A Month After Emergency Declaration, Trump's Promises Largely Unfulfilled

One month ago today, President Trump declared a national emergency.

In a Rose Garden address, flanked by leaders from giant retailers and medical testing companies, he promised a mobilization of public and private resources to attack the coronavirus.

"We've been working very hard on this. We've made tremendous progress," Trump said. "When you compare what we've done to other areas of the world, it's pretty incredible."

But few of those promises have come to pass.

NPR's Investigations Team dug into each of the claims made from the podium that day. And rather than a sweeping national campaign of screening, drive-through sample collection and lab testing, it found a smattering of small pilot projects and aborted efforts.

In some cases, no action was taken at all.

Target did not formally partner with the federal government, for example.

And a lauded Google project turned out not to be led by Google at all, and then once launched was limited to a smattering of counties in California.

The remarks in the Rose Garden highlighted the Trump administration's strategic approach: a preference for public-private partnerships. But as the White House defined what those private companies were going to do, in many cases it promised more than they could pull off.

"What became clear in the days and weeks or even in some cases the hours following that event was that they had significantly over-promised what the private sector was ready to do," said Jeremy Konyndyk, senior policy fellow at the Center for Global Development.

The White House declined to comment on this story.

Drive-Through Testing Largely Nonexistent At Retail Partners

During the Rose Garden address, the president introduced a series of leaders from major retailers to suggest there would be cooperation between the federal government and private sector companies for drive-through testing.

"We've been in discussions with pharmacies and retailers to make drive-through tests available in the critical locations identified by public health professionals," President Trump said.

NPR contacted the retailers who were there and found that discussions have not led to any wide-scale implementation of drive-through tests.

In the month since the announcement, Walmart has opened two testing sites — one in the Chicago area and another in Bentonville, Ark. Walgreens has opened two in Chicago; CVS has opened four sites.

Target has not opened any. In fact, the company said it had no formal partnership with the federal government, and suggested they were waiting for the government to take the lead.

"At this time, federal, state and local officials continue to lead the planning for additional testing sites," a Target spokesperson said. "We stand committed to offering our parking lot locations and supporting their efforts when they are ready to activate."

Home Testing Promised, But Not Implemented

The president also welcomed Bruce Greenstein, an executive vice president of the LHC Group, to the microphone.

Greenstein's organization primarily provides in-home health care, and he pledged that it would be helping with testing "for Americans that can't get to a test site or live in rural areas far away from a retail establishment."

NPR called more than 20 LHC sites in 12 states, and none of them are doing in-home testing one month following the Rose Garden address. Employees at the LHC sites said they lacked both testing kits and the training to administer kits.

In response to NPR's reporting, Greenstein said that their primary focus so far has been getting proper personal protective equipment, or PPE, for their nurses, and working with hospitals on transitioning recovered COVID patients home. He says they'll start working with one New Orleans hospital "as soon as next week" to provide in-home testing, and to expand the service later.

No Screening Website To Facilitate Drive-Through Testing

During the March 13 Rose Garden address, the president also promised that Google was working to develop a website to determine whether a COVID-19 test would be warranted, and if so, to direct individuals to nearby testing.

The president said there were 1,700 Google engineers working on it, and the vice president said that guidance on the website would be available in two days.

"Google is helping to develop a website," the president said. "It's going to be very quickly done, unlike websites of the past, to determine whether a test is warranted and to facilitate testing at a nearby convenient location."

Dr. Deborah Birx, the coronavirus response coordinator at the White House, said that the website would screen patients, tell them where to receive drive-through testing, and provide testing results.

No such screening and testing website was ever developed by Google.

A pilot program was developed by Verily, a sister company to Google owned by the same parent company: Alphabet. Verily's program, called Project Baseline, was created to support California community-based COVID-19 testing from screening to testing to delivery of test results.

Verily has rolled out six testing sites primarily in coordination with the California state government — not the federal government — and is currently only available to residents of five counties in California.

"We work in partnership with local public health agencies, the California Governor's office, and the California Department of Public Health," a spokesperson for Verily said, adding that their COVID-19 testing program was "federally supported."

There were not 1,700 engineers ever engaged in the project, as the president had claimed, according to Verily.

"As we initially ramped this program, we had nearly 1,000 volunteers from across Alphabet supporting a variety of functions," a Verily spokesperson told NPR.

Verily is in discussions with other health care organizations to support this kind of testing project outside of California, but there has been no announcement of future plans to do so.

A Department of Health and Human Services spokesperson pointed out that Apple had released a screening tool in collaboration with the CDC and the White House. That screening tool does not have the functions outlined in the March 13 Rose Garden address.

The President's Federal Agency Promises

In declaring the national emergency last month, the president also proposed several policy changes that were solely within the realm of the federal government to execute. On these, the administration largely followed through.

President Trump promised to waive interest on student loans held by government agencies, for instance. That policy was implemented by the secretary of education on March 20.

And the president made good on pledges to waive regulations and laws to give medical providers flexibility to respond to the healthcare crisis.

But there were exceptions. The president said he would waive license requirements so that doctors could practice in states with the greatest needs, for example. But medical licensing is a state issue, and the president does not have the authority to waive it.

"There's no statutory authority for the federal government to take over the delivery of health care services" says Dale Van Demark, a partner advising health industries at the law firm McDermott Will & Emery. Added Iris Hentze, policy specialist at The National Conference of State Legislatures: "These occupational licenses are really more or less completely controlled and regulated by states." What the federal government was able to do is to waive in-state requirements for healthcare providers that serve people enrolled in Medicare, Medicaid and CHIP, so they can get reimbursed for the out-of-state care they provided.

The promises weren't limited to matters of health care. The president announced that his administration would "purchase, at a very good price, large quantities of crude oil for storage in the U.S. Strategic Reserve."

"We're going to fill it right up to the top," he said, "saving the American taxpayer billions and billions of dollars."

The Trump administration has not done so. The president made the promise without first securing the funds from Congress, and the Department of Energy puts the responsibility on Congress' shoulders.

"Despite strong efforts from the Administration, Congress would not provide funding for the purchase of oil for SPR in the Stimulus bill," a Department of Energy spokesperson said. "The Department continues to work with Congress to deliver on the President's directive to provide relief to the American energy industry during this tumultuous time."

A Failure In Public-Private Partnerships

Later in that March 13 press conference, when asked whether he took responsibility for the apparent lag in coronavirus testing in the United States, the president responded, "I don't take responsibility at all."

He also suggested that laboratory capacity for testing would soon greatly expand. And he singled out two companies:

"I want to thank Roche, a great company, for their incredible work. I'd also like to thank Thermo Fisher," he said.

Trump noted that the FDA was approving their processes, and then made a prediction: "It'll go very quickly," he said. "It's going very quickly — which will bring, additionally, 1.4 million tests on board next week and 5 million within a month. I doubt we'll need anywhere near that."

Roche and Thermo Fisher Scientific said they were able to get millions of tests distributed on schedule to labs in the United States, one of the rare bright spots in the coronavirus crisis. These tests are what are used at labs to check whether samples contain the coronavirus.

But those tests were not the primary reason for inadequate testing. The United States lags behind in sample collection kits — the swabs and tubes that frontline medical workers send to labs.

And those labs themselves struggled with processing capacity.

In the days before the March 13 Rose Garden address, leaders of diagnostic testing labs like LabCorp and Quest went to the White House with three core requests. And during the Rose Garden address, the CEOs of those two organizations stood with the president as the coronavirus task force pledged to wield government resources for their partnership.

More than a month later, the diagnostic testing labs — and the group that represents them in Washington, the American Clinical Laboratory Association — still have those three requests: government funds to build new testing facilities, national standards to prioritize who gets tested, and government support for the supply chain.

Konyndyk said it was an indication that the public-private partnerships the president touted on March 13 were a one-way street.

"What you want to have is a constructive partnership between the federal government and the private sector. Instead, what we see, I think, is a game of 'not it,'" said Konyndyk, who served in the Obama administration at USAID, leading the government response to international disasters.

Although the federal government needs the help of the private sector, the federal government has only limited power over those companies. So to make things work, there needs to be close cooperation and advanced negotiation before announcing what companies will do, and that didn't happen, Konyndyk said.

Private companies did part of what was promised in the Rose Garden address — there is more testing today than a month ago.

But by over-promising what private sector companies would do — and in some cases, without adequate consultation about what they could do — the White House left other pledges that day unfulfilled. [Copyright 2020 NPR]