trump again assured the American people that the virus was “very well under control.”

Then he departed for a weekend at his Mar-a-Lago club in Florida, where he&nbsp;<a href="https://twitter.com/realDonaldTrump/status/1223640662689689602?s=20" target="_blank">tweeted a photo of himself playing golf</a>&nbsp;at his club in West Palm Beach.

“Getting a little exercise this morning!” the president wrote.

The following day, the U.S. declared its own emergency. Still, U.S. citizens returning from China who did not have a fever weren’t tested for the virus but were encouraged to self-quarantine at home for 14 days.

At that point, the CDC had confirmed just eight cases of COVID-19 in the U.S. The agency amended its testing criteria to include people with fevers who had traveled to China, rather than just Wuhan.

Four days after the U.S. declared a state of emergency, only 178 patients had been tested and 82 others were listed as “pending,” meaning they were awaiting final results, according to CDC data released at the time.

To help increase the number of people being screened, the Food and Drug Administration issued emergency authorization for CDC-certified labs run by state health departments to begin processing swabs, and they were provided with kits that could test 250 patients.

As the first tests were processed at the state labs, technicians reported getting inconclusive results, which the CDC has said could be due to the test looking for signs of generic coronaviruses, of which there are many, rather than the specific virus that causes COVID-19.

Whatever the reason, by mid-February, only about a half-dozen state and local public health labs had reliable tests. But still, CDC Director Dr. Robert Redfield continued to insist his agency had developed “a very accurate test.”

“We found that, in some of the states, it didn’t work,” Redfield&nbsp;<a href="https://www.whitehouse.gov/briefings-statements/remarks-president-trump-tour-centers-disease-control-prevention-atlanta-ga/" target="_blank">said earlier this month</a>. “We figured out why. I don’t consider that a fault. I consider that doing quality control. I consider that success.”

The testing problems emerged just as the CDC broadened its criteria to include patients who were “severely ill” with COVID-19 symptoms “even if a known source of exposure has not been identified.”

As more sick people sought to be tested, many states were forced to limit access because of the flawed CDC test. Accounts began to emerge through social media of people with all the symptoms of COVID-19 who either couldn’t get tested or had test results delayed by days or even a week.

“I know of doctor friends of mine who have critically ill patients in the ICU, and we don’t know if they have COVID or not because we can’t get a test,” Jha said last week.

On Feb. 24, exasperated officials at the Association of Public Health Laboratories sent a letter to the FDA, basically asking permission for state labs to develop their own tests. Within days, the FDA reversed its previous position and said both public and private labs could conduct testing.

Trump continued to insist the virus would die out on its own. “One day, it’s like a miracle. It will disappear,” he predicted Feb. 27.

By then, experts say, the opportunity to halt the relentless spread of the virus within the U.S. population had been lost.

On Feb. 29, only 472 patients had been tested nationwide, with just 22 cases confirmed, according to CDC data. Of those, nine cases were not related to travel but had spread person-to-person within the U.S.

By comparison, South Korea had its first confirmed case of COVID-19 on Jan. 20, the same day as the U.S. Officials there used a test that focused on the same gene targets as the WHO test, according to the website of a test manufacturer. They then quickly permitted private-sector labs to run the samples. As a result, a nation with less than one-sixth the population of the U.S. mobilized to test more than 20,000 people a day.

South Korea also instituted drive-thru centers, allowing quicker identification of those who were infected but might not be displaying symptoms, thus slowing the emergence of new cases to a more manageable level.

Meanwhile, the rate of U.S. infections soared.

“The system is not really geared to what we need right now, what you are asking for,”&nbsp;<a href="https://apnews.com/76b0f255426ad655a26e927062e1fef9">Fauci conceded during a congressional hearing</a>&nbsp;earlier this month. “That is a failing. Let’s admit it.”

As public outrage over the lack of available U.S. tests grew, the FDA announced it would allow private diagnostic lab companies to produce new tests without preauthorization from regulators.

Trump and HHS Secretary Alex Azar&nbsp;<a href="https://www.whitehouse.gov/briefings-statements/remarks-president-trump-tour-centers-disease-control-prevention-atlanta-ga/" target="_blank">visited the CDC lab</a>&nbsp;in Atlanta on March 6, praising the agency’s performance and promising 4 million test kits would be available by the end of the following week.

That lofty number didn’t match the ability of U.S. labs to process tests, however. Private providers were just then ramping up, while CDC and state health labs processed about 25,200 COVID-19 tests in the following seven days, according to CDC data.

At the same news conference, Trump said he wanted infected passengers to remain on a cruise ship off the West Coast to keep the number of confirmed COVID-19 cases in the U.S. low.

“I like the numbers being where they are,” Trump said, shortly before departing Atlanta for&nbsp;<a href="https://www.instagram.com/p/B9fP7XNHPWI/?utm_source=ig_embed" target="_blank">another weekend of golf in Florida</a>. “I don’t need to have the numbers double because of one ship that wasn’t our fault.”

Trump has also attempted to&nbsp;<a href="https://apnews.com/f4cd4c72e896d7fbd8ebd3516e864550">mislay blame</a>&nbsp;for the testing troubles on the Obama administration. In 2018, Trump disbanded the White House directorate charged with preparing for and responding to global pandemics.

“I don’t take responsibility at all,” Trump replied when asked about the testing shortfall in a March 13 briefing at the White House.

Morrison said Trump appears to see the virus as a political issue rather than a public health threat.

“You can imagine a White House that said, ‘Do whatever it takes to test everybody for the virus,’” he said. “That wasn’t the mentality. It was the opposite mentality, and ultimately the responsibility to protect the American people lies with the White House.”

Trump and other officials have falsely said they declined to use the WHO test because it isn’t reliable.

“Quality testing for our American people is paramount to us,” Deborah Birx, who is coordinating the U.S. coronavirus response, said last week. “It doesn’t help to put out a test where 50% or 47% are false positives.”

“It was a bad test,” Trump chimed in.

Tarik Jašarević, a WHO spokesman, told the AP last week that his agency had shipped 1.5 million testing kits manufactured in Germany to 120 countries around the globe, with no such problems emerging.

“The test has been validated in three external laboratories, adapted by WHO and manufactured in line with international quality standards,” he said. “It has shown consistently good performance in laboratory and clinical use, and neither a significant number of false-positive nor false-negative results have been reported.”

Over the past two weeks, U.S. testing capacity has surged, with private companies joining in. LabCorp began providing tests March 5, and Quest Diagnostics followed four days later. Tests also are being conducted at hospitals and other centers.

With the increased testing has come a skyrocketing number of confirmed cases, zooming from 43 at the beginning of March to 33,404 by Monday.

Only in the last few days has the United States finally begun testing more people each day than far smaller South Korea, according to data complied by Johns Hopkins University.

Jha estimates the U.S. should be testing 100,000 to 150,000 people per day — figures he said should be obtainable given the number of high-quality diagnostic labs in the country.

“We certainly have the capacity. It’s just we’re not doing it,” Jha said Thursday. “We are up to about 40,000 tests per day now — and so we are moving in the right direction. Still far from where we need to be, but moving.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1584219029698.png" alt="Photo courtesy Missouri Department of Health and&nbsp; Senior Services" />
 <figcaption>Photo courtesy Missouri Department of Health and&nbsp; Senior Services</figcaption>
 </figure>WASHINGTON (AP) — A series of missteps at the nation’s top public health agency caused a critical shortage of reliable laboratory tests for&nbsp;<a href="https://apnews.com/VirusOutbreak">the coronavirus</a>, hobbling the federal response as the pandemic spread across the country like wildfire, an Associated Press review found.President Donald Trump assured Americans early this month that the COVID-19 test developed by the Centers for Disease Control and Prevention is “perfect” and that “anyone who wants a test can get a test.” But more than two months after the first U.S. case of the new disease was confirmed, many people still cannot get tested.In the critical month of February, as the virus began taking root in the U.S. population, CDC data shows government labs processed 352 COVID-19 tests — an average of only a dozen per day.“You cannot fight a fire blindfolded,” Tedros Adhanom Ghebreyesus, head of the World Health Organization, said at a recent briefing. “We cannot stop this pandemic if we don’t know who is infected.”The Department of Health and Human Services, which includes the CDC, has begun an internal review to assess its own mistakes. But outside observers and federal health officials have pointed to four primary issues that together hampered the national response — the early decision not to use the test adopted by the World Health Organization, flaws with the more complex test developed by the CDC, government guidelines restricting who could be tested and delays in engaging the private sector to ramp up testing capacity.Combined with&nbsp;<a href="https://apnews.com/67a9a72531ca2e332bea9225cec2fda5">messaging from the White House minimizing the disease</a>, that fueled a lackluster response that missed chances to slow the spread of the virus, they said.“There were many, many opportunities not to end up where we are,” Dr. Ashish K. Jha, the director of the Global Health Institute at Harvard, told the AP. “Basically, they took this as business as usual. ... And that’s because the messaging from the White House was ‘this is not a big deal, this is no worse than the flu.’ So that message basically created no sense of urgency within the FDA or the CDC to fix it.”Even as private labs have been cleared by government regulators to process tens of thousands of additional tests in the last two weeks, experts warn that the nation is still falling well short of enough testing capacity to keep ahead of&nbsp;<a href="https://apnews.com/UnderstandingtheOutbreak">the highly contagious virus</a>. And it can often take a week just to get results back.Trump last week rated his administration’s response to the crisis as a perfect 10. However,&nbsp;<a href="https://apnews.com/432a37435f28015e8b45eeff710cd254">Dr. Anthony Fauci</a>, the director of the National Institute of Allergy and Infectious Diseases, said the CDC’s system wasn’t designed to test for and track a widespread outbreak, which he characterized as “a failing.”In interviews with the AP, two federal health officials with direct knowledge of the situation said CDC experts don’t know why many of the agency’s test kits failed to reliably detect the virus. The officials spoke on the condition of anonymity because they were not authorized to speak publicly about what went wrong.J. Stephen Morrison, a health policy expert at the Center for Strategic and International Studies in Washington, called the testing issues a “debacle,” contributing to what he described as a confused and delayed federal response to the crisis.As a result, he said, the CDC has now been marginalized within the White House — a worrisome development.“CDC has generally been regarded as the best in the game,” Morrison said. “I don’t think they anticipated the technical difficulty or the speed with which the virus has been moving. The virus was racing out ahead of them.”___FATEFUL DECISIONSOn New Year’s Eve, Chinese scientists informed the World Health Organization about a cluster of 27 pneumonia cases of unknown cause in the industrial megalopolis of Wuhan that they linked to the city’s wholesale fish market. Less than two weeks later, the Chinese had sequenced the virus’ genetic makeup and shared it with the world.Within days, German scientists had developed a test that could identify a unique part of the virus’ DNA. The WHO quickly adopted the German test,&nbsp;<a href="https://www.who.int/docs/default-source/coronaviruse/protocol-v2-1.pdf?sfvrsn=a9ef618c_2" target="_blank">publishing technical guidelines</a>&nbsp;on Jan. 17 and working with private companies to produce testing kits.As they have done with some past outbreaks, officials at the CDC headquarters in Atlanta decided to develop their own test, focusing on three gene targets distinct from what the WHO used. Over the decades, the headquarters lab had built a track record of being among the first to develop tests for new diseases and quickly making them available for disease tracking.The CDC published the technical details for its COVID-19 test on Jan. 28, 10 days after the WHO. By then, the virus had already been in the U.S. for at least two weeks.The 35-year-old man who would become the first American to test positive had arrived in Seattle on Jan. 15, following a trip to Wuhan. After swabs from his nose and throat were flown to the CDC lab, federal officials announced the results Jan. 21.In&nbsp;<a href="https://www.cnbc.com/2020/01/22/trump-on-coronavirus-from-china-we-have-it-totally-under-control.html" target="_blank">an interview on CNBC</a>&nbsp;the following day, the Republican president was asked about the risk to the nation.“We have it totally under control,” he said. “It’s one person coming in from China. ... It’s going to be just fine.”With limited capacity at the CDC lab in Atlanta, the agency placed strict criteria on who could be tested: people with fevers, coughing or difficulty breathing who had also visited Wuhan within the preceding two weeks or who had close contact with someone already confirmed or under investigation for having the virus.On Jan. 30, the day the WHO declared the outbreak a public health emergency, Trump again assured the American people that the virus was “very well under control.”Then he departed for a weekend at his Mar-a-Lago club in Florida, where he&nbsp;<a href="https://twitter.com/realDonaldTrump/status/1223640662689689602?s=20" target="_blank">tweeted a photo of himself playing golf</a>&nbsp;at his club in West Palm Beach.“Getting a little exercise this morning!” the president wrote.The following day, the U.S. declared its own emergency. Still, U.S. citizens returning from China who did not have a fever weren’t tested for the virus but were encouraged to self-quarantine at home for 14 days.At that point, the CDC had confirmed just eight cases of COVID-19 in the U.S. The agency amended its testing criteria to include people with fevers who had traveled to China, rather than just Wuhan.___FLAWED TEST KITSFour days after the U.S. declared a state of emergency, only 178 patients had been tested and 82 others were listed as “pending,” meaning they were awaiting final results, according to CDC data released at the time.To help increase the number of people being screened, the Food and Drug Administration issued emergency authorization for CDC-certified labs run by state health departments to begin processing swabs, and they were provided with kits that could test 250 patients.As the first tests were processed at the state labs, technicians reported getting inconclusive results, which the CDC has said could be due to the test looking for signs of generic coronaviruses, of which there are many, rather than the specific virus that causes COVID-19.Whatever the reason, by mid-February, only about a half-dozen state and local public health labs had reliable tests. But still, CDC Director Dr. Robert Redfield continued to insist his agency had developed “a very accurate test.”“We found that, in some of the states, it didn’t work,” Redfield&nbsp;<a href="https://www.whitehouse.gov/briefings-statements/remarks-president-trump-tour-centers-disease-control-prevention-atlanta-ga/" target="_blank">said earlier this month</a>. “We figured out why. I don’t consider that a fault. I consider that doing quality control. I consider that success.”The testing problems emerged just as the CDC broadened its criteria to include patients who were “severely ill” with COVID-19 symptoms “even if a known source of exposure has not been identified.”As more sick people sought to be tested, many states were forced to limit access because of the flawed CDC test. Accounts began to emerge through social media of people with all the symptoms of COVID-19 who either couldn’t get tested or had test results delayed by days or even a week.“I know of doctor friends of mine who have critically ill patients in the ICU, and we don’t know if they have COVID or not because we can’t get a test,” Jha said last week.___COMMUNITY TRANSMISSIONOn Feb. 24, exasperated officials at the Association of Public Health Laboratories sent a letter to the FDA, basically asking permission for state labs to develop their own tests. Within days, the FDA reversed its previous position and said both public and private labs could conduct testing.Trump continued to insist the virus would die out on its own. “One day, it’s like a miracle. It will disappear,” he predicted Feb. 27.By then, experts say, the opportunity to halt the relentless spread of the virus within the U.S. population had been lost.On Feb. 29, only 472 patients had been tested nationwide, with just 22 cases confirmed, according to CDC data. Of those, nine cases were not related to travel but had spread person-to-person within the U.S.By comparison, South Korea had its first confirmed case of COVID-19 on Jan. 20, the same day as the U.S. Officials there used a test that focused on the same gene targets as the WHO test, according to the website of a test manufacturer. They then quickly permitted private-sector labs to run the samples. As a result, a nation with less than one-sixth the population of the U.S. mobilized to test more than 20,000 people a day.South Korea also instituted drive-thru centers, allowing quicker identification of those who were infected but might not be displaying symptoms, thus slowing the emergence of new cases to a more manageable level.Meanwhile, the rate of U.S. infections soared.“The system is not really geared to what we need right now, what you are asking for,”&nbsp;<a href="https://apnews.com/76b0f255426ad655a26e927062e1fef9">Fauci conceded during a congressional hearing</a>&nbsp;earlier this month. “That is a failing. Let’s admit it.”___SHIFTING BLAMEAs public outrage over the lack of available U.S. tests grew, the FDA announced it would allow private diagnostic lab companies to produce new tests without preauthorization from regulators.Trump and HHS Secretary Alex Azar&nbsp;<a href="https://www.whitehouse.gov/briefings-statements/remarks-president-trump-tour-centers-disease-control-prevention-atlanta-ga/" target="_blank">visited the CDC lab</a>&nbsp;in Atlanta on March 6, praising the agency’s performance and promising 4 million test kits would be available by the end of the following week.That lofty number didn’t match the ability of U.S. labs to process tests, however. Private providers were just then ramping up, while CDC and state health labs processed about 25,200 COVID-19 tests in the following seven days, according to CDC data.At the same news conference, Trump said he wanted infected passengers to remain on a cruise ship off the West Coast to keep the number of confirmed COVID-19 cases in the U.S. low.“I like the numbers being where they are,” Trump said, shortly before departing Atlanta for&nbsp;<a href="https://www.instagram.com/p/B9fP7XNHPWI/?utm_source=ig_embed" target="_blank">another weekend of golf in Florida</a>. “I don’t need to have the numbers double because of one ship that wasn’t our fault.”Trump has also attempted to&nbsp;<a href="https://apnews.com/f4cd4c72e896d7fbd8ebd3516e864550">mislay blame</a>&nbsp;for the testing troubles on the Obama administration. In 2018, Trump disbanded the White House directorate charged with preparing for and responding to global pandemics.“I don’t take responsibility at all,” Trump replied when asked about the testing shortfall in a March 13 briefing at the White House.Morrison said Trump appears to see the virus as a political issue rather than a public health threat.“You can imagine a White House that said, ‘Do whatever it takes to test everybody for the virus,’” he said. “That wasn’t the mentality. It was the opposite mentality, and ultimately the responsibility to protect the American people lies with the White House.”Trump and other officials have falsely said they declined to use the WHO test because it isn’t reliable.“Quality testing for our American people is paramount to us,” Deborah Birx, who is coordinating the U.S. coronavirus response, said last week. “It doesn’t help to put out a test where 50% or 47% are false positives.”“It was a bad test,” Trump chimed in.Tarik Jašarević, a WHO spokesman, told the AP last week that his agency had shipped 1.5 million testing kits manufactured in Germany to 120 countries around the globe, with no such problems emerging.“The test has been validated in three external laboratories, adapted by WHO and manufactured in line with international quality standards,” he said. “It has shown consistently good performance in laboratory and clinical use, and neither a significant number of false-positive nor false-negative results have been reported.”Over the past two weeks, U.S. testing capacity has surged, with private companies joining in. LabCorp began providing tests March 5, and Quest Diagnostics followed four days later. Tests also are being conducted at hospitals and other centers.With the increased testing has come a skyrocketing number of confirmed cases, zooming from 43 at the beginning of March to 33,404 by Monday.Only in the last few days has the United States finally begun testing more people each day than far smaller South Korea, according to data complied by Johns Hopkins University.Jha estimates the U.S. should be testing 100,000 to 150,000 people per day — figures he said should be obtainable given the number of high-quality diagnostic labs in the country.“We certainly have the capacity. It’s just we’re not doing it,” Jha said Thursday. “We are up to about 40,000 tests per day now — and so we are moving in the right direction. Still far from where we need to be, but moving.”___

Testing blunders crippled US response as coronavirus spread

DICKINSON COUNTY —In an effort to deal with COVID-19, a Stay-at-Home order has been issued for Dickinson County residents, effective at 12:01 a.m. Wednesday, according to local Health Officer, Dr. Brian Holmes, and remains in effect until further notice.

On Tuesday morning, Sedgwick County joined other Kansas counties and issued a stay-at-home order for their 500,000-plus residents to prevent the spread of coronavirus. The emergency order is scheduled to begin on Wednesday and last 30-days. 

<a href="https://www.sedgwickcounty.org/media/56915/covid-19-order-for-stay-at-home.pdf">Click here to read a draft of the order.</a>

<a href="https://www.facebook.com/sedgwickcounty/videos/1089722544723589/">Click here to watch</a>&nbsp;Tuesday's Sedgwick County Coronavirus briefing.

Sedgwick County commission chair Pete Meitzner said during a Tuesday coronavirus press conference that Dr. Garold Minns, the county's health director had signed the stay-at-home order. Commissioners voted 3-2 approving the draft order during an emergency meeting Monday.

There are 4 confirmed cases of coronavirus in Sedgwick County, according to the KDHE.

On Monday, Gov. Laura Kelly announced that she will tighten restrictions on public gatherings and issue an executive order Tuesday to ban public gatherings of more than 10 people.

Kelly said she is not yet issuing a statewide shelter-in-place order as governors have done in some other states, including California, Illinois, Massachusetts, Michigan and New York, because 89 of Kansas' 105 counties had yet to see a confirmed coronavirus case as of Monday morning. But she warned that such an order could become “unavoidable in the coming days.”

Dr. Lee Norman, the state's health secretary, said Monday he expects Kansas to have between 300 and 400 confirmed cases by the end of March.

The Sedgwick County coronavirus hotline&nbsp; (316) 660-9000 or go to stayathomefaq@sedgeick.gov&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1585067404157.png" alt="Sedgwick County Commission chair Pete Meitzner spoke during Tuesday's announcement." />
 <figcaption>Sedgwick County Commission chair Pete Meitzner spoke during Tuesday's announcement.</figcaption>
 </figure>DICKINSON COUNTY —In an effort to deal with COVID-19, a Stay-at-Home order has been issued for Dickinson County residents, effective at 12:01 a.m. Wednesday, according to local Health Officer, Dr. Brian Holmes, and remains in effect until further notice.On Tuesday morning, Sedgwick County joined other Kansas counties and issued a stay-at-home order for their 500,000-plus residents to prevent the spread of coronavirus. The emergency order is scheduled to begin on Wednesday and last 30-days. <a href="https://www.sedgwickcounty.org/media/56915/covid-19-order-for-stay-at-home.pdf">Click here to read a draft of the order.</a><a href="https://www.facebook.com/sedgwickcounty/videos/1089722544723589/">Click here to watch</a>&nbsp;Tuesday's Sedgwick County Coronavirus briefing.Sedgwick County commission chair Pete Meitzner said during a Tuesday coronavirus press conference that Dr. Garold Minns, the county's health director had signed the stay-at-home order. Commissioners voted 3-2 approving the draft order during an emergency meeting Monday.There are 4 confirmed cases of coronavirus in Sedgwick County, according to the KDHE.On Monday, Gov. Laura Kelly announced that she will tighten restrictions on public gatherings and issue an executive order Tuesday to ban public gatherings of more than 10 people.Kelly said she is not yet issuing a statewide shelter-in-place order as governors have done in some other states, including California, Illinois, Massachusetts, Michigan and New York, because 89 of Kansas' 105 counties had yet to see a confirmed coronavirus case as of Monday morning. But she warned that such an order could become “unavoidable in the coming days.”Dr. Lee Norman, the state's health secretary, said Monday he expects Kansas to have between 300 and 400 confirmed cases by the end of March.The Sedgwick County coronavirus hotline&nbsp; (316) 660-9000 or go to stayathomefaq@sedgeick.gov&nbsp;

 Sedgwick and Dickinson Counties issue stay-at-home orders

Helping Hands is the title of a new initiative to help the elderly, handicapped and / or high risk people in Geary County who do not have the available resources to retrieve essential needs during this COVID-19 time. The program will allow delivery of pharmacy items, and groceries from Dillons and Wal Mart.&nbsp;

David Gilbert, Sheriff's Department Captain, said for example pharmacies would have prescriptions ready for delivery. "They would call us, we would go pick up their prescriptions. If they have groceries at the grocery pick up we could pick that up, take it out to their homes, drop it off on their porches. That way it limits contact for them and it will provide them their necessities to get through this time."

Pick up times would be limited to Monday through Friday 8 a.m. to 4 p.m. For those who participate you would need to provide your name, date of birth, address and location, the medication, medical supplies or groceries that need to be retrieved. The items must be prepaid for the Sheriff's Office to retrieve them.

The Sheriff's Department is also partnering with the Geary County 4-H / Senior Center where donations have been received from many in the community as well as calls from senior citizens who have been able to get necessities for&nbsp; various reasons. In this partnership the Sheriff's Office will help deliver the donations.

By Dewey TerrillJC PostHelping Hands is the title of a new initiative to help the elderly, handicapped and / or high risk people in Geary County who do not have the available resources to retrieve essential needs during this COVID-19 time. The program will allow delivery of pharmacy items, and groceries from Dillons and Wal Mart.&nbsp;David Gilbert, Sheriff's Department Captain, said for example pharmacies would have prescriptions ready for delivery. "They would call us, we would go pick up their prescriptions. If they have groceries at the grocery pick up we could pick that up, take it out to their homes, drop it off on their porches. That way it limits contact for them and it will provide them their necessities to get through this time."Pick up times would be limited to Monday through Friday 8 a.m. to 4 p.m. For those who participate you would need to provide your name, date of birth, address and location, the medication, medical supplies or groceries that need to be retrieved. The items must be prepaid for the Sheriff's Office to retrieve them.The Sheriff's Department is also partnering with the Geary County 4-H / Senior Center where donations have been received from many in the community as well as calls from senior citizens who have been able to get necessities for&nbsp; various reasons. In this partnership the Sheriff's Office will help deliver the donations.

Geary County Sheriff's Office will implement a Helping Hands initiative

TOKYO (AP) — The Tokyo Olympics have been officially postponed until 2021. The International Olympic Committee along with Japanese Prime Minister Shinzo Abe and local organizers have decided that the Tokyo Games cannot go ahead as scheduled this year because of the coronavirus outbreak. The games were scheduled to begin July 24.

<a href="https://www.olympic.org/news/joint-statement-from-the-international-olympic-committee-and-the-tokyo-2020-organising-committee">Click here to read the joint statement</a> from IOC and Tokyo organizing committee.

The IOC says the games will be held “not later than summer 2021” but they will still be called the 2020 Tokyo Olympics.

TOKYO&nbsp;(AP) — IOC President Thomas Bach has agreed “100%” to a proposal of postponing the Tokyo Olympics for about one year until 2021 because of the coronavirus outbreak, Japanese Prime Minister Shinzo Abe said Tuesday.

Abe said after his telephone talks with Bach that he requested a postponement of about one year “taking into consideration the current circumstances” and to secure an environment in which athletes can perform in their best conditions and the sense of safety and security for the audience.

Abe held telephone talks with Bach after the IOC said it would make a decision on the Tokyo Games over the next four weeks.

TOKYO (AP) — The Tokyo Olympics have been officially postponed until 2021. The International Olympic Committee along with Japanese Prime Minister Shinzo Abe and local organizers have decided that the Tokyo Games cannot go ahead as scheduled this year because of the coronavirus outbreak. The games were scheduled to begin July 24.<a href="https://www.olympic.org/news/joint-statement-from-the-international-olympic-committee-and-the-tokyo-2020-organising-committee">Click here to read the joint statement</a> from IOC and Tokyo organizing committee.<div><blockquote class="twitter-tweet">After his telephone talks with IOC President Bach, PM Abe spoke to the press and explained that the two have agreed that the Tokyo Olympic Games would not be cancelled, and the games will be held by the summer of 2021. <a href="https://t.co/ihe8To2g3R">pic.twitter.com/ihe8To2g3R</a>&mdash; PM&#39;s Office of Japan (@JPN_PMO) <a href="https://twitter.com/JPN_PMO/status/1242428276464812033?ref_src=twsrc%5Etfw">March 24, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>The IOC says the games will be held “not later than summer 2021” but they will still be called the 2020 Tokyo Olympics.<div><blockquote class="twitter-tweet">To safeguard the health of the athletes and everyone involved in the Tokyo 2020 Games. The Tokyo 2020 Olympic and Paralympic Games will now take place no later than summer 2021.&mdash; #Tokyo2020 (@Tokyo2020) <a href="https://twitter.com/Tokyo2020/status/1242440149310435328?ref_src=twsrc%5Etfw">March 24, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>--------TOKYO&nbsp;(AP) — IOC President Thomas Bach has agreed “100%” to a proposal of postponing the Tokyo Olympics for about one year until 2021 because of the coronavirus outbreak, Japanese Prime Minister Shinzo Abe said Tuesday.Abe said after his telephone talks with Bach that he requested a postponement of about one year “taking into consideration the current circumstances” and to secure an environment in which athletes can perform in their best conditions and the sense of safety and security for the audience.Abe held telephone talks with Bach after the IOC said it would make a decision on the Tokyo Games over the next four weeks.---------

2020 Summer Olympics postponed amid coronavirus pandemic

WASHINGTON (AP) — President Donald Trump said Monday that he wants to reopen the country for business in weeks, not months, and he claimed, without evidence, that continued closures could result in more deaths than the coronavirus pandemic.

“We can’t have the cure be worse than the problem,” Trump told reporters at a press briefing, echoing a midnight Sunday tweet. “We have to open our country because that causes problems that, in my opinion, could be far bigger problems.”

Trump acknowledged there were trade-offs, “there’s no question about that,” but claimed that, if closures stretch on for months, there would be “probably more death from that than anything that we’re talking about with respect to the virus.”

The comments were further evidence that Trump has grown impatient with the pandemic, even before it has reached its expected peak. In recent days, tensions have been rising between those who argue the country needs to get back up and running to prevent a deep economic depression, and medical experts who warn that, unless more extreme action is taken, the human cost will be catastrophic.

Health experts have made clear that unless Americans continue to dramatically limit social interaction — staying home from work and isolating themselves — the number of infections will overwhelm the health care system, as it has in parts of Italy, leading to many more deaths. While the worst outbreaks are concentrated in certain parts of the country, such as New York, experts warn that the highly infectious disease is certain to spread.

But with the economic impact now snapping into focus with millions out of work, businesses shuttered and the markets in free fall — all undermining Trump’s reelection message — the chorus of backlash is growing louder.

“We can’t shut in the economy. The economic cost to individuals is just too great,” Larry Kudlow, Trump’s top economic adviser, said in an interview Monday on Fox News Channel. “The president is right. The cure can’t be worse than the disease, and we’re going to have to make some difficult trade-offs.”

It’s an opinion that has been echoed by others in the White House, some Republicans in Congress and on Fox, where host Steve Hilton delivered a monologue Sunday night that appeared to have, at least partially, inspired Trump’s tweet.

“You know that famous phrase, the cure is worse than the disease? That is exactly the territory we’re hurtling towards,” Hilton told his viewers, describing the economic, social and human impact of the shutdown as an “even bigger crisis” than the virus.

“You think it’s just the coronavirus that kills people? This total economic shutdown will kill people,” he said, pointing to growing poverty and despair.

The White House, which for the last two weeks has largely allowed doctors to lead the administration’s response, already seemed to be shifting in that direction.

“I’m not looking at months, I can tell you right now,” Trump said Monday, adding that America will soon be back open for business. He said, though, that states could continue to enforce stricter measures.

Even as Trump tweeted that he would be waiting until the end of the current 15-day period of recommended closures and self-isolation to make any decisions, the Centers for Disease Control and Prevention was exploring new guidance making it possible for people working in “critical infrastructure” jobs who have been exposed to the virus to return to work faster “by wearing a mask for a certain period of time,” Vice President Mike Pence said.

It’s a change in tone that is drawing criticism from public health experts, who suggested Trump risks making a dangerous mistake if he sets up a conflict between public health and the nation’s economic well-being, given how unlikely it is that the threat posed by the virus will subside in another week.

If the U.S. stops social distancing too soon, “you will have more deaths and more dives in the stock market,” warned Lawrence Gostin of Georgetown University, a lawyer with extensive public health expertise.

And the outbreak could come surging back once people return to their normal routines of commuting, working, dining out and socializing — further stressing the economy.

John Auerbach, president of the nonpartisan Trust for America’s Health, which works with governments at all levels to improve preparedness for public health emergencies, said widespread illness and death also have a powerful economic impact that’s impossible to ignore or play down.

“If you don’t flatten the curve and minimize those who are getting infected, the amount of sickness will cripple business,” said Auerbach.

Even Republican Sen. Lindsey Graham of South Carolina, a close Trump ally, urged Trump to stick with the advice of public health officials.

“There is no functioning economy unless we control the virus,” he warned on Twitter. “Try running an economy with major hospitals overflowing, doctors and nurses forced to stop treating some because they can’t help all, and every moment of gut-wrenching medical chaos being played out in our living rooms, on TV, on social media, and shown all around the world.”

But Stephen Moore, a former Trump economic adviser, said it’s time now “to start thinking about what kind of dramatic costs to society are we absorbing from the shutdown,” including tens of millions unemployed and potential spikes in drug overdoses and suicides.

He said he has been urging his former colleagues to selectively open the economy in ways that minimize the public health risk with more testing and, for instance, taking people’s temperature in public places, as they are now doing in other countries.

“There’s no good solutions here. There’s just bad solutions,” Moore conceded. “And to me, the worst solution is to just grind our economy to a halt.”

Other economists warned that if Americans return to work too soon, there could be recurring outbreaks that would only worsen a recession. But if the period of isolation continues for too long, there will be a steep cost in trying to restart and sustain economic growth.

Joe Brusuelas, chief economist at the consultancy RSM, said lifting restrictions after 15 days would be “potentially a profound policy mistake” because it could lead to a second or third wave of outbreaks that would do even more harm to economic growth.

“We got one shot to get this all right,” Brusuelas said, noting that Trump has a great deal at stake personally, given the upcoming election in November. “The last thing one would want to do from an economic policy perspective is to elevate one’s electoral interests above that of the economy or, most importantly, public health.”

Analysts at Morgan Stanley estimated Monday that the economy will shrink at a record-breaking annualized pace of 30% in the second quarter. The unemployment rate would surge to 12.8% — the highest level ever in data that go back to the 1940s. But this forecast assumes the outbreak peaks in late April, after which there would be fewer reasons to restrict economic activity, and a sharp rebound would begin in the June-August quarter, leading to solid growth in 2021.

Austan Goolsbee, an economist at the University of Chicago and a former adviser to President Barack Obama, says there is no real tension between containing the outbreak and preserving the U.S. economy. He has repeatedly emphasized that halting the outbreak is needed so that growth can resume as companies feel comfortable hiring and consumers ramp up spending.

“Anything that slows the spread of the virus is by far the best thing to restore the economy,” Goolsbee wrote on Twitter.

For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

Worldwide, more than 375,000 cases have been reported, and while most people recover in weeks, more than 16,000 have died from the virus

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1585001637945.png" alt="President Trump during Monday's Coronavirus Task Force briefing-image courtesy White House" />
 <figcaption>President Trump during Monday's Coronavirus Task Force briefing-image courtesy White House</figcaption>
 </figure>WASHINGTON (AP) — President Donald Trump said Monday that he wants to reopen the country for business in weeks, not months, and he claimed, without evidence, that continued closures could result in more deaths than the coronavirus pandemic.“We can’t have the cure be worse than the problem,” Trump told reporters at a press briefing, echoing a midnight Sunday tweet. “We have to open our country because that causes problems that, in my opinion, could be far bigger problems.”Trump acknowledged there were trade-offs, “there’s no question about that,” but claimed that, if closures stretch on for months, there would be “probably more death from that than anything that we’re talking about with respect to the virus.”The comments were further evidence that Trump has grown impatient with the pandemic, even before it has reached its expected peak. In recent days, tensions have been rising between those who argue the country needs to get back up and running to prevent a deep economic depression, and medical experts who warn that, unless more extreme action is taken, the human cost will be catastrophic.Health experts have made clear that unless Americans continue to dramatically limit social interaction — staying home from work and isolating themselves — the number of infections will overwhelm the health care system, as it has in parts of Italy, leading to many more deaths. While the worst outbreaks are concentrated in certain parts of the country, such as New York, experts warn that the highly infectious disease is certain to spread.But with the economic impact now snapping into focus with millions out of work, businesses shuttered and the markets in free fall — all undermining Trump’s reelection message — the chorus of backlash is growing louder.“We can’t shut in the economy. The economic cost to individuals is just too great,” Larry Kudlow, Trump’s top economic adviser, said in an interview Monday on Fox News Channel. “The president is right. The cure can’t be worse than the disease, and we’re going to have to make some difficult trade-offs.”It’s an opinion that has been echoed by others in the White House, some Republicans in Congress and on Fox, where host Steve Hilton delivered a monologue Sunday night that appeared to have, at least partially, inspired Trump’s tweet.“You know that famous phrase, the cure is worse than the disease? That is exactly the territory we’re hurtling towards,” Hilton told his viewers, describing the economic, social and human impact of the shutdown as an “even bigger crisis” than the virus.“You think it’s just the coronavirus that kills people? This total economic shutdown will kill people,” he said, pointing to growing poverty and despair.The White House, which for the last two weeks has largely allowed doctors to lead the administration’s response, already seemed to be shifting in that direction.“I’m not looking at months, I can tell you right now,” Trump said Monday, adding that America will soon be back open for business. He said, though, that states could continue to enforce stricter measures.Even as Trump tweeted that he would be waiting until the end of the current 15-day period of recommended closures and self-isolation to make any decisions, the Centers for Disease Control and Prevention was exploring new guidance making it possible for people working in “critical infrastructure” jobs who have been exposed to the virus to return to work faster “by wearing a mask for a certain period of time,” Vice President Mike Pence said.It’s a change in tone that is drawing criticism from public health experts, who suggested Trump risks making a dangerous mistake if he sets up a conflict between public health and the nation’s economic well-being, given how unlikely it is that the threat posed by the virus will subside in another week.If the U.S. stops social distancing too soon, “you will have more deaths and more dives in the stock market,” warned Lawrence Gostin of Georgetown University, a lawyer with extensive public health expertise.And the outbreak could come surging back once people return to their normal routines of commuting, working, dining out and socializing — further stressing the economy.John Auerbach, president of the nonpartisan Trust for America’s Health, which works with governments at all levels to improve preparedness for public health emergencies, said widespread illness and death also have a powerful economic impact that’s impossible to ignore or play down.“If you don’t flatten the curve and minimize those who are getting infected, the amount of sickness will cripple business,” said Auerbach.Even Republican Sen. Lindsey Graham of South Carolina, a close Trump ally, urged Trump to stick with the advice of public health officials.“There is no functioning economy unless we control the virus,” he warned on Twitter. “Try running an economy with major hospitals overflowing, doctors and nurses forced to stop treating some because they can’t help all, and every moment of gut-wrenching medical chaos being played out in our living rooms, on TV, on social media, and shown all around the world.”But Stephen Moore, a former Trump economic adviser, said it’s time now “to start thinking about what kind of dramatic costs to society are we absorbing from the shutdown,” including tens of millions unemployed and potential spikes in drug overdoses and suicides.He said he has been urging his former colleagues to selectively open the economy in ways that minimize the public health risk with more testing and, for instance, taking people’s temperature in public places, as they are now doing in other countries.“There’s no good solutions here. There’s just bad solutions,” Moore conceded. “And to me, the worst solution is to just grind our economy to a halt.”Other economists warned that if Americans return to work too soon, there could be recurring outbreaks that would only worsen a recession. But if the period of isolation continues for too long, there will be a steep cost in trying to restart and sustain economic growth.Joe Brusuelas, chief economist at the consultancy RSM, said lifting restrictions after 15 days would be “potentially a profound policy mistake” because it could lead to a second or third wave of outbreaks that would do even more harm to economic growth.“We got one shot to get this all right,” Brusuelas said, noting that Trump has a great deal at stake personally, given the upcoming election in November. “The last thing one would want to do from an economic policy perspective is to elevate one’s electoral interests above that of the economy or, most importantly, public health.”Analysts at Morgan Stanley estimated Monday that the economy will shrink at a record-breaking annualized pace of 30% in the second quarter. The unemployment rate would surge to 12.8% — the highest level ever in data that go back to the 1940s. But this forecast assumes the outbreak peaks in late April, after which there would be fewer reasons to restrict economic activity, and a sharp rebound would begin in the June-August quarter, leading to solid growth in 2021.Austan Goolsbee, an economist at the University of Chicago and a former adviser to President Barack Obama, says there is no real tension between containing the outbreak and preserving the U.S. economy. He has repeatedly emphasized that halting the outbreak is needed so that growth can resume as companies feel comfortable hiring and consumers ramp up spending.“Anything that slows the spread of the virus is by far the best thing to restore the economy,” Goolsbee wrote on Twitter.For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.Worldwide, more than 375,000 cases have been reported, and while most people recover in weeks, more than 16,000 have died from the virus

Trump says he intends to reopen country in weeks, not months

WICHITA, Kan. (AP) — Aircraft parts maker Spirit Aerosystems announced Tuesday that it was temporarily halting work for Boeing that is performed in Wichita and two Oklahoma facilities amid an outbreak of the coronavirus. 

The move came after Boeing announced Monday that it was suspending operations at its Seattle area facilities. At least 110 people have died from COVID-19 in Washington state, mostly in the Seattle area. Boeing employs about 70,000 people in the region. 

The company said 32 employees have tested positive for the virus, including 25 in the greater Seattle area.

WICHITA, Kan. (AP) — Aircraft parts maker Spirit Aerosystems announced Tuesday that it was temporarily halting work for Boeing that is performed in Wichita and two Oklahoma facilities amid an outbreak of the coronavirus. The move came after Boeing announced Monday that it was suspending operations at its Seattle area facilities. At least 110 people have died from COVID-19 in Washington state, mostly in the Seattle area. Boeing employs about 70,000 people in the region. The company said 32 employees have tested positive for the virus, including 25 in the greater Seattle area.

Kan. aircraft parts maker temporarily suspends Boeing work

WASHINGTON (AP) — Top congressional and White House officials emerged from grueling negotiations at the Capitol over&nbsp;<a href="https://apnews.com/be6a343cc5a8ee6672a135a96849a4d4">the nearly $2 trillion coronavirus rescue package</a>&nbsp;saying they expected to reach a deal Tuesday.

Treasury Secretary Steven Mnuchin and Senate Democratic leader Chuck Schumer said they had spoken by phone with President Donald Trump during the long night of negotiations. While the two sides have resolved many issues in the sweeping package, some remain.

At midnight Monday, they emerged separately to say talks would continue into the night.

“We look forward to having a deal tomorrow,” Mnuchin told reporters after exiting Schumer's office.

“The president is giving us direction," Mnuhcin said. "The president would like to have a deal, and he's hopeful we can conclude this.”

Moments later, Schumer agreed that a deal was almost within reach. “That's the expectation — that we finish it tomorrow and hopefully vote on it tomorrow evening," he said.

The long evening of shuttle negotiations came after a long day trying to close the deal. The massive package is a far-reaching effort to prop up the U.S. economy, help American households and bolster the health care system amid the growing crisis. Mnuchin said talks were expected to resume at 9:30 a.m. EDT.

Tensions flared Monday as Washington strained to respond to&nbsp;<a href="https://apnews.com/VirusOutbreak">the worsening coronavirus outbreak</a>, with Congress arguing over a nearly $2 trillion economic rescue package and an impatient Trump musing openly about letting the&nbsp;<a href="https://apnews.com/5d272073cbbc43b63d0ae7d9caeeeb6e">15-day shutdown</a>&nbsp;expire next Monday, March 30.

As the U.S. braces for an onslaught of sick Americans, and millions are&nbsp;<a href="https://apnews.com/d1ddda5b644a9cdd6b844a196377b88e">forced indoors</a>&nbsp;to avert a spike that risks overwhelming hospitals, the most ambitious federal intervention in modern times is testing whether Washington can act swiftly to deal with&nbsp;<a href="https://apnews.com/UnderstandingtheOutbreak">the pandemic</a>&nbsp;on the home front.

“It’s time to get with the program, time to pass historic relief,” said an angry Senate Majority Leader Mitch McConnell earlier in the day as he opened the chamber after a nonstop weekend session that failed to produce a deal. “This is a national emergency.”

Fuming, McConnell warned Democrats — pointedly House Speaker Nancy Pelosi — to quit stalling on “political games,” as he described Democratic efforts to steer more of the aid toward public health and workers, and push other priorities.

Trump, who has largely been hands off from the negotiations, weighed in late Monday from the White House briefing room, declaring that Congress should vote “for the Senate bill as written," dismissing any Democratic proposal.

“It must go quickly," Trump said. “This is not the time for political agendas."

The Republican president also sounded a note of frustration about the unprecedented modern-day effort to halt the virus' march by essentially shutting down public activities in ways that now threaten the U.S. economy.

Even though Trump's administration recommended Americans curtail activities starting a week ago, the president said: “We cannot let the cure be worse than the problem itself. At the end of the 15-day period, we will make a decision as to which way we want to go.”

“Let's go to work," he said. “This country was not built to be shut down. This is not a county that was built for this.”

Trump said that he may soon allow parts of the nation's economy, in regions less badly hit by the virus, to begin reopening, contradicting the advice of medical and public health experts across the country, if not the globe, to&nbsp;<a href="https://apnews.com/1510caddee80ea2d73363fab76d55967">hunker down even more firmly</a>.

Pelosi assailed Trump's idea and fluctuating response to the crisis.

"He's a notion-monger, just tossing out things that have no relationship to a well-coordinated, science-based, government-wide response to this," Pelosi said on a health care conference call. "Thank God for the governors who are taking the lead in their state. Thank God for some of the people in the administration who speak truth to power.”

The White House team led by Mnuchin worked on Capitol Hill for a fourth straight day of talks as negotiators narrowed on a bipartisan accord.

In the nearly empty building, the virus continued to strike close. Republican Sen. Rand Paul of Kentucky, who announced&nbsp;<a href="https://apnews.com/c3db22a242e9577126052dece8285d2f">he tested positive for coronavirus</a>, is now among five senators under self-quarantine. Several other lawmakers have cycled in and out of isolation. And the husband of Sen. Amy Klobuchar, D-Minnesota, is&nbsp;<a href="https://apnews.com/8a4cd664a9c403394b54973148caf522">in a hospital with pneumonia after testing positive</a>, she said Monday.

First lady Melania Trump, meanwhile, has tested negative for the coronavirus, Trump said.

With a wary population watching and waiting, Washington labored under the size and scope of a rescue package — larger than&nbsp;<a href="https://apnews.com/e00c645ac9badfeaf4faddcffd5d02d6">the 2008 bank bailout</a>&nbsp;and 2009 recovery act combined.

Democrats are holding out as they argue the package is tilted toward corporations and should do more to help suddenly jobless workers and health care providers with dire needs.

In particular, Schumer, D-N.Y., wants constraints on the largely Republican-led effort to provide $500 billion for corporations, which Democrats have called a “slush fund.” Schumer wants the bill to limit stock buy-backs, CEO pay and layoffs.

Yet, he said, “We're very close to reaching a deal." Even so, another attempt to move the package forward snagged, blocked as Democrats refused to quit negotiating.

Democrats won one concession — to provide four months of expanded unemployment benefits, rather than just three as proposed, according to an official granted anonymity to discuss the private talks. The jobless pay also would extend to self-employed and so-called gig workers.

But Republicans complained Democrats were holding out for more labor protections for workers, wanting assurances that corporations taking federal aid will commit to retaining their employees.

Pelosi came out with the House Democrats' own sweeping $2.5 trillion bill, which would provide $1,500 directly to the public and $200 billion to the states, as governors are pleading for aid. She urged Senate negotiators “to move closer to the values” in it.

Trump has balked at using his authority under the recently invoked Defense Protection Act to compel the private sector to manufacture needed medical supplies like masks and ventilators, even as he encourages them to spur production. “We are a country not based on nationalizing our business,” said Trump, who has repeatedly railed against socialism overseas and among Democrats.

From his home, Democratic presidential rival Joe Biden criticized Trump for stopping short of using the full force of emergency federal authority .

“Trump keeps saying he’s a wartime president,” Biden said in an online address. “Well, start acting like one.”

On the economic front, the Federal Reserve announced Monday it will lend to small and large businesses and local governments as well as extend its bond-buying programs as part of a series of sweeping steps to support the flow of credit through an economy ravaged by the viral outbreak.

Central to the emerging rescue package is as much as $350 billion for small businesses to keep making payroll while workers are forced to stay home. The package also proposes a one-time rebate of about $1,200 per person, or $3,000 for a family of four, as well as extended unemployment benefits.

Hospitals would get about $110 billion for the expected influx of sick patients, said Mnuchin. But Democrats are pushing for more health-care dollars for the front-line hospitals and workers.

The urgency to act is mounting, as jobless claims skyrocket and financial markets are eager for signs that Washington can soften the blow of the health-care crisis and what experts say is a looming recession.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.

WASHINGTON (AP) — Tensions flared Monday as Washington strained to respond to the worsening coronavirus outbreak, with Congress arguing over a nearly $2 trillion economic rescue package and an impatient President Donald Trump musing openly about letting the&nbsp;<a href="https://apnews.com/5d272073cbbc43b63d0ae7d9caeeeb6e">15-day shutdown&nbsp;</a>expire.

As the U.S. braces for an onslaught of sick Americans, and millions are&nbsp;<a href="https://apnews.com/d1ddda5b644a9cdd6b844a196377b88e">forced indoors&nbsp;</a>to avert a spike that risks overwhelming hospitals, the most ambitious federal intervention in modern times is testing whether Washington can swiftly halt the pandemic on the home-front.

“It’s time to get with the program, time to pass historic relief,” said an angry Senate Majority Leader Mitch McConnell as he opened the chamber after a nonstop weekend session that failed to produce a deal. “This is a national emergency.”

The White House team led by Treasury Secretary Steven Mnuchin returned to Capitol Hill for a fourth straight day of talks as negotiators narrowed on a bipartisan accord.

“We’re making a lot of progress,” Mnuchin said midday as he shuttled through the halls.

But McConnell fumed, warning Democrats — pointedly House Speaker Nancy Pelosi — to quit stalling on “political games,” as he described Democratic efforts to steer more of the aid toward public health and workers.

From the White House, Trump sounded a note of frustration about the unprecedented modern-day effort to halt the virus’s march by essentially shutting down public activities in ways that now threaten the U.S. economy.

Even though Trump’s administration recommended Americans curtail activities starting a week ago, the president in all capital letters tweeted: “We cannot let the cure be worse than the problem itself. At the end of the 15-day period, we will make a decision as to which way we want to go.”

His musing contradicts the advice of medical and public health experts across the country, if not the globe, to hunker down even more firmly.

Pelosi assailed Trump’s idea and fluctuating response to the crisis.

“He’s a notion-monger, just tossing out things that have no relationship to a well coordinated, science-based, government-wide response to this,” Pelosi said on a health-care conference call. “Thank God for the governors who are taking the lead in their state. Thank God for some of the people in the administration who speak truth to power.”

At the Capitol, the virus continued to strike close. Republican Sen. Rand Paul of Kentucky, who announced he tested positive for coronavirus, is now among five senators under self-quarantine. Several other lawmakers have cycled in and out of isolation. And the husband of Sen. Amy Klobuchar, D-Minn., is in a hospital with pneumonia after testing positive, she said Monday.

In particular, Senate Democratic leader Chuck Schumer, D-N.Y., wants constraints on the largely Republican-led effort to provide $500 billion for corporations. Democrats call that a “slush fund.”

Yet, he said, “We’re very close to reaching a deal.” Even so, another attempt to move the package forward snagged, blocked as Democrats refused to quit negotiating.

Pelosi came out with the House Democrats’ own sweeping $2.5 trillion bill, which would provide $1,500 directly to the public and $200 billion to the states, as governors are pleading for aid. She urged Senate negotiators “to move closer to the values” in it.

WASHINGTON (AP) — Top congressional and White House officials emerged from grueling negotiations at the Capitol over&nbsp;<a href="https://apnews.com/be6a343cc5a8ee6672a135a96849a4d4">the nearly $2 trillion coronavirus rescue package</a>&nbsp;saying they expected to reach a deal Tuesday.<div><blockquote class="twitter-tweet">It is time we put partisanship aside and pass the Coronavirus Aid, Relief, and Economic Security Act. I took to the Senate floor today to urge my colleagues to do right by the American people. Watch here: <a href="https://t.co/DkQ7XdfWwV">https://t.co/DkQ7XdfWwV</a>&mdash; Senator Pat Roberts (@SenPatRoberts) <a href="https://twitter.com/SenPatRoberts/status/1242220966073241607?ref_src=twsrc%5Etfw">March 23, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>Treasury Secretary Steven Mnuchin and Senate Democratic leader Chuck Schumer said they had spoken by phone with President Donald Trump during the long night of negotiations. While the two sides have resolved many issues in the sweeping package, some remain.At midnight Monday, they emerged separately to say talks would continue into the night.“We look forward to having a deal tomorrow,” Mnuchin told reporters after exiting Schumer's office.“The president is giving us direction," Mnuhcin said. "The president would like to have a deal, and he's hopeful we can conclude this.”Moments later, Schumer agreed that a deal was almost within reach. “That's the expectation — that we finish it tomorrow and hopefully vote on it tomorrow evening," he said.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1585044728915.png" alt="U.S. Senate&nbsp; staff were busy during negotiations late Monday-image courtesy Sen. Lamar Alexander" />
 <figcaption>U.S. Senate&nbsp; staff were busy during negotiations late Monday-image courtesy Sen. Lamar Alexander</figcaption>
 </figure>The long evening of shuttle negotiations came after a long day trying to close the deal. The massive package is a far-reaching effort to prop up the U.S. economy, help American households and bolster the health care system amid the growing crisis. Mnuchin said talks were expected to resume at 9:30 a.m. EDT.Tensions flared Monday as Washington strained to respond to&nbsp;<a href="https://apnews.com/VirusOutbreak">the worsening coronavirus outbreak</a>, with Congress arguing over a nearly $2 trillion economic rescue package and an impatient Trump musing openly about letting the&nbsp;<a href="https://apnews.com/5d272073cbbc43b63d0ae7d9caeeeb6e">15-day shutdown</a>&nbsp;expire next Monday, March 30.As the U.S. braces for an onslaught of sick Americans, and millions are&nbsp;<a href="https://apnews.com/d1ddda5b644a9cdd6b844a196377b88e">forced indoors</a>&nbsp;to avert a spike that risks overwhelming hospitals, the most ambitious federal intervention in modern times is testing whether Washington can act swiftly to deal with&nbsp;<a href="https://apnews.com/UnderstandingtheOutbreak">the pandemic</a>&nbsp;on the home front.“It’s time to get with the program, time to pass historic relief,” said an angry Senate Majority Leader Mitch McConnell earlier in the day as he opened the chamber after a nonstop weekend session that failed to produce a deal. “This is a national emergency.”Fuming, McConnell warned Democrats — pointedly House Speaker Nancy Pelosi — to quit stalling on “political games,” as he described Democratic efforts to steer more of the aid toward public health and workers, and push other priorities.Trump, who has largely been hands off from the negotiations, weighed in late Monday from the White House briefing room, declaring that Congress should vote “for the Senate bill as written," dismissing any Democratic proposal.“It must go quickly," Trump said. “This is not the time for political agendas."The Republican president also sounded a note of frustration about the unprecedented modern-day effort to halt the virus' march by essentially shutting down public activities in ways that now threaten the U.S. economy.Even though Trump's administration recommended Americans curtail activities starting a week ago, the president said: “We cannot let the cure be worse than the problem itself. At the end of the 15-day period, we will make a decision as to which way we want to go.”“Let's go to work," he said. “This country was not built to be shut down. This is not a county that was built for this.”Trump said that he may soon allow parts of the nation's economy, in regions less badly hit by the virus, to begin reopening, contradicting the advice of medical and public health experts across the country, if not the globe, to&nbsp;<a href="https://apnews.com/1510caddee80ea2d73363fab76d55967">hunker down even more firmly</a>.Pelosi assailed Trump's idea and fluctuating response to the crisis."He's a notion-monger, just tossing out things that have no relationship to a well-coordinated, science-based, government-wide response to this," Pelosi said on a health care conference call. "Thank God for the governors who are taking the lead in their state. Thank God for some of the people in the administration who speak truth to power.”The White House team led by Mnuchin worked on Capitol Hill for a fourth straight day of talks as negotiators narrowed on a bipartisan accord.In the nearly empty building, the virus continued to strike close. Republican Sen. Rand Paul of Kentucky, who announced&nbsp;<a href="https://apnews.com/c3db22a242e9577126052dece8285d2f">he tested positive for coronavirus</a>, is now among five senators under self-quarantine. Several other lawmakers have cycled in and out of isolation. And the husband of Sen. Amy Klobuchar, D-Minnesota, is&nbsp;<a href="https://apnews.com/8a4cd664a9c403394b54973148caf522">in a hospital with pneumonia after testing positive</a>, she said Monday.First lady Melania Trump, meanwhile, has tested negative for the coronavirus, Trump said.With a wary population watching and waiting, Washington labored under the size and scope of a rescue package — larger than&nbsp;<a href="https://apnews.com/e00c645ac9badfeaf4faddcffd5d02d6">the 2008 bank bailout</a>&nbsp;and 2009 recovery act combined.Democrats are holding out as they argue the package is tilted toward corporations and should do more to help suddenly jobless workers and health care providers with dire needs.In particular, Schumer, D-N.Y., wants constraints on the largely Republican-led effort to provide $500 billion for corporations, which Democrats have called a “slush fund.” Schumer wants the bill to limit stock buy-backs, CEO pay and layoffs.Yet, he said, “We're very close to reaching a deal." Even so, another attempt to move the package forward snagged, blocked as Democrats refused to quit negotiating.Democrats won one concession — to provide four months of expanded unemployment benefits, rather than just three as proposed, according to an official granted anonymity to discuss the private talks. The jobless pay also would extend to self-employed and so-called gig workers.But Republicans complained Democrats were holding out for more labor protections for workers, wanting assurances that corporations taking federal aid will commit to retaining their employees.Pelosi came out with the House Democrats' own sweeping $2.5 trillion bill, which would provide $1,500 directly to the public and $200 billion to the states, as governors are pleading for aid. She urged Senate negotiators “to move closer to the values” in it.Trump has balked at using his authority under the recently invoked Defense Protection Act to compel the private sector to manufacture needed medical supplies like masks and ventilators, even as he encourages them to spur production. “We are a country not based on nationalizing our business,” said Trump, who has repeatedly railed against socialism overseas and among Democrats.From his home, Democratic presidential rival Joe Biden criticized Trump for stopping short of using the full force of emergency federal authority .“Trump keeps saying he’s a wartime president,” Biden said in an online address. “Well, start acting like one.”On the economic front, the Federal Reserve announced Monday it will lend to small and large businesses and local governments as well as extend its bond-buying programs as part of a series of sweeping steps to support the flow of credit through an economy ravaged by the viral outbreak.Central to the emerging rescue package is as much as $350 billion for small businesses to keep making payroll while workers are forced to stay home. The package also proposes a one-time rebate of about $1,200 per person, or $3,000 for a family of four, as well as extended unemployment benefits.Hospitals would get about $110 billion for the expected influx of sick patients, said Mnuchin. But Democrats are pushing for more health-care dollars for the front-line hospitals and workers.The urgency to act is mounting, as jobless claims skyrocket and financial markets are eager for signs that Washington can soften the blow of the health-care crisis and what experts say is a looming recession.For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.———<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1584991015310.png" alt="House Speaker Nancy Pelosi assailed Trump’s idea and fluctuating response to the crisis.-image courtesy office of House Speaker" />
 <figcaption>House Speaker Nancy Pelosi assailed Trump’s idea and fluctuating response to the crisis.-image courtesy office of House Speaker</figcaption>
 </figure>WASHINGTON (AP) — Tensions flared Monday as Washington strained to respond to the worsening coronavirus outbreak, with Congress arguing over a nearly $2 trillion economic rescue package and an impatient President Donald Trump musing openly about letting the&nbsp;<a href="https://apnews.com/5d272073cbbc43b63d0ae7d9caeeeb6e">15-day shutdown&nbsp;</a>expire.As the U.S. braces for an onslaught of sick Americans, and millions are&nbsp;<a href="https://apnews.com/d1ddda5b644a9cdd6b844a196377b88e">forced indoors&nbsp;</a>to avert a spike that risks overwhelming hospitals, the most ambitious federal intervention in modern times is testing whether Washington can swiftly halt the pandemic on the home-front.“It’s time to get with the program, time to pass historic relief,” said an angry Senate Majority Leader Mitch McConnell as he opened the chamber after a nonstop weekend session that failed to produce a deal. “This is a national emergency.”The White House team led by Treasury Secretary Steven Mnuchin returned to Capitol Hill for a fourth straight day of talks as negotiators narrowed on a bipartisan accord.“We’re making a lot of progress,” Mnuchin said midday as he shuttled through the halls.But McConnell fumed, warning Democrats — pointedly House Speaker Nancy Pelosi — to quit stalling on “political games,” as he described Democratic efforts to steer more of the aid toward public health and workers.From the White House, Trump sounded a note of frustration about the unprecedented modern-day effort to halt the virus’s march by essentially shutting down public activities in ways that now threaten the U.S. economy.Even though Trump’s administration recommended Americans curtail activities starting a week ago, the president in all capital letters tweeted: “We cannot let the cure be worse than the problem itself. At the end of the 15-day period, we will make a decision as to which way we want to go.”His musing contradicts the advice of medical and public health experts across the country, if not the globe, to hunker down even more firmly.<div><blockquote class="twitter-tweet">Today, we mark the 10th anniversary of the Affordable Care Act and introduce the third <a href="https://twitter.com/hashtag/FamiliesFirst?src=hash&amp;ref_src=twsrc%5Etfw">#FamiliesFirst</a> proposal, the Take Responsibility for Workers and Families Act. <a href="https://t.co/90N9ahn72B">https://t.co/90N9ahn72B</a>&mdash; Nancy Pelosi (@SpeakerPelosi) <a href="https://twitter.com/SpeakerPelosi/status/1242150100987719687?ref_src=twsrc%5Etfw">March 23, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>Pelosi assailed Trump’s idea and fluctuating response to the crisis.“He’s a notion-monger, just tossing out things that have no relationship to a well coordinated, science-based, government-wide response to this,” Pelosi said on a health-care conference call. “Thank God for the governors who are taking the lead in their state. Thank God for some of the people in the administration who speak truth to power.”At the Capitol, the virus continued to strike close. Republican Sen. Rand Paul of Kentucky, who announced he tested positive for coronavirus, is now among five senators under self-quarantine. Several other lawmakers have cycled in and out of isolation. And the husband of Sen. Amy Klobuchar, D-Minn., is in a hospital with pneumonia after testing positive, she said Monday.With a wary population watching and waiting, Washington labored under the size and scope of a rescue package — larger than&nbsp;<a href="https://apnews.com/e00c645ac9badfeaf4faddcffd5d02d6">the 2008 bank bailout</a>&nbsp;and 2009 recovery act combined.Democrats are holding out as they argue the package is tilted toward corporations and should do more to help suddenly jobless workers and health care providers with dire needs.In particular, Senate Democratic leader Chuck Schumer, D-N.Y., wants constraints on the largely Republican-led effort to provide $500 billion for corporations. Democrats call that a “slush fund.”Yet, he said, “We’re very close to reaching a deal.” Even so, another attempt to move the package forward snagged, blocked as Democrats refused to quit negotiating.Democrats won one concession — to provide four months of expanded unemployment benefits, rather than just three as proposed, according to an official granted anonymity to discuss the private talks. The jobless pay also would extend to self-employed and so-called gig workers.But Republicans complained Democrats were holding out for more labor protections for workers, wanting assurances that corporations taking federal aid will commit to retaining their employees.Pelosi came out with the House Democrats’ own sweeping $2.5 trillion bill, which would provide $1,500 directly to the public and $200 billion to the states, as governors are pleading for aid. She urged Senate negotiators “to move closer to the values” in it.Trump has balked at using his authority under the recently invoked Defense Protection Act to compel the private sector to manufacture needed medical supplies like masks and ventilators, even as he encourages them to spur production. “We are a country not based on nationalizing our business,” said Trump, who has repeatedly railed against socialism overseas and among Democrats.From his home, Democratic presidential rival Joe Biden criticized Trump for stopping short of using the full force of emergency federal authority .“Trump keeps saying he’s a wartime president,” Biden said in an online address. “Well, start acting like one.”On the economic front, the Federal Reserve announced Monday it will lend to small and large businesses and local governments as well as extend its bond-buying programs as part of a series of sweeping steps to support the flow of credit through an economy ravaged by the viral outbreak.Central to the emerging rescue package is as much as $350 billion for small businesses to keep making payroll while workers are forced to stay home. The package also proposes a one-time rebate of about $1,200 per person, or $3,000 for a family of four, as well as extended unemployment benefits.Hospitals would get about $110 billion for the expected influx of sick patients, said Mnuchin. But Democrats are pushing for more health-care dollars for the front-line hospitals and workers.The urgency to act is mounting, as jobless claims skyrocket and financial markets are eager for signs that Washington can soften the blow of the health-care crisis and what experts say is a looming recession.For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.___

Negotiators inch closer on a nearly $2 trillion virus aid package

By DAN MARGOLIES <a href="https://www.kcur.org/post/most-kansas-city-area-hospitals-put-elective-surgeries-prepare-covid-19#stream/0">Kansas News Service</a>

As
 the coronavirus continues its relentless spread, hospitals are making 
tough decisions about postponing or canceling elective procedures.

Earlier
 this week, the Centers for Medicare and Medicaid Services recommended 
that providers consider a range of factors in determining whether to 
postpone surgery or other procedures. They include patient risk, urgency
 of the procedure, bed availability, staffing and the availability of 
personal protective equipment.

“The reality is clear and the 
stakes are high: we need to preserve personal protective equipment for 
those on the front lines of this fight,” CMS Administrator Seema Verma 
said in a statement Wednesday.

The University of Kansas Health 
System, which operates the area’s largest hospital, has indefinitely 
postponed all elective procedures.

“It’s part of our conservation
 efforts to make sure that we have enough supplies,” said spokeswoman 
Jill Chadwick. “And it's to help protect patients whose annual check-up,
 etc., can wait. We know social distancing works and we are assessing 
everyday how to do our part.”&nbsp;&nbsp;

In a conference call with 
reporters Friday, Steve Stites, KU’s chief medical officer, said the 
hospital’s operating rooms were currently operating at about 25% 
capacity because most elective procedures had been canceled or deferred.

He
 said KU had prioritized cases into three tiers: ones that can readily 
be postponed, such as cosmetic surgery; ones with a risk of harm, where 
the physician and patient need to make an informed decision about what 
the relative harm and risk may be; and ones that can't be postponed.

“So cases that you have to do are cancer surgery,” Stites said. “You can’t let the tumor grow.”

Stites
 said the measures were being taken to conserve personal protective 
equipment in the expectation of an influx of COVID-19 patients in coming
 weeks.

“We're trying to conserve as much as we can right now for
 the eventual rapid increase in the number of COVID-19 patients inside 
the hospital,” Stites said. “And that’s the reason we've been holding 
back surgery, in order to preserve our personal protective equipment.”

At
 Saint Luke’s Health System, another large hospital network, elective 
procedures are being deferred, although what constitutes “elective” in 
some cases is being left to physicians’ discretion.

“We are 
deferring all cases that can be safely deferred,” spokeswoman Laurel 
Gifford said. “Some technically elective procedures are still medically 
necessary so our physicians and surgeons are reviewing them on a 
case-by-case basis. But I think it’s safe to say that all cases that are
 not required at this point and where it’s in the best interests of the 
patient, are being rescheduled and deferred to a later date.”

HCA
 Midwest Health, the largest hospital operator in the Kansas City area, 
said it’s following CMS’ guidelines but also deferring to the clinical 
judgment of its physicians.

“Our COVID-19 preparedness efforts 
include reinforcing infection prevention protocols and guidance from the
 CDC, sourcing necessary supplies and equipment, and emergency planning,
 so our hospitals are prepared to safely meet the needs of all of our 
patients and protect the health and well-being of our colleagues,” HCA 
spokeswoman Christine Hamele said.

Safety-net hospital Truman 
Medical Centers is postponing “anything that’s true elective surgery,” 
according to spokeswoman Leslie Carto.

“There are some, like a 
malignancy that can possibly wait but they have the diagnosis, those are
 being done. But anything truly elective – those are being canceled,” 
Carto said.

At least one local healthcare provider, AdventHealth 
System, which operates AdventHealth Shawnee Mission (formerly known 
Shawnee Mission Medical Center, has not postponed elective procedures.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/3/1584973978568.png" alt="The University of Kansas Health System has postponed elective surgeries to prepare for an influx of coronavirus patients. KU Hospital" />
 <figcaption>The University of Kansas Health System has postponed elective surgeries to prepare for an influx of coronavirus patients. KU Hospital</figcaption>
 </figure>By DAN MARGOLIES <a href="https://www.kcur.org/post/most-kansas-city-area-hospitals-put-elective-surgeries-prepare-covid-19#stream/0">Kansas News Service</a>As
 the coronavirus continues its relentless spread, hospitals are making 
tough decisions about postponing or canceling elective procedures.Earlier
 this week, the Centers for Medicare and Medicaid Services recommended 
that providers consider a range of factors in determining whether to 
postpone surgery or other procedures. They include patient risk, urgency
 of the procedure, bed availability, staffing and the availability of 
personal protective equipment.“The reality is clear and the 
stakes are high: we need to preserve personal protective equipment for 
those on the front lines of this fight,” CMS Administrator Seema Verma 
said in a statement Wednesday.The University of Kansas Health 
System, which operates the area’s largest hospital, has indefinitely 
postponed all elective procedures.“It’s part of our conservation
 efforts to make sure that we have enough supplies,” said spokeswoman 
Jill Chadwick. “And it's to help protect patients whose annual check-up,
 etc., can wait. We know social distancing works and we are assessing 
everyday how to do our part.”&nbsp;&nbsp;In a conference call with 
reporters Friday, Steve Stites, KU’s chief medical officer, said the 
hospital’s operating rooms were currently operating at about 25% 
capacity because most elective procedures had been canceled or deferred.He
 said KU had prioritized cases into three tiers: ones that can readily 
be postponed, such as cosmetic surgery; ones with a risk of harm, where 
the physician and patient need to make an informed decision about what 
the relative harm and risk may be; and ones that can't be postponed.“So cases that you have to do are cancer surgery,” Stites said. “You can’t let the tumor grow.”Stites
 said the measures were being taken to conserve personal protective 
equipment in the expectation of an influx of COVID-19 patients in coming
 weeks.“We're trying to conserve as much as we can right now for
 the eventual rapid increase in the number of COVID-19 patients inside 
the hospital,” Stites said. “And that’s the reason we've been holding 
back surgery, in order to preserve our personal protective equipment.”At
 Saint Luke’s Health System, another large hospital network, elective 
procedures are being deferred, although what constitutes “elective” in 
some cases is being left to physicians’ discretion.“We are 
deferring all cases that can be safely deferred,” spokeswoman Laurel 
Gifford said. “Some technically elective procedures are still medically 
necessary so our physicians and surgeons are reviewing them on a 
case-by-case basis. But I think it’s safe to say that all cases that are
 not required at this point and where it’s in the best interests of the 
patient, are being rescheduled and deferred to a later date.”HCA
 Midwest Health, the largest hospital operator in the Kansas City area, 
said it’s following CMS’ guidelines but also deferring to the clinical 
judgment of its physicians.“Our COVID-19 preparedness efforts 
include reinforcing infection prevention protocols and guidance from the
 CDC, sourcing necessary supplies and equipment, and emergency planning,
 so our hospitals are prepared to safely meet the needs of all of our 
patients and protect the health and well-being of our colleagues,” HCA 
spokeswoman Christine Hamele said.Safety-net hospital Truman 
Medical Centers is postponing “anything that’s true elective surgery,” 
according to spokeswoman Leslie Carto.“There are some, like a 
malignancy that can possibly wait but they have the diagnosis, those are
 being done. But anything truly elective – those are being canceled,” 
Carto said.At least one local healthcare provider, AdventHealth 
System, which operates AdventHealth Shawnee Mission (formerly known 
Shawnee Mission Medical Center, has not postponed elective procedures.“We
 haven’t told (physicians) that they need to cancel things. I will tell 
you that’s something that’s being reviewed daily and that position can 
change,” Adventist spokeswoman Morgan Shandler said.At the top 
of its website, AdventHealth posted this notice: “While preventing the 
spread of COVID-19 and treating COVID-19 patients is of highest priority
 in our community, we recognize that we have many patients with medical 
needs unrelated to COVID-19 that still need addressed. At this time, 
AdventHealth Shawnee Mission has not cancelled or delayed scheduled 
procedures. However, individual physicians are reviewing their scheduled
 cases and may opt to postpone elective cases that are not time 
sensitive. If your case will be postponed, your physician’s office will 
contact you directly. We will continue to update this policy as the 
situation with COVID-19 evolves.”Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter <a href="https://twitter.com/DanMargolies">@DanMargolies</a>.

Coronavirus Update