By Stephanie Armour and Andrew Restuccia 

WASHINGTON -- The Trump administration defended its coronavirus response and said the risk to Americans remains low, even as concern about the outbreak grew among Democratic and Republican lawmakers and cities nationwide made fresh preparations.

Administration officials also rejected the idea of appointing a so-called czar to oversee the anti-coronavirus effort, backing Health and Human Services Secretary Alex Azar as the top official leading the U.S. response amid multiplying cases overseas. On Capitol Hill, party leaders said they would seek billions of dollars in emergency spending beyond the $2.5 billion plan President Trump has proposed.

"The immediate risk to the American public remains low, but there is now community transmission in a number of countries outside Asia that is deeply concerning," Mr. Azar told a House Appropriations subcommittee hearing. "We expect to see more cases here," he added.

Officials have also discussed having the Food and Drug Administration grant authorization to state and local health labs to design their own coronavirus tests without going through the current regulatory process, a source of frustration for public-health officials, according to people familar with the conversations. The Centers for Disease Control and Prevention has been working to roll its test kits out to other public-health labs, but the process was stalled when some labs got inconclusive results. About 445 people have been tested

The fast-moving developments came a day after a top CDC official, Nancy Messonnier, warned businesses, schools and communities to plan for potential outbreaks. Mr. Trump, who has sought to project confidence that the number of cases in the U.S. will be contained, was angered by the tone of the remarks, according to two people familiar with the discussions.

U.S. stocks fell for the fifth consecutive session Wednesday as investors continued to assess the economic impact of the coronavirus epidemic.

In the U.S., 15 locally diagnosed cases have been confirmed, including a new one Wednesday, with an additional 42 from the outbreak on the Diamond Princess cruise ship in Asia and three among Americans who returned from China aboard U.S.-chartered flights. More than 2,700 people have died globally as a result of the virus, which is believed to have originated in China and has spread to Iran, Italy, South Korea and other countries.

U.S. cities have begun preparing for possible outbreaks. In San Francisco, officials are working with hospitals and clinics to identify rooms for isolating coronavirus patients and to screen patients for travel history and symptoms. City officials also told schools to start planning to manage potential closures.

"Although there are still zero confirmed cases in San Francisco residents, the global picture is changing rapidly, and we need to step up preparedness," said Mayor London Breed.

In Texas, Dr. Umair A. Shah, director of Harris County Public Health, said a team of doctors, scientists and outreach personnel have been meeting daily for nearly two months to coordinate readiness in the Houston area.

New York City Mayor Bill de Blasio said there are 1,200 public hospital beds that can be made available to patients who need isolation without affecting current health needs. New York Gov. Andrew Cuomo said he is seeking an emergency appropriation of $40 million for the state's Department of Health to use for equipment and personnel.

"We're preparing, but this situation is not a situation that should cause undue fear among people," Mr. Cuomo said.

The virus's spread is worrying some in the Trump administration, who fear the consequences of a large-scale outbreak in the U.S., both in terms of public health and the president's prospects for re-election if the response falters. Planning for the coronavirus has been hampered by haphazard communications between states and the federal government, according to people familiar with the planning and some Democratic state leaders.

Some state leaders also say the lack of a coronavirus czar to head operations has Trump administration agency heads and advisers clashing over who is in charge.

A federal coronavirus task force has been meeting daily, and Mr. Azar said he is communicating regularly with Mr. Trump. The FDA is monitoring drug supply for any potential shortages and the CDC has been operating its pandemic preparedness and response, working with states and providing daily monitoring of people under quarantine.

At Wednesday's House hearing, Mr. Azar rejected the need for a czar, saying his department is designated as the lead under a national response plan. He called the decision to name an Ebola czar during the Obama administration an "oddity." In his testimony, Mr. Azar said operations were running smoothly.

Some Republicans, including Sens. Rick Scott of Florida and Mitt Romney of Utah, have joined Democrats in calling for a czar to supervise operations. Administration officials have privately discussed appointing a czar to oversee the response, according to two people familiar with the conversations.

The discussions also reflect discontent in some corners of the administration about Mr. Azar, who has faced criticism for his handling of the U.S. response to the virus and has butted heads with some administration officials, according to people familiar with the matter. Mr. Azar, a former drug company executive, worked on disease outbreaks as an HHS official in the George W. Bush administration.

"Secretary Azar has decades worth of experience at the helm of HHS during many public health emergencies, including SARS, 9/11 response, Anthrax, pandemic flu preparedness, Monkeypox, Smallpox preparation, Ebola, etc.," said Caitlin Oakley, an HHS spokeswoman.

White House officials said Mr. Trump has no plans to name such a czar. Mr. Trump took "decisive action by creating the Coronavirus Virus Task Force a month ago and is pleased" with Mr. Azar's leadership, tweeted White House spokesman Judd Deere.

Mr. Trump, who returned Wednesday morning from a trip to India, accused Democrats and the media of exaggerating the threat.

The president, in a series of tweets, also said he would hold a news conference at 6:30 p.m. ET at the White House to discuss the virus alongside CDC representatives.

Democrats have criticized the president for eliminating a global health position on the National Security Council that Mr. Obama established after the Ebola crisis. The administration's recently released budget request to Congress proposes large cuts to key agencies overseeing the coronavirus response, including a nearly 16% cut to the CDC and 10% at HHS.

On Capitol Hill, negotiations on funding a response to the disease began, with staff from both chambers and parties meeting Wednesday. The Trump administration's proposal to spend at least $2.5 billion on combating coronavirus -- with $1.25 billion in new funds and at least $1.25 billion in repurposed funds -- has disappointed members of both parties.

"We will work on it, but it will be higher than what they've got," Senate Appropriations Chairman Richard Shelby (R., Ala.) said, referring to the Trump proposal. "We will make sure that we've got the resources without any doubt."

Senate Minority Leader Chuck Schumer (D., N.Y.) proposed his own $8.5 billion emergency spending package on Wednesday. House Minority Leader Kevin McCarthy (R., Calif.) said he expected the package to come in around $4 billion.

Mr. Azar on Wednesday stressed the low number of diagnosed cases even though problems with coronavirus tests have delayed further detection of the disease.

Mr. Azar said money from the administration's emergency funding request would be used for a fund at the CDC to reimburse state and local agencies.

Already, the administration has transferred about $140 million from the Department of Health and Human Services toward fighting the virus, including $60 million from the National Institutes of Health and $40 million from a program that helps low-income Americans with energy bills.

--Andrew Duehren and Jim Carlton contributed to this article.

Write to Stephanie Armour at stephanie.armour@wsj.com and Andrew Restuccia at Andrew.Restuccia@wsj.com

(END) Dow Jones Newswires

February 26, 2020 18:41 ET (23:41 GMT)