New York: "All risk and no upside" is how doctors on the frontline of the coronavirus pandemic in America are describing US President Donald Trump's push to "liberate" the country's economy even as the virus killed 36,000 people and sickened more than 680,000 Americans by Friday.
Trump's urgency to revive the economy, a crucial piece in his re-election strategy, resulted in re-opening guidelines being issued by the White House this week in preparation for a much touted May 1 timeline. The final guidance, a three-step process with robust testing hardwired into it, is a diluted version of recommendations from the Centers for Disease Control and Prevention (CDC).
"So far as I can see, this thought experiment of early, slipshod opening, without testing, without PPE, without data, without planning - is all risk and no upside", is how emergency room doctor Megan Ranney, describes Trump's ambition.
"When do you not even think of reopening a country? When you see this", Eric Topol, physician-scientist, wrote on Twitter, pointing to the US curve, climbing relentlessly northward.
"Mayhem" is how New York Governor Andrew Cuomo describes the disconnect between federal claims and ground reality on testing - a foundational requirement for easing up on social distancing guidelines.
Across the country, Americans awash in a month-long crash course of medical knowledge are putting their faith in state level policy amidst incredibly mixed messaging from the White House.
Testing at scale in the US remains a rabbit hole, asymptomatic spread is a real danger and Trump's task force has already warned that re-opening the economy could result in a second wave of infections.
COVID19 survivors like Diana Berrent are alarmed about the prospect of asymptomatic spread. "We were seeing story after story all telling the same thing. People were going to go donate their plasma 14 days post symptomatic - those are the rules in order to qualify for any study or any convalescent plasma program, and almost all of them are proving to still have the virus in their system", Berrent said.
Berrent is New York State's first convalescent plasma donor for a Columbia University clinical trial hoping to find cures for COVID19. Berrent's point is that people coming back to work could unknowingly infect others and an explosive cycle of re-infection could begin in the US.
A month ago, Trump announced that "anybody who wants a test, can get a test". In recent weeks, Trump's topmost doctors have explained in great detail that widespread testing is a fundamental requirement for re-opening the economy. The reality is very different, depending on where you live.
Trump has now shifted the responsibility. "The States have to step up their TESTING!" Trump declared on Twitter.
Greg Anderson, whose partner is a nurse at a New York hospital, says even he doesn't know where to go for testing. "Yeah, it's that bad", he told IANS over phone from Hoboken.
Lifelong New Yorker and tour guide Jane Marx is betting on Andrew Cuomo to deliver. "I do believe in the consortium of states. I do believe in Andrew Cuomo", Marx said via text message, referring to the collaboration between a clutch of US East Coast states to come up with their own, more considered re-opening plan.
"But I do think it's a double prong. Resurrect our economic life which will never be the same but let's pretend it is and also reduce any kind of possibility of increasing the risk", Marx said.
Dr. Anthony Fauci, America's top infectious diseases doctor on the White House task force said Friday that "in order to be really sure", testing will have to be done every day or every other day or every week, because of the ease of contagion and how much is still unknown about COVID19.
"The difference between what we really need for Phase One (re-opening) is to be able to identify, isolate and contact trace - a very important part when you're pulling back gradually and slowly on the mitigation, and you have people who might be infected you want to know they're infected, you want to put them in care."
According to top medical experts on the White House coronavirus task force, the "new normal" in America will look very different from the pre-coronavirus time. Trump, though, says he wants to see "110,000 people out there" at football games.
"Unhinged", is how Washington's governor describes Trump's response.
(Nikhila Natarajan can be contacted at @byniknat)