WASHINGTON — With hundreds of millions of people still seeking advice on resuming their lives safely, the Centers for Disease Control and Prevention issued a scant six pages of recommendations Thursday to guide schools, businesses, day-care facilities and others into the next phase of the coronavirus pandemic.
The six checklists — which also address restaurants, mass transit and camps — come days, and in some cases weeks, after many states have begun to lift restrictions on their own. The advice is less detailed than draft recommendations the agency sent to the White House for review last month.
The nation is still awaiting that detailed technical guidance, which the White House has held up and not shared publicly. The delay has left the responsibility for decision-making about reopening to states and localities. It has also left many health experts clamoring for greater transparency.
"We need to unleash the voices of the scientists in our public health system in the United States so they can be heard, and their guidances need to be listened to," said Rick Bright, a former top U.S. vaccine official who testified before a House panel Thursday, decrying the piecemeal approach the Trump administration has taken to the pandemic. "And we need to be able to convey that information to the American public so they have the truth about the real risk and dire consequences of this virus."
Senate Minority Leader Charles Schumer, D-N.Y., said a day earlier on the Senate floor that the CDC advice must be released.
"The country needs the guidance of the nation's best medical and scientific experts. These literally are matters of life and death," Schumer said. "And that's exactly why the CDC prepared this guidance. America needs and must have the candid guidance of our best scientists — unfiltered, unedited and uncensored by President Trump or his political minions."
The White House at first shelved the CDC guidelines. When asked about them, the White House said they were "overly specific" and in the process of being revised.
A CDC spokesman said additional recommendations may still come from the agency. The six decision trees were ready for release, so the administration decided to put them out while other guidelines make their way through the review process.
The documents released Thursday are aimed at helping facilities decide if they're ready to open and inform how they do so, he said.
"This was an effort on our part to make some decision trees we thought might be helpful to those moving forward with opening their establishment," the spokesperson said.
But with many states already moving on, it is unclear what impact any additional recommendations might have. And the mixed messages from President Donald Trump and other officials in his administration have left state and local officials struggling with decisions on whether and how to relax public-health restrictions.
Trump has been pushing for states to reopen, and on Thursday he traveled to Pennsylvania to urge its leadership to loosen its coronavirus restrictions, especially in areas he said have barely been affected by the pandemic, part of the president's escalating personal appeal to state leaders to let American life get back to normal.
His visit to the swing state — during which he attacked its Democratic governor, whom Trump views as moving too slowly to reopen — came on the same day that he cheered a "win" in Wisconsin, where a court ruling against stay-at-home orders issued by another Democratic governor led to chaos and scenes of bars packed with people. Trump's us-against-them language underscored the rift with federal scientists who continue to warn against lifting coronavirus restrictions too swiftly amid fears of the potential for a new wave of infections and fatalities.
"We have to get your governor of Pennsylvania to open up a little bit," Trump said of Gov. Tom Wolf, a Democrat. "You have areas of Pennsylvania that are barely affected, and they want to keep it closed."
Trump also called testing "overrated" as a tool to track and control the virus, even though the White House has moved to a protocol of testing all visitors and requiring most employees to wear masks.
Trump's approach put him at odds with Bright and Anthony Fauci, the nation's top infectious-disease expert. Fauci testified Tuesday about the need for accurate, widespread testing and further limits on daily life and commerce.
Trump and other Republicans have increasingly criticized Fauci, confusing the federal message at a time when, Bright said, the crisis demands a "single point of leadership."
"And we don't have a single point of leadership right now for this response, and we don't have a master plan for this response," Bright said. "So those two things are absolutely critical."
Bright said prospects were dim for a vaccine anytime soon, echoing Fauci's belief that there will be no fail-safe protection available before schools must make decisions about opening in the fall.
Bright told lawmakers that the United States faces the "darkest winter in modern history" if it does not develop a more coordinated national response to the novel coronavirus before an expected resurgence later this year.
"Our window of opportunity is closing," Bright said before the House Energy Committee's subcommittee on health. "If we fail to develop a national coordinated response, based in science, I fear the pandemic will get far worse and be prolonged, causing unprecedented illness and fatalities."
Trump in recent weeks has urged governors to move more quickly in reopening their states, despite safety benchmarks issued by his administration that many have yet to meet.
"The people want to get on with their lives. The place is bustling!" Trump tweeted approvingly after the Wisconsin Supreme Court struck down an extension of restrictions by Gov. Tony Evers, a Democrat. The ruling late Wednesday produced a confusing patchwork across the state, with some localities maintaining limits on businesses and activities.
"We're the Wild West," rued Evers during an interview on MSNBC.
The 4-to-3 decision by the high court in Wisconsin limits Evers' ability to make statewide rules during emergencies such as a global pandemic, instead requiring him to work with the state legislature on how the state should handle the outbreak.
By Thursday, many of the reopened Wisconsin bars were dark once again, shuttered as more than a dozen cities and counties that have been hit hard by the coronavirus moved to enact local stay-at-home ordinances.
"Well, that was fun while it lasted," a patron wrote on the Facebook page of Limanski's Pub in West Allis, which briefly opened Wednesday night before Milwaukee County ordered bars and restaurants to remain closed indefinitely to in-person dining and drinking.
Bars in much of greater Milwaukee were closed, including two communities to the south — Racine and Kenosha, cities where COVID-19 cases have surged in recent days. But to the north of Milwaukee, some cities and counties chose to allow bars and restaurants to reopen, though many establishments remained shuttered.
In Grafton, about 20 miles north of Milwaukee in Ozaukee County, the Milwaukee Ale House opened its doors for lunch service at 11 a.m. sharp after weeks of serving takeout and delivery — business that was not nearly enough to pay the bills, according to owner Mike Stoner.
"I take it seriously," Stoner said Thursday afternoon, as he sat at the upstairs bar of his restaurant, which remained mostly empty except for several masked servers and bartenders who stood waiting for customers. "I don't know why things have to be so political, so angry. . . . I am just trying to keep my business alive."
Trump has been aggressively calling for states to reopen even as health officials have sent a more cautious message, urging a data-driven and scientific approach.
In mid-April, the White House unveiled a three-phase plan for a gradual reopening of communities. The blueprint called for states to move forward after they met an initial test of 14 days of declining coronavirus cases and continue to progress as they passed additional safety checkpoints.
But many states, their economies in free fall, ignored the requirements for the first phase and moved ahead. The plan did not include specifics that many state and local officials, business leaders and millions of people sought to help them safely resume a version of their previous lives.
The documents released Thursday were reviewed extensively by White House Office of Management and Budget officials who were concerned the initial draft was too burdensome on churches and restaurants, among others.
The CDC removed from an earlier draft a recommendation that no facility open in an area where spread of the virus requires "significant mitigation." But it left a warning against reopening against local or state orders. That puts the responsibility squarely on state and local governments to impose those rules.
"Usually it's the state and local health department that follow CDC's lead and not the other way around," said Matthew Seeger, who has researched crisis communication for the past 35 years at Wayne State University. "It's the latest way the current leadership is putting the onus on states and trying to make this a decentralized structure. That's not how CDC usually works."
Thursday's guidance helps workplaces decide whether to reopen, how to promote hygiene measures such as mask-wearing and hand-washing before they do and how to monitor employees for symptoms of infection, among other advice.
It recommends that restaurants and bars "encourage social distancing and enhance spacing at establishments," in part by "spacing of tables/stools, limiting party sizes and occupancy, avoiding self-serve stations, restricting employee shared spaces, [and] rotating or staggering shifts, if feasible."
It advises mass transit systems to "limit routes to and from high transmission areas" before resuming full service.
No decision tree for faith communities was released. Telling houses of worship how to operate stirred controversy when the CDC's original draft instructions were leaked last month.
Public health experts said the way the Trump administration has rolled out guidelines makes it less likely people will heed them.
"In many ways, this advice is the only medicine we have," Seeger said. "We don't have a vaccine yet. We don't have treatment. All we have is human behavior and that behavior is based on the information people get and whether they will listen to that information."