Health officials shift tone on coronavirus, say elderly and sick at risk

The government's top infectious disease expert on Sunday said that the coronavirus outbreak is getting worse and warned elderly and sick people to avoid traveling or circulating in crowds — a point later reinforced by new CDC guidance.

The remarks from Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, signaled a change in tone from health officials representing the Trump administration, making it clear that the outbreak is past the point where it can be prevented from spreading or easily tracked. That contrasted with the more measured language from some Trump officials including Vice President Mike Pence.

Fauci's warnings were followed by CDC guidance recommending the public, especially those with underlying health conditions, defer any cruise ship travel. That guidance was released as public health officials prepare to evacuate thousands of passengers aboard the Grand Princess cruise ship off the California coast, where 21 people — 19 crew members and two passengers — have tested positive for the virus.

The ship is due to dock at the Port of Oakland as soon as Monday, according to Princess Cruises and California officials. More than 2,400 passengers will undergo health screenings, and about 1,000 California residents will be transferred to a federal facility for testing. The process will take two to three days, California Gov. Gavin Newsom said Sunday.

The majority of the nearly 1,000 Californians on board will be quickly transferred to Travis Air Force Base, Newsom said. Residents of other states and countries will be flown on chartered flights.

Meanwhile, Washington, D.C., Maryland and Virginia all reported their first cases of the virus in the past week — and at least one lawmaker has come in contact with an infected person. Sen. Ted Cruz (R-Texas) said he interacted with a person at the Conservative Political Action Conference in National Harbor, Md., last week, who later tested positive for coronavirus.

“I’m not experiencing any symptoms, and I feel fine and healthy,” Cruz said in a statement Sunday evening. He added that "out of an abundance of caution" he would self-quarantine in his Texas home for a full 14 days.

Rep. Paul Gosar (R-Ariz.) announced Sunday night that he and three of his senior staffers are "officially under self-quarantine after sustained contact at CPAC with a person who has since been hospitalized" with the virus. "We are all asymptomatic and feel great," he tweeted. "But we are being proactive and cautious."

Likewise, two attendees of AIPAC's recent conference in D.C., tested positive for coronavirus, potentially exposing others. Since then, a number of major national conferences and gatherings have been canceled, including South by Southwest in Austin, Texas, as public health officials across the country prepare for more community spread.

Fauci and other health officials dominated the Sunday morning shows — a change from last week, when Pence and HHS Secretary Alex Azar made a series of appearances to discuss testing for the virus and other aspects of the administration's response.

"If you get infected, the risk of getting into trouble is considerable, so it’s our responsibility to protect the vulnerable," Fauci said on NBC's "Meet the Press." "When I say protect, I mean right now, not wait until things get worse, say 'no large crowds, no long trips, and above all, don’t get on a cruise ship.'"

Fauci noted many of the newly confirmed cases showed signs of “community spread,” meaning they couldn’t be traced back to a single source and suggesting the outbreak is intensifying.

Ben Carson, the neurosurgeon who leads the Department of Housing and Urban Development, said on ABC's “This Week with George Stephanopoulos” that healthy people should go about normal daily activities but noted, "If you are not healthy, think very seriously about attending places where there are crowds."

Elsewhere, New Jersey officials said they are still awaiting CDC confirmation on samples taken from six patients who tested positive at the state’s public health lab. New Jersey uncovered its first presumptive case late Wednesday evening and a second around midday Thursday.

“We reached out to the CDC this morning for clarification and explanation of why we didn't receive the results,” state Assistant Health Commissioner Chris Neuwirth said during a media briefing on Sunday. “They did not provide that explanation.”

Officials in King Country, Wash., confirmed two more deaths, according to local reports, bringing the total number in the state to 18. The two most recent fatalities were residents of Life Care, a skilled nursing facility in Kirkland, Wash., where the majority of cases have occurred. There are 114 confirmed cases in Washington state.

Scott Gottlieb, Trump's former FDA commissioner, predicted the coming weeks will "change the complexion in this country," adding that lockdowns of certain states or cities "are going to need to happen" or health systems will get exhausted and fatalities will rise quickly.

"We have a narrow window of opportunity to implement tough measures to try to push down the scope of the epidemic," Gottlieb said on CBS' "Face the Nation," adding that Americans are probably looking at two months of "difficulty" as the virus rapidly spreads the way it did in Italy and South Korea.

The Associated Press reported late Saturday that the White House overruled a CDC warning that elderly and physically fragile Americans be advised not to fly on commercial airlines. Trump administration officials denied the report.

Current and former administration officials have said President Donald Trump's eagerness to downplay bad news has undercut his own administration's efforts to contain the outbreak. Meanwhile, there were more reports of the virus circulating in communities, with Washington, D.C., reporting its first known case.

Trump on Sunday took to Twitter to express confidence in his administration's response and praised Pence for leading the effort.

Maryland Republican Gov. Larry Hogan on Sunday criticized Trump’s communication around the outbreak but also praised Pence and the rest of his team. “Has the president been perfect in his communication? I would say he hasn't communicated the way I would, and the way I might like him to,” Hogan said on "Meet the Press." “But I think the rest of the team has been doing a pretty good job.”

Surgeon General Jerome Adams said on CNN's "State of the Union" that local leaders have to consider whether to cancel large gatherings, and evaluate telework policies and school closings.

"We're shifting into a mitigation phase, which means that we're helping communities understand, you're going to see more cases. Unfortunately, you're going to see more deaths," Adams said.

Fauci said health officials still hope the coronavirus will burn itself out the way SARS outbreak did in 2003. But he said the coronavirus could reappear seasonally, necessitating a vaccine he said is at least a year away from being deployed.

Victoria Guida, Victoria Colliver and Sam Sutton contributed to this report.