States across the country continued to work toward reopening Thursday as scientists kept up their hunt for a coronavirus vaccine.
California, one of the first states to implement a stay-at-home order, is set to begin loosening some restrictions Friday, though state Health Secretary Dr. Mark Ghaly warned residents, "It does not mean a return to normal."
"We still know that the virus is alive in California and that your good efforts have helped us suppress it quite a bit, but it is still there spreading," he said.
Starting Friday, some retail stores will be able to do more curbside pickup and potentially delivery, though they should continue to encourage social distancing, Ghaly said. Manufacturers should keep workers farther apart for social distancing, and warehouse workers should have sanitation materials and use personal protective equipment during deliveries.
Meanwhile, potential vaccines to prevent Covid-19 infections are racing through development at unprecedented speeds, with one maker, Moderna Inc., announcing Thursday it would soon begin a phase 2 study for its potential vaccine after getting approval from the US Food and Drug Administration.
President Donald Trump had said a vaccine would be available by December, then appeared this week to back off his claim. Dr. Anthony Fauci, the nation's top infectious disease expert, has said it's possible to have a coronavirus vaccine by January.
But scientists won't know whether vaccines can prevent infection until April or May next year, said Dr. Mark Mulligan, director of the Vaccine Center at New York University's Langone Health, who is working with Pfizer Inc. on its vaccine trial.
Still, that time frame is "blazing process" for vaccine development, he told CNN Wednesday.
"We're doing things in months that normally would be done in years," Mulligan said.
More than 75,000 people have died of the virus and more than 1.2 million are infected as of Thursday in the United States, according to Johns Hopkins University.
For now, as states continue disjointed efforts to reopen local economies, the White House will not implement a 17-page draft recommendation by the US Centers for Disease Control and Prevention for reopening America, a senior CDC official confirmed Thursday to CNN.
The guidance provided more detailed suggestions beyond reopening guidelines the Trump administration put forth last month, including specific suggestions for schools, communities of faith, restaurants and bars, mass transit and employers with vulnerable workers.
In the meantime, another 3.2 million Americans filed for first-time unemployment benefits last week, the Department of Labor said Thursday, further highlighting the virus's impact on the economy. That brings the total number of first-time filings since mid-March to 33.5 million.
States have not met criteria for reopening, expert says
More than 40 states are partially reopening and lifting stay-at-home restrictions. But none of them have met the White House's guidelines on reopening, according to epidemiologist Caitlin Rivers, a senior scholar and assistant professor at Johns Hopkins Bloomberg School of Public Health who spoke before a House Appropriations Subcommittee on Wednesday.
"The first is to see the number of new cases decline for at least two weeks, and some states have met that criteria," Rivers said. "But there are three other criteria and we suggest they should all be met."
They include having enough resources to conduct contact tracing on new cases, enough diagnostic testing to test everybody with Covid-like symptoms and "enough health care system capacity to treat everyone safely."
And with states reopening, it could be weeks before we understand the full impact of loosening restrictions.
California Gov. Gavin Newsom previously outlined a phased reopening of the state and said he was lifting restrictions based on six key factors, including the stability of hospitalizations, inventory of personal protective equipment, hospital surge capacity, testing capacity, tracing capacity and the ability to reintroduce restrictions if necessary.
Personal care businesses such as salons and gyms will not reopen until later, officials said Thursday, with the governor saying California's first case of community spread occurred in a nail salon.
Ohio Gov. Mike DeWine announced Thursday that outdoor dining will be allowed to begin May 15, with dine-in services able to resume beginning May 21. Restaurants will need to adhere to social distancing guidelines and employees will need to wear masks.
Personal services such as hair salons, barber shops, spas and nail salons will also be able to open beginning May 15 with some guidelines, like workers wearing masks and clients waiting in their cars until their appointment.
Rhode Island Gov. Gina Raimondo confirmed her statewide stay-at-home order will expire Friday and the state will start the first phase for reopening.
Several industries can reopen if they comply with additional rules such as frequent cleaning, reduced capacity and employee screening, including retail stores. Restaurants will still be limited to delivery and takeout, but outdoor dining could eventually be allowed.
Movie theaters, bowling alleys, museums, gyms, salons and barber shops will remain closed, the governor said. Nursing homes and assisted living facilities will also remain closed to visitors.
"This is not the time for social gatherings," Raimondo said. "The economic devastation in this state and every state around this country is untenable. So I am focused like a laser on work, getting people enabled to work."
Vaccine approved for phase 2 trial
There are more than 100 vaccines under development across the globe, according to the World Health Organization.
The first phrase of a vaccine trial determines whether it is safe, Mulligan said, and typically takes three to four months.
"That's actually the most important first question, and then we want to know if it's tolerated well and if it produces an antibody response that might be protective after those first three or four months," he said.
"You go on to the question: Does it protect? And that'll take several months as well," he added. "I do really think we're talking about getting through to the end of the year and into early next year before we would have a definitive answer."
Moderna's candidate was the first US vaccine to start clinical trials in the United States after receiving a green light from the FDA in early March.
Phase 2 of Moderna's study will include 600 participants, the company said, up from the 45 volunteers in phase 1. Participants older than 55 will be enrolled in phase 2, Moderna said.
Vaccine clinical trials involve three phases, per the CDC. The first examines safety, while the second expands the number of participants. In the third phase, the vaccine is given to even more people and tested for effectiveness.
Moderna -- which has never brought a product to market -- is now finalizing the protocol for the study's phase 3, which could begin in early summer, the company said in a news release.
In an investor call Thursday morning, Moderna said the first batches of the vaccine are expected to be manufactured in July, with a goal of manufacturing up to 1 billion doses a year.
At least one other vaccine by another maker is in phase 2, and several others are doing simultaneous phase 1 and phase 2 trials.
White House rejects CDC reopening guidelines
Concerns over the President's possible exposure to the coronavirus resurfaced Thursday after CNN learned a member of the US Navy who serves as one of the President's personal valets tested positive for the virus.
Valets are members of an elite military unit dedicated to the White House and often work close to the President and the first family. A source told CNN that President Trump was subsequently tested again for the coronavrius by the White House physician.
The President and the vice president tested negative, deputy White House press secretary Hogan Gidley said in a statement.
Meanwhile, it became clear the White House will not implement the CDC's recommendations, even after the agency asked for them, the senior CDC official told CNN Wednesday night.
The White House's decision to not use the guidance was first reported by The Associated Press.
Trump's guidelines for reopening "made clear that each state should open up in a safe and responsible way based on the data and response efforts in those individual states," an official with the White House Coronavirus Task Force told CNN.
States that implemented shutdowns have seen plateaus or slower declines than expected in the number of coronavirus cases, particularly compared with other countries where stricter social distancing measures and shutdowns cut down cases faster, per data from Johns Hopkins.
"We're seeing it gradually decline. We'd like to see a steeper, faster, decline, but this is where we are," New York Gov. Andrew Cuomo said Wednesday, expressing his own frustration. "It's a painfully slow decline, but it's better than the numbers going the other way."
The slower declines illustrate the weaknesses in America's social distancing measures, which have been hindered by exceptions in stay-home orders, a haphazard federal response and struggles with testing, contact tracing and quarantines.