| Hours after administration officials urged Americans to prepare for the “hardest and saddest week” and President Trump predicted “a lot of deaths,” he insisted on Sunday that there is “light at the end of the tunnel” as the nation braces for more fallout from the coronavirus pandemic. The president made his Sunday remarks as the White House cautioned Americans that the worst is ahead for many parts of the country, with New York remaining the equivalent of a five-alarm fire and other cities and states emerging as hot spots. The death toll, public health officials explain, continues to climb during pandemics, even as new cases of infection begin to taper, which is the phenomenon of “flattening the curve” that infectious disease experts describe as the mitigation goal. Confirmed new infections during testing are the echoes of exposures that happened a week or more before. As new cases and hospital admissions decline, fatalities eventually follow. “The next two weeks are extraordinarily important. This is the moment to not be going to the grocery store, not going to the pharmacy, but doing everything you can to keep your family and friends safe,” Deborah Birx, immunologist and public health adviser with the White House coronavirus task force, warned during Saturday’s televised briefing. U.S. Surgeon General Jerome Adams appeared on “Fox News Sunday” to underscore Birx’s warning. “This is going to be the hardest and the saddest week of most Americans’ lives,” he said (The Hill and The Associated Press). 
© Getty Images States: New coronavirus hot spots have been identified in Washington, D.C., Pennsylvania and Colorado, while New York, Louisiana and Detroit continue to account for many of the 337,646 confirmed cases of COVID-19 in the United States (NPR). Eight states do not have stay-at-home orders in effect (CNN). New York: Gov. Andrew Cuomo (D) on Sunday said New York experienced a drop in new hospital admissions and a declining daily tally of deaths, which he called a “blip.” But if it holds, it could foreshadow relief in the Empire State from the ravages of the coronavirus, which has killed more than 4,000 people there (The New York Times). “You could argue that you’re seeing a slight plateauing in the data, which obviously would be good news,” Cuomo said during his daily briefing in Albany. Louisiana: The Rev. Emmanuel Mulenga, pastor at Saint Augustine Catholic Church, in New Orleans, a nearly 200-year-old church in the city’s historically African American Treme neighborhood, gave out palm fronds on Palm Sunday to parishioners while still adhering to social distancing guidelines. He blessed the fronds and put them on a table near the back of the church where people could easily spot them. “Despite the social distancing ... the spiritual aspects of our lives, faith, still continues, and I personally believe that under the present circumstances we need those personal connections and prayer even more,” Mulenga said (The Associated Press). … Louisiana Gov. John Bel Edwards (D), who has warned his state could be “the next Italy” in terms of COVID-19 spread, said on Sunday that the majority of the state’s 4,500 churches are adhering to orders not to convene in large groups, but he said the separation of church and state means his administration will not use law enforcement to mandate compliance from defiant pastors (The Advocate). Washington: A state that was first to see COVID-19 infect its population is a beacon of hope for many other states as community-spread of the disease plateaus there. Washington on Sunday announced that it will return more than 400 ventilators to the Strategic National Stockpile after determining that the machines could be better used in states facing more dire conditions. Washington had 7,498 known cases on Sunday, with 319 deaths (The New York Times). 
© Getty Images Vaccine dilemma: Ensuring the manufacture and distribution of enough eventual COVID-19 vaccine to everyone in the United States who needs it is the enormous undertaking Trump’s savviest advisers want him to get a grip on now, especially because everyone wants the world to return to work. Who gets a vaccine when supplies are initially scarce? Who will own a vaccine in a world in which open science for pharmaceuticals is rare? How fast can a vaccine that is proved effective be manufactured and deployed? Anthony Fauci, director of the Institute of Allergy and Infectious Diseases, recently told his colleagues at the National Institutes of Health during a videoconference that even if a vaccine is available next year, "I don’t think we’ll have enough doses for everyone” (ABC News). Researchers believe those infected who recover from COVID-19 develop immunity that may fight off future infection for some period of years, but the coronavirus is expected to be seasonal and could develop into different strains in the future, a potential challenge for vaccine development. There is much about the disease that researchers say they need to learn, and Fauci has outlined ambitious plans to scale up a future vaccine (Bloomberg Law). The 79-year-old immunologist said on Sunday that the virus is unlikely to be eradicated this year (CBS’s “Face the Nation”). Tom Bossert, a former national security adviser to Trump, said on Sunday that the president needs to look further down the road to get the United States prepared (The Hill). “He needs to be looking 20 yards, 200 yards and as far in front of his headlights as he can, or we’re going to end up having shortages or shortfalls in our vaccine manufacturing capabilities,” he said on ABC News. Former Health and Human Services Secretary Mike Leavitt, who helped former President George W. Bush prepare in 2005 for a potential influenza pandemic, made the same point in March, citing his experience and lessons learned (Fox News). “The goal of developing and stockpiling vaccines is simply stated, but not easily achieved,” Leavitt wrote. “Developing and stockpiling vaccines is not a job for any one government. It is not even a job for any one nation. It requires cooperation between nations, cooperation between different government entities within nations, and cooperation between governments and the private sector.” Former Homeland Security Department official Juliette Kayyem, an author and national security analyst for CNN, wrote in The Atlantic last week that the question of distributing vaccines to the U.S. population, if left by the Trump administration to the 50 states to manage, will be agonizing. “Everyone will be clamoring for it,” she predicted. “Medical professionals and first responders will go to the front of the line, as they should. But who goes next? Elderly people, who are more vulnerable, or healthy young people, who are more mobile, more likely to be infected without symptoms, and more likely to be working in jobs requiring contact with others? Those in urban areas, who are more likely to be exposed by casual transmission, or people all across a state? You or me? Decide quickly.” There is some suggestion that the administration, behind the scenes, believes the country that develops a vaccine will control it. Many companies are racing to find a vaccine, and global researchers have been praised for open-science efforts to collaborate to unlock a cure that is safe and effective for worldwide use. The New York Times in March described reports in Germany and some glimmers in the United States that the U.S. government sought to buy or bring a German biotech firm under U.S. control because of its promising early research on potential vaccine candidates for COVID-19 (“The Daily” podcast). The administration told the Times that such reports were “overblown.” The Hill: Feds send ventilators to coronavirus hot spots around the country. The Associated Press: Trump sees limits of presidency in avoiding blame for virus. Axios: Trump administration officials sparred privately over the weekend about the therapeutic science behind hydroxychloroquine and COVID-19. The Hill: Trump promotes use of malaria drug for coronavirus: “I’m not a doctor. But I have common sense.” | 
