By JASON DEAREN and MIKE STOBBE

GAINESVILLE, Fla. (AP) — The Trump administration has shelved a document created by the nation’s top disease investigators with step-by-step advice to local authorities on how and when to reopen restaurants and other public places during the still-raging coronavirus outbreak.

The 17-page report by a Centers for Disease Control and Prevention team, titled “Guidance for Implementing the Opening Up America Again Framework,” was researched and written to help faith leaders, business owners, educators and state and local officials as they begin to reopen.

It was supposed to be published last Friday, but agency scientists were told the guidance “would never see the light of day,” according to a CDC official. The official was not authorized to talk to reporters and spoke to The Associated Press on the condition of anonymity.

The AP obtained a copy from a second federal official who was not authorized to release it. The guidance was described in AP stories last week, prior to the White House decision to shelve it.

The Trump administration has been closely controlling the release of guidance and information during the pandemic spurred by a new coronavirus that scientists are still trying to understand, with the president himself leading freewheeling daily briefings until last week.

Traditionally, it’s been the CDC’s role to give the public and local officials guidance and science-based information during public health crises. During this one, however, the CDC has not had a regular, pandemic-related news briefing in nearly two months. CDC Director Dr. Robert Redfield has been a member of the White House coronavirus task force, but largely absent from public appearances.

The dearth of real-time, public information from the nation’s experts has struck many current and former government health officials as dangerous.

“CDC has always been the public health agency Americans turn to in a time of crisis,” said Dr. Howard Koh, a Harvard professor and former health official in the Obama administration during the H1N1 swine flu pandemic in 2009. “The standard in a crisis is to turn to them for the latest data and latest guidance and the latest press briefing. That has not occurred, and everyone sees that.”

The Trump administration has instead sought to put the onus on states to handle COVID-19 response. This approach to managing the pandemic has been reflected in President Donald Trump’s public statements, from the assertion that he isn’t responsible for the country’s lackluster early testing efforts, to his description last week of the federal government’s role as a “supplier of last resort” for states in need of testing aid.

A person close to the White House’s coronavirus task force said the CDC documents were never cleared by CDC leadership for public release. The person said that White House officials have refrained from offering detailed guidance for how specific sectors should reopen because the virus is affecting various parts of the country differently. The person spoke on the condition of anonymity to discuss internal deliberations.

The rejected reopening guidance was described by one of the federal officials as a touchstone document that was to be used as a blueprint for other groups inside the CDC who are creating the same type of instructional materials for other facilities.

The guidance contained detailed advice for making site-specific decisions related to reopening schools, restaurants, summer camps, churches, day care centers and other institutions. It had been widely shared within the CDC and included detailed “decision trees,” flow charts to be used by local officials to think through different scenarios. One page of the document can be found on the CDC website via search engines, but it did not appear to be linked to any other CDC pages.

Some of the report’s suggestions already appear on federal websites. But the guidance offered specific, tailored recommendations for reopening in one place.

For example, the report suggested restaurants and bars should install sneeze guards at cash registers and avoid having buffets, salad bars and drink stations. Similar tips appear on the CDC’s site and a Food and Drug Administration page.

But the shelved report also said that as restaurants start seating diners again, they should space tables at least 6 feet (1.8 meters) apart and try to use phone app technology to alert a patron when their table is ready to avoid touching and use of buzzers. That’s not on the CDC’s site now.

“You can say that restaurants can open and you need to follow social distancing guidelines. But restaurants want to know, ‘What does that look like?’ States would like more guidance,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials.

The White House’s own “Opening Up America Again” guidelines released last month were more vague than the CDC’s unpublished report. They instructed state and local governments to reopen in accordance with federal and local “regulations and guidance” and to monitor employees for symptoms of COVID-19. The White House guidance also included advice developed earlier in the pandemic that remains important like social distancing and encouraging working from home.

At a briefing Wednesday, White House spokeswoman Kayleigh McEnany echoed the administration’s stance that state’s are most responsible for their own COVID-19 response: “We’ve consulted individually with states, but as I said, it’s (a) governor-led effort. It’s a state-led effort on … which the federal government will consult. And we do so each and every day.”

The CDC is hearing daily from state and county health departments looking for scientifically valid information with which to make informed decisions.

Still, behind the scenes, CDC scientists like those who produced the guidance for “Opening Up America Again″ are working to get information to local governments. The agency still employs hundreds of the world’s most respected epidemiologists and doctors, who in times of crisis are looked to for their expertise, said former CDC director Tom Frieden. People have clicked on the CDC’s coronavirus website more than 1.2 billion times.

States that directly reach out to the CDC can tap guidance that’s been prepared but that the White House has not released.

“I don’t think that any state feels that the CDC is deficient. It’s just the process of getting stuff out,” Plescia said.

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Stobbe reported from New York. Associated Press writers Darlene Superville and Zeke Miller in Washington contributed to this report.

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The Associated Press receives support for health and science coverage from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

By NICOLE WINFIELD, ANGELA CHARLTON and CHRIS BLAKE

ROME (AP) — From the marbled halls of Italy to the wheat fields of Kansas, health authorities are increasingly warning that the question isn’t whether a second wave of coronavirus infections and deaths will hit, but when — and how badly.

As more countries and U.S. states chaotically re-open for business — including some where infection rates are still rising — managing future cases is as important as preventing them.

In India, which partly eased its virus lockdown this week, health authorities scrambled Wednesday to contain an outbreak at a massive market. Experts in hard-hit Italy, which just began easing some restrictions, warned lawmakers that a new wave of virus infections and deaths is coming. They urged intensified efforts to identify possible new victims, monitor their symptoms and trace their contacts.

Germany warned of a second and even a third wave, and threatened to re-impose virus restrictions if new cases can’t be contained. German Chancellor Angela Merkel was meeting Wednesday with the country’s 16 governors to discuss further loosening restrictions that have crippled Europe’s largest economy.

“There will be a second wave, but the problem is to which extent. Is it a small wave or a big wave? It’s too early to say,” said Olivier Schwartz, head of the virus and immunity unit at France’s Pasteur Institute.

Many areas are still struggling with the first wave of this pandemic. Brazil for the first time locked down a large city, the capital of Maranhão state. Across the ocean, the number of confirmed coronavirus cases in Africa has shot up 42% in the past week and infections are expected to surpass 50,000 on Wednesday.

An Associated Press analysis, meanwhile, found that U.S. infection rates outside the New York City area are in fact rising, notably in rural areas. It found New York’s progress against the virus was overshadowing increasing infections elsewhere.

“Make no mistakes: This virus is still circulating in our community, perhaps even more now than in previous weeks,” said Linda Ochs, director of the Health Department in Shawnee County, Kansas.

The virus is known to have infected more than 3.6 million and killed more than 251,000 people, according to a tally by Johns Hopkins that all experts agree is an undercount due to limited testing, uneven victim criteria and deliberate concealment by some governments.

The U.S. has seen over 71,000 deaths amid its 1.2 million infections, and Europe has endured over 144,000 reported coronavirus deaths. Behind each of those vast numbers is a family in pain.

“Burying both parents at the same time? It’s hard,” said Desmond Tolbert, who lost his mother and father in rural southwest Georgia. Because they had the virus, he couldn’t be with them when they died.

U.S. President Donald Trump, with his eye on being reelected in November, is pushing hard to ease state stay-at-home orders and resuscitate the U.S. economy, which has seen over 30 million workers lose their jobs in less than two months. Trump is expected to wind down the country’s coronavirus task force, possibly within weeks, despite concerns that states aren’t being careful enough as they reopen.

A century ago, the Spanish flu epidemic’s second wave was far deadlier than its first, in part because authorities allowed mass gatherings from Philadelphia to San Francisco.

As Italy’s lockdown eased this week, Dr. Silvio Brusaferro, president of the Superior Institute of Health, urged “a huge investment” of resources to train medical personnel to monitor possible new cases. He said tracing apps — which are being built by dozens of countries and companies and touted as a possible technological solution — aren’t enough to manage future waves of infection.

“We are not out of the epidemic. We are still in it. I don’t want people to think there’s no more risk and we go back to normal,” said Dr. Giovanni Rezza, the head of the institute’s infectious disease department.

In Germany, authorities may reimpose restrictions on any county that reports 50 new cases for every 100,000 inhabitants within the past week.

Lothar Wieler, head of Germany’s national disease control center, said scientists “know with great certainty that there will be a second wave” of infections but said Germany is well-prepared to deal with it. The country has been hailed for testing widely and has suffered four times fewer deaths than Italy or Britain, which both have smaller populations.

Britain has begun recruiting 18,000 people to trace contacts of people infected. British officials acknowledge that they should have done more testing and tracing earlier and could learn from South Korea, which brought its outbreak under control by rigorously testing, tracing and isolating infected people.

South Africa, which has years of experience tracking HIV and other infections, is already testing and tracing widely. Turkey has an army of 5,800 teams of contact tracers who have tracked down and tested nearly half a million people linked to infected cases. Israel plans to conduct 100,000 antibody tests to determine how widespread the coronavirus outbreak has been and prevent a second wave.

India was concentrated on the immediate drama around the market in the southern city of Chennai, which is now tied to at least 1,000 virus cases. Another 7,000 people connected to the now-shuttered Koyambedu market are being traced and quarantined. Experts are worried about a health catastrophe in a country of 1.3 billion people with an already stressed medical system.

New confirmed daily infections in the U.S. exceed 20,000, and deaths per day are well over 1,000, according to the Johns Hopkins tally. And public health officials warn that the failure to lower the infection rate could lead to many more deaths — perhaps tens of thousands — as people venture out and businesses reopen.

“The faster we reopen, the lower the economic cost — but the higher the human cost, because the more lives lost,” New York Gov. Andrew Cuomo sai d. “That, my friends, is the decision we are really making.”

Trump acknowledged the toll but argued that keeping the U.S. economy closed carries deadly costs of its own, such as drug abuse and suicides.

“I’m not saying anything is perfect, and yes, will some people be affected? Yes. Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon,” he said during a visit to Arizona in which he did not don a face mask.

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Charlton reported from Paris and Blake from Bangkok. Associated Press journalists around the world contributed to this report.

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Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak