Covid-19 Live Updates: Top U.S. Officials Instructed the C.D.C. to Change Testing Guidelines

The C.D.C. was pressured to change guidance on testing asymptomatic people who had been exposed to the virus.

The Centers for Disease Control and Prevention was instructed by higher-ups in the Trump administration to modify its coronavirus testing guidelines this week to exclude people who do not have symptoms of Covid-19 — even if they have been recently exposed to the virus, according to two federal health officials.

One official said the directive came from the top down. Another said the guidelines were not written by the C.D.C. but were imposed, Sheryl Gay Stolberg reports for The Times.

Admiral Brett M. Giroir, the administration’s coronavirus testing czar, told reporters the guidelines ultimately belong to the C.D.C., specifically its director, Dr. Robert Redfield. But he also said other members of President Trump’s coronavirus task force were involved.

“Let me tell you right up front that the new guidelines are a C.D.C. action,” Dr. Giroir said. “As always, guidelines received appropriate attention, consultation and input from task force experts — and I mean the medical and scientific experts — including C.D.C. director Redfield and myself.”

But the final debate over the guidance took place at a task force meeting last Thursday, the same day Dr. Anthony S. Fauci, a member of the task force, was having surgery under general anesthesia to remove a polyp on his vocal cord, and he was not present, according to a person familiar with Dr. Fauci’s thinking. Dr. Fauci has “some concerns,” this person said, about advising against testing for people exposed to the virus, which is spread by asymptomatic people as well as those with symptoms.

The newest version of the guidelines, posted on Monday, amended the agency’s guidance to say that people who have been in close contact with an infected individual — typically defined as being within six feet of a person with the coronavirus and for at least 15 minutes — “do not necessarily need a test” if they do not have symptoms. Scientists and epidemiologists say people infected with the virus can spread it even if they show no symptoms.

Exceptions, the agency noted, might be made for “vulnerable” individuals, or if health care providers or state or local public health officials recommend testing.

Mr. Trump has suggested that the nation should do less testing, arguing that doing more tests was driving coronavirus case numbers up, making the United States look bad. But experts say the true measure of the pandemic is not case numbers, but test positivity rate — the percentage of tests coming back positive.

But Dr. Giroir denied that politics were involved.

“There was no weight on the scales by the president or the vice president or Secretary Azar,” he said, referring to Alex M. Azar II, the secretary of health and human services. “This was a product produced by the scientific and medical people that was discussed extensively at the task force.”

Experts have called the revisions alarming and dangerous, noting that the country needs more testing, not less. And they have expressed deep concern that the C.D.C. is posting guidelines that its own officials did not author. The former C.D.C. director, Tom Frieden, railed against the move on Twitter:

Case numbers remain persistently high across much of the United States, though they have been falling in recent weeks, to an average of about 42,000 new cases a day from a peak of more than 66,000 last month. Many of the states that saw the largest outbreaks in early summer are now reporting sustained progress, including Arizona and Florida. But parts of the Midwest, as well as Hawaii and some U.S. territories, are still seeing increases in new cases.

But Dr. Giroir made the case that getting tested soon after you are exposed to the virus is pointless because it can take several days for the virus to show on a test.

“A negative test on Day 2 doesn’t mean you’re negative,” he said. “So what is the value of that? It doesn’t mean on Day 4 you can go out and visit grandma or Day 6 go without a mask.” He added, “We’re trying to get appropriate testing, not less testing.”

N.Y.C.’s subway and bus service would be reduced by 40 percent without federal aid, the M.T.A. warns.

Facing a staggering financial crisis and a stalemate in Washington, the Metropolitan Transportation Authority threatened on Wednesday to adopt a doomsday plan if it did not receive as much as $ 12 billion in federal aid, including slashing subway and bus service in New York City by 40 percent.

The plan paints a bleak picture for riders: Wait times would increase by eight minutes on the subway and 15 minutes on buses; Long Island Rail Road and Metro-North trains would run at 60- or 120-minute intervals. Upgrades to the subway’s signal systems, which have been the source of many delays, would be scrapped.

The M.T.A. — which runs the city’s subway, buses and the two commuter rails — laid out the plan as part of a broader political strategy to pressure Washington to provide assistance.

The state-run agency is facing a staggering $ 16.2 billion deficit through 2024, after the pandemic wiped out its operating revenue — which comes from fares, tolls and subsidies — virtually overnight. Ridership on the subway, which plummeted by 90 percent in April, has only reached a quarter of usual levels, even as more and more New Yorkers return to work.

The transit agency has requested $ 12 billion in aid to cover its operating losses through 2024. But after negotiations over the next stimulus package stalled earlier this month, immediate federal support did not appear to be forthcoming. Throughout the city, between the elbow bumps and happy hours, lurked a deep and intense anxiety over what might lie ahead, as summer gave way to autumn and a new rash of frightening unknowns. In interviews, New Yorkers, even as they leaned into summer activities and visited parks and cafes, shared a common foreboding that looked beyond the virus itself.

Education ROUNDUP

At U.S.C., classes are online, but university officials report an ‘alarming increase’ in cases anyway.

A Monopoly game, a study group and other small gatherings in off-campus apartments have landed more than 100 students in quarantine at the University of Southern California, where health officials have reported an “alarming increase” in cases in the first week of the fall semester, even though classes are almost entirely online.

At least 43 U.S.C. students have tested positive since Aug. 16, the day before classes started, according to a memo released this week by university health officials. At least 14 of the cases were identified through testing of people without symptoms; others were identified through contact tracing and testing of symptomatic and exposed students.

The numbers are small compared with those of schools like the University of Alabama, where more than 500 infections were reported this week, days after the resumption of classes. But they were striking given U.S.C.’s extensive preventive efforts.

Instruction has been almost entirely remote because of high infection rates in the surrounding Los Angeles County, and only about 700 of the school’s 48,500 students are living in campus housing, according to Jeremy Pepper, a campus spokesman. Access to the campus has been restricted, and students have been advised by the university to stay home if they can.

But because of leases that couldn’t be broken or the desire for social interaction, many students — as at other institutions around the country — have moved into apartment buildings near campus.

Earlier this month, a photo of a crowded bash at a big off-campus apartment complex near U.S.C. went viral on Reddit. But the current surge is arising from smaller, more mundane venues.

Among those now in quarantine, Ms. Tilley said, are three students apparently infected during a Monopoly game and a five-person study group in which at least four students tested positive.

“We’re not hearing about big parties,” Ms. Tilley said. “We’re hearing, ‘Three girls across the hall came over for dinner, and then the next day, we visited some other friends at their apartment.’”

In other education news:

• A New York Times survey found more than 26,000 cases at more than 750 American colleges and universities over the course of the pandemic. Clusters of cases have emerged in recent weeks in dorms, on Greek rows and at college bars, in some cases upending plans for the fall semester. Stuart Bell, the University of Alabama president, warned in a note to students and employees this week that those who violated health restrictions were “subject to harsh disciplinary action, up to and including suspension.” More than 500 cases have already been identified on Alabama’s flagship campus in Tuscaloosa.

• The pandemic continues to undermine plans for even a truncated, diminished college football season, less than two weeks before its scheduled start. North Carolina State and Virginia Tech, who were to play their Atlantic Coast Conference game on Sept. 12, said on Wednesday that the matchup would be postponed until Sept. 26 because of a cluster of cases within N.C. State’s athletic department. Other programs are also struggling. Texas Tech announced on Tuesday that it had 21 active cases in its football program, and Coach Lincoln Riley of the University of Oklahoma told reporters that an entire position group — except for one player — had to stop practicing because of positive test results.

• With nations determined to return to in-person learning, many will have trouble matching Germany’s formula: fast and free testing, robust contact tracing and low community spread.

Should I stay or should I go? When a storm threatens a virus hot spot, it may not be an easy call.

The decision to evacuate when a hurricane looms can be a difficult one in the best of circumstances. It becomes even more agonizing in the grip of a pandemic.

As Hurricane Laura roars toward Louisiana and Texas, many people living in the storm’s path, especially those with heightened vulnerability or with older relatives to care for, have had to weigh the risk of riding out the storm at home against the risk of exposure to the virus if they flee. Others lack the means to escape because their livelihoods have been eviscerated as the economy cratered.

Those two states were hit hard by the virus over the summer, though they have made some progress lately, with daily reports of new cases declining somewhat from their July peaks, according to a New York Times database. Louisiana has had more virus cases per capita than any other state in the country. And Arkansas, where it appears the storm will head next as it moves inland, has been struggling with rising deaths from the virus.

Like many of his neighbors, Chris Vinn of Lake Charles, La., got busy boarding up his house soon after officials issued a mandatory evacuation order. Mr. Vinn, who tested positive for the virus in July, and his family decided to leave, but not to an evacuation center. They booked an Airbnb about three hours’ drive away in Lafayette instead.

“We do try to take safety precautions as much as possible, so we did not want to be in a hotel full of people or run to a shelter or anything like that,” Mr. Vinn said. “It’s going to get us away from people and give us some privacy.”

Memories of another major storm, Hurricane Rita in 2005, kept Amy L’Hoste from evacuating from Lake Charles this time. She said she did not want to repeat the terrifying experience of riding out that storm at her grandparents’ house in Ragley, La., about 20 miles north. “I’ll never forget waking up the next morning, and it looked like a war zone,” she said.

This time, she said, she will hunker down on her own.

As of Wednesday morning, the State of Louisiana had evacuated about 900 people who lacked ready access to transportation out of the Lake Charles area to hotel rooms elsewhere, mostly around Baton Rouge, according to Mike Steele, a state spokesman.

Louisiana was also preparing to mark the 15th anniversary of Hurricane Katrina on Saturday. Unlike the storm’s 10th anniversary, when current and former presidents visited and the city drew international attention, the commemorations this year will be understated, mainly because of the pandemic.

GLOBAL ROUNDUP

Kenya’s president extends a nationwide 9 p.m. curfew for another 30 days.

Kenya’s president, Uhuru Kenyatta, has extended a nightly nationwide curfew aimed at curbing the pandemic as the virus burrows deeper into the East African nation.

In a speech delivered on Wednesday, Mr. Kenyatta said that while Kenyans were responsibly following Covid-19 protocols and infections had been reduced to a “manageable level,” the disease was still spreading.

“The new frontier of this invisible enemy is increasingly shifting to the counties and rural areas,” he said.

Kenya has reported 33,016 cases and 564 deaths from the virus.

The curfew runs from 9 p.m. to 4 a.m., and will be extended for another 30 days. Mr. Kenyatta said that the closure of bars and nightclubs would continue for another month, and that restaurants should close at 8 p.m. instead of 7 p.m.

Investigations related to stolen funds at government medical agencies should conclude in the next three weeks, Mr. Kenyatta added. Allegations of impropriety had pushed public medical workers to go on strike last week, creating a dire health care crisis.

Mr. Kenyatta also lifted a ban on the secondhand clothing trade that the authorities had instituted in late March as a precautionary measure.

In other news from around the world:

• The World Economic Forum is pushing back its annual summit in Davos, Switzerland, from January to early next summer, it announced on Wednesday. The annual gathering of the global elite in the Alps normally brings together about 3,000 of the world’s most prominent executives and political leaders. Organizers made the decision to postpone on the advice of experts, who said the gathering could not convene safely in January.

• For the first time in three months, virus infections in South Africa have fallen below 2,000 per day. The country saw a peak of 13,944 daily cases in July, but recorded 1,677 on Monday and 1,567 on Tuesday. But as confirmed cases are decreasing, fewer tests are being carried out, Health Minister Zweli Mkhize said this week.

• The Vatican announced on Wednesday that, starting next month, Pope Francis would resume his weekly Wednesday audience in public, six months after the coronavirus put a halt to the pontiff’s participatory events with the faithful.

• Days before schools are set to open in Britain, Prime Minister Boris Johnson said on Wednesday that it would be “clearly nonsensical” for students to wear face masks in class. “You can’t teach with face coverings, you can’t expect people to learn with face coverings. The most important thing is just to wash your hands,” Mr. Johnson said. In areas where local lockdowns are in place, students and staff members will be required to wear masks in communal areas with the exception of classrooms, where the government said “protective measures already mean the risks are lower.”

• North Korea’s leader, Kim Jong-un, has urged his government to eliminate “shortcomings” and “​defects” in its battle against Covid-19, state media reported. The country has reported no infections, but outside experts are skeptical, citing its decrepit public health system and its proximity to China, where the virus was first detected.

• The local authorities have tightened restrictions in Marseille, the second-largest city in France, where the per capita rate of cases is more than four times the national rate. Under the new rules, which begin on Wednesday night and will remain in effect until at least Sept. 30, wearing a mask will be mandatory throughout the city. Bars and restaurants in the Bouches-du-Rhône region, which includes Marseille, will have to close overnight.

• Phil Hogan, the influential trade commissioner for the European Union, resigned Wednesday night over breaches of virus guidelines during a recent dinner with lawmakers and other public figures in his native Ireland. The dinner, attended by about 80 politicians and government officials, violated a ban on large gatherings and fueled a sense that the powerful consider themselves above the rules they impose on others. The uproar had already led to the resignation of Ireland’s agriculture minister and the disciplining of several lawmakers.

• The Hamas-run Health Ministry in the blockaded Gaza Strip announced 21 new cases of community transmission of the virus on Wednesday and two virus-related deaths as the authorities sought to contain the pandemic. Yousef Abu Rish, the deputy health minister, told a news conference in Gaza City on Wednesday that he expected “more and more” infections in the coming days, but emphasized that there was still an opportunity to contain the pandemic.

A study finds a clue about why the virus hits men harder than women.

Older men are up to twice as likely to become severely sick and to die from the coronavirus as women of the same age.

Why? The first study to look at immune response by sex has turned up a clue: Men produce a weaker immune response to the virus than women, the researchers concluded.

The findings, published on Wednesday in Nature, suggest that men, particularly those over 60, may need to depend more on vaccines to protect against the infection.

“Natural infection is clearly failing” to spark adequate immune responses in men, said Akiko Iwasaki, an immunologist at Yale who led the work.

The results are consistent with what’s known about sex differences following various challenges to the immune system. Women mount faster and stronger immune responses, perhaps because their bodies are rigged to fight pathogens that threaten unborn or newborn children.

The findings underscore the need for companies pursing vaccines to parse their data by sex and may influence decisions about dosing, said Dr. Marcus Altfeld, an immunologist at the Heinrich Pette Institute and at the University Medical Center Hamburg-Eppendorf in Germany, and other experts.

“You could imagine scenarios where a single shot of a vaccine might be sufficient in young individuals or maybe young women, while older men might need to have three shots of vaccine,” Dr. Altfeld said.

u.s. roundup

Long shielded by geography, U.S. islands see cases grow.

American islands in the Caribbean and Pacific, including the state of Hawaii, are emerging as some of the nation’s most alarming virus hot spots.

For months, geographic isolation helped spare Hawaii, Guam and the U.S. Virgin Islands early on. All adopted early mitigation efforts, and were able to restrict travelers more readily than mainland states could.

But their cases are surging now, revealing how the virus can spread rapidly in places with relaxed restrictions, sluggish contact tracing and widespread pressure to end the economic pain that comes with lockdowns.

Inconsistent reopenings have sown confusion in Hawaii, especially in Honolulu, where gyms remain open but hiking trails and parks are closed. Restaurants in the city are open, but residents are not supposed to entertain visitors at home. Hawaii now ranks among the states where new cases have grown fastest over the past 14 days.

The situation on Guam, an American territory in the western Pacific, seems especially problematic. Cases are emerging in several schools, at the territorial port authority and in an emergency dispatch center.

The U.S. military has a major presence on Guam, with large naval and air bases. When the aircraft carrier Theodore Roosevelt was stricken with a virus outbreak in the spring, the ship put in to Guam, and hundreds of sailors were quarantined on shore.

The U.S. Virgin Islands, which registered almost no cases in the early days of the pandemic, is now dealing with nearly 1,000 new cases a day, pushing its per capita infection numbers higher than those of several states. The authorities are shutting nonessential businesses and imposing stay-at-home orders, checking all visitors’ temperatures and conducting aggressive testing of residents.

One exception to the crisis unfolding on U.S. islands: American Samoa, an archipelago in the Pacific, remains the only territory or state in the country without a single confirmed case.

In other news from around the United States:

• New Mexico will allow indoor dining to resume on Saturday at restaurants, bars and similar establishments, at 25 percent of normal capacity, the office of Gov. Michelle Lujan Grisham said in a statement. Houses of worship will be allowed to operate at 40 percent of capacity, up from 25 percent now.

• In New Jersey, Gov. Philip D. Murphy said Wednesday that “if the data that we look at stays as good as it is,” he hoped that indoor dining could resume before mid-September. He added that there was no set date so “I’m not hanging my hat on it.” Movie theaters could be reopened around the same time, he said. Gyms, though, got a firm reopening date: Tuesday, with 25 percent capacity, masks and other rules. Health clubs in the state have been closed since March for everything other than personal training sessions.

• A cluster of cases in rural Maine that has been linked to a wedding reception held in early August in the town of Millinocket has spread to a county jail elsewhere in the state, infecting 18 inmates and employees, according to the Maine Center for Disease Control and Prevention.

• New York City’s mayor said Wednesday that officials have stopped more than 3,000 vehicles entering the city as part of a move to promote compliance with the state’s 14-day quarantine requirement for many travelers.

• New York City’s largest municipal union has filed an unfair labor practice complaint against the American Museum of Natural History over the institution’s plan to require employees to record possible virus symptoms on an app. The head of the union called the requirement overly intrusive.

Reporting was contributed by Katrin Bennhold, Alan Blinder, Chelsea Brasted, Aurelien Breeden, Alexander Burns, Jill Cowan, Abdi Latif Dahir, Steven Erlanger, Christina Goldbaum, Lauren Hirsch, Shawn Hubler, Choe Sang-Hun, Mike Ives, Andrew Jacobs, Julia Jacobs, Isabella Kwai, Alex Lemonides, Patrick J. Lyons, Apoorva Mandavilli, Jonathan Martin, Patricia Mazzei, Heather Murphy, Elian Peltier, Elisabetta Povoledo, Adam Rasgon, Campbell Robertson, Rick Rojas, Simon Romero, Amanda Rosa, Anna Schaverien, Mitch Smith, Matina Stevis-Gridneff, Sheryl Gay Stolberg, Eileen Sullivan, Tracey Tully, Billy Witz and Katherine J. Wu.