NEW YORK (AP) — No quick dispatching of disease investigators. No televised news conference to inform the public. No timely health alerts to doctors.

In the midst of a hantavirus outbreak that involves Americans and is making headlines around the worldthe U.S. government’s top public health agency, the Centers for Disease Control and Prevention, has been uncharacteristically missing in actionaccording to a number of experts.

To President Donald Trump, “We seem to have things under very good control,” as he told reporters Friday evening.

To experts, the situation aboard a cruise ship has not spiraled because, unlike COVID-19 or measles or the flu, hantavirus does not spread easily. It has been health experts in other countries, not the United States, who have been dealing primarily with the outbreak in the past week.

“The CDC is not even a player,” said Lawrence Gostin, an international public health expert at Georgetown University. “I’ve never seen that before.”

Not until late Friday did CDC actions accelerate.

Health officials confirmed the deployment of a team to Spain’s Canary Islands, where the ship was expected to arrive early Sunday local time, to meet the Americans onboard. They said a second team will go to Offutt Air Force Base in Nebraska as part of a plan to evacuate American passengers from the ship to a University of Nebraska quarantine center for evaluation and monitoring. Also, the CDC issued its first health alert to U.S. doctors, advising them of the possibility of imported cases.

At their first briefing, held Saturday by telephone only for invited reporters, officials pledged to be transparent in updating the public but said the media could not cite the speakers by name under rules set by aides to Health Secretary Robert F. Kennedy Jr. They did not directly answer a question about whether the American passengers could leave the university medical facility when they wanted.

The CDC’s diminished role in this outbreak is an indicator the agency is no longer the force in international health or the protector of domestic health that it once was, some experts said.

The hantavirus outbreak is “a sentinel event” that speaks to “how well the country is prepared for a disease threat. And right now, I’m very sorry to say that we are not prepared,” said Dr. Jeanne Marrazzo, chief executive officer of the Infectious Diseases Society of America.

How the outbreak unfolded

Early last month, a 70-year-old Dutch man developed a feverish illness on a cruise ship traveling from Argentina to Antarctica and some islands in the South Atlantic. He died less than a week later. More people became sick, including the man’s wife and a German woman, who both died.

Hantavirus was first identified as a cause of sickness of one of the cases on May 2. The World Health Organization swung into action and by Monday was calling it an outbreak. About two dozen Americans were on the ship, including about seven who disembarked last month and 17 who remained on board.

It’s WHO taking center stage

For decades, the CDC partnered with the WHO in such situations. The CDC acted as a mainstay of any international investigation, providing staff and expertise to help unravel any outbreak mystery, develop ways to control it and communicate to the public what they should know and how they should worry.

Such actions were a large reason why the CDC developed a reputation as the world’s premier public health agency.

But this time, the WHO has been center stage. It made the risk assessment that has told people the outbreak is not a pandemic threat.

“I don’t think this is a giant threat to the United States,” said Jennifer Nuzzo, director of Brown University’s Pandemic Center. But how this situation has played out “just shows how empty and vapid the CDC is right now,” she said.

Tumult under Trump

The current situation comes after 16 tumultuous months during which the Trump administration withdrew from the WHO, has restricted CDC scientists from talking to international counterparts at times and embarked on a plan to build its own international public health network through one-on-one agreements with individual countries.

The administration has laid off thousands of CDC scientists and public health professionals, including members of the agency’s ship sanitation program.

As this was playing out, Kennedy said he was working to “restore the CDC’s focus on infectious disease, invest in innovation, and rebuild trust through integrity and transparency.”

Waiting to hear from the CDC

The CDC has not been completely silent on hantavirus.

The agency on Wednesday issued a short statement that said the risk to the American public is “extremely low,” and described the U.S. government as “the world’s leader in global health security.”

Said Nuzzo: “Not only was that not helpful, it actually does damage because a core principle of public health communications is humility.”

The CDC’s acting director, Dr. Jay Bhattacharya, posted a message on social media that the agency was lending its expertise in coordinating with other federal agencies and international authorities. Arizona officials this week said they learned from the CDC that one of the Americans who left the ship — a person with no symptoms and not considered contagious — had already returned to the state. WHO officials said the CDC has been sharing technical information.

The CDC also is “monitoring the health status and preparing medical support for all of the American passengers on the cruise,” Bhattacharya wrote.

But federal health officials have mostly been tight-lipped, declining interview requests. The first on-camera appearance by a CDC official came Saturday morning, when Bhattacharya appeared on a Fox News program and said, “My message to the American people is please don’t worry.” But he got some details wrong and overstated what was known about the outbreak.

He incorrectly said two passengers in their 80s had died after they had contracted the virus while bird-watching in Argentina. The travelers were a 70-year-old Dutch man and his 69-year-old wife and while Argentine health officials think it is possible they were infected during a bird-watching outing, it has not been established.

COVID-19 comparison

In interviews this week, some experts made a comparison with a 2020 incident involving the Diamond Princess, a cruise ship docked in Japan that became the setting of one of the first large COVID-19 outbreaks outside of China.

The CDC sent personnel to the port, helped evacuate American passengers, ran quarantinesshared genetic data on the virus, coordinated with the WHO and Japan, held public briefings and rapidly published reports “that became the world’s reference data on cruise ship COVID transmission,” said Dr. Tom Frieden, a former CDC director.

Some aspects of the international response to the Diamond Princess were criticized, and it did not halt the outbreak or stop COVID-19’s spread across the world. But some experts say it was not for the CDC’s lack of trying.

“The CDC was right on top of it, very visible, very active in trying to manage and contain it,” Gostin said, while the agency’s work now is delayed and subdued.

Instead of working with nearly all of the world’s nations through the WHO, the Trump administration has pursued bilateral health agreements with individual nations for information sharing, public health support, and what it describes as “the introduction of innovative American technologies.” Roughly 30 agreements are currently in place.

That’s not sufficient, Gostin said. “You can’t possibly cover a global health crisis by doing one-on-one deals with countries here and there,” he said.

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Associated Press writers Ali Swenson in New York, Darlene Superville in Washington and Susan Montoya Bryan in Albuquerque, New Mexico, contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

HONG KONG (AP) — China’s exports rose 14.1% in April from a year earlier, the government said Saturday, despite the Iran war and lingering impacts from higher U.S. tariffs.

The data were released just days ahead of a planned meeting next week between U.S. President Donald Trump and Chinese leader Xi Jinping in Beijing.

That beat analysts’ estimates and was a significant improvement from March’s 2.5% year-on-year expansion. Exports to the U.S. rose 11.3% from the year before, up from a 26.5% drop in March.

Imports climbed 25.3%, slower than the 27.8% growth in March but still robust.

The Trump-Xi summit comes at a time when relations are beset by multiple issues, with efforts to end the war in Iran eclipsing the usual sources of friction.

“We’re expecting that overall external demand will remain a solid driver of growth this year,” said Lynn Song, chief economist for Greater China at Dutch bank ING, likely led by China’s exports of semiconductors and autos.

In March, Chinese leaders set an annual economic growth target of 4.5% to 5%slightly lower than last year’s 5% expansion and the lowest target since 1991. Export growth is expected to continue to power its wider economy, especially as shipments increased from China to Europe, Southeast Asia, Latin America and Africa over the past months.

China’s exports to the U.S. have fallen for most of the months since Trump imposed steeper tariffs and harsher controls on sharing of technology after he took office last year. But trade with the U.S. is likely improving this year, said Song, particularly because of the base effects of sharp declines caused by Trump’s tariff hikes in 2025.

Apart from efforts to broker a peace agreement to end the Iran war, trade and export controls, including rare earths and U.S. tech restrictions on China, will likely be on the agenda during the Trump-Xi summit, following a yearlong U.S.-China trade truce reached late last year when the two leaders last met in South Korea.

Major breakthroughs on export controls are unlikely, but the leaders’ upcoming meeting may bring “incremental” steps to troubleshoot trade friction, HSBC economists said in a recent research note.

“On balance, China looks to have more leverage,” wrote Leah Fahy, senior China economist of Capital Economics, in a note. “But higher tariffs haven’t stopped China’s exports from continuing to surge over the past year, and Beijing has showed that it is prepared to wait out U.S. pressure.”

For China, oil and fuel price hikes caused by the war in Iran are also feeding higher manufacturing and logistics costs across its many factories, said Wei Li, head of multi-asset investments at BNP Paribas Securities (China), while higher global inflation could dampen consumer purchasing power in China’s overseas markets.

Still, China’s overall economy has remained resilient compared with other countries, owing to its large oil reserves and more diversified energy sources.

ING’s Song said China’s trade surplus, which reached an all-time high of almost $1.2 trillion last year, could narrow for the whole of this year. Imports so far have been stronger in 2026, though China is still recovering from a prolonged property slump that has dragged on consumption and investment.

Libyan Dr. Faysal Alghoula needs to renew his green card to continue caring for roughly 1,000 patients in southwestern Indiana. But he hasn’t been able to do that since the Trump administration stopped reviewing applications for people from several dozen countries it deemed high-risk.

Alghoula has lived in the U.S. since 2016, and his current visa will expire in September if his application is denied.

But last week, Alghoula and doctors like him got a potential lifeline when the administration quietly made an exemption for physicians with pending visa or green card applications. It’s a move physicians, organizations and immigration attorneys had sought for months, citing widespread shortages and a high proportion of foreign-trained doctors, who disproportionately work in underserved areas, according to the National Library of Medicine.

The lack of doctors is top of mind for Alghoula, a pulmonologist and Intensive Care Unit doctor who serves a mostly rural population spanning parts of Indiana, Illinois and Kentucky.

“It is about four to five months wait to get the pulmonologist here,” he said.

Still, applicants and immigration attorneys say it’s unclear how big a difference the exemption will make. The change means doctors can have their cases reviewed, but it doesn’t guarantee their green cards or visas will be renewed. It is also unclear whether U.S. Citizenship and Immigration Services will be able to process those applications in time to meet immigration deadlines like Alghoula’s — especially as many doctors with pending applications still haven’t heard any updates from the federal government directly since the announcement was first made.

Despite his qualifications, Alghoula said he is still concerned about his upcoming appointment, given stories circulating about immigrants being detained at appointments to renew their paperwork.

“I’m still scared to go to my interview,” Alghoula said Wednesday. That uncertainty intensified on Friday when he learned that his interview, scheduled for early June, had been canceled without any explanation. He said he doesn’t know what that means for his application.

Meanwhile, the pause remains in effect for thousands of others, including researchers and entrepreneurs from 39 countries, including Iran, Afghanistan and Venezuela. While they’re on hold, many can’t legally work, get health insurance or a driver’s license. If they leave the U.S., they won’t be let back in.

Immigrants unable to work or see family

The Trump administration decided last year to stop reviewing green card and visa applications for people from a list of countries deemed high-risk and this year stopped reviewing visa applications for citizens of more than 75 countries over concerns they would seek public assistance. The moves came amid the U.S. government’s broader crackdown on immigrants.

The pause followed the shooting of two National Guard troops by an Afghan citizen, which the administration said highlighted “what a lack of screening, vetting, and prioritizing expedient adjudications can do to the American people.”

The Department of Homeland Security, which oversees immigration officials, didn’t answer questions about the pause or recent changes to exempt physicians but said in an email it wants to ensure applicants are properly screened after determining the prior administration failed to do so.

“There are lots of bans and lots of pauses that are happening right now,” said Greg Siskind, an immigration attorney based in Memphis, Tennessee. “It is all about making life miserable for people who are here legally so they will choose other countries.”

It isn’t clear how many doctors have been affected by the pause, according to a spokesperson for the American Academy of Family Physicians, who said several doctors have reached out to the organization asking for help.

Some doctors have already been denied

Before the exemption, many immigrants filed federal lawsuits demanding that the government issue decisions on their cases.

One of them was Iranian Dr. Zahra Shokri Varniab, who came to the United States three years ago to conduct radiology research. She was waiting for a green card to attend a residency program but her application got stuck in the pause. She filed a lawsuit demanding an answer to her application and a federal judge ordered immigration officials to review her case.

They did — and denied her. The 33-year-old doctor said she believes it was in retaliation for her lawsuit.

“I feel completely confused,” Shokri Varniab said.

In court filings, U.S. government lawyers wrote that Shokri Varniab’s application contained inconsistencies about whether she plans to become a practicing doctor or researcher. She said she plans to do both.

She said the exemption doesn’t appear to apply to her since her case was decided but is seeking relief in court.

Immigration policy compounding war abroad

Immigrants who hold prestigious jobs in science and technology said they currently can’t work due to the pause because they’re waiting on employment authorization documents. Some said they are running out of money for rent and groceries and worry their careers could be thwarted if they’re forced to leave the country.

Those from Iran are especially worried about returning home during the ongoing war with U.S. and Israeli forces. They said they can’t regularly reach family due to the Iranian government’s internet blackout or count on them for financial support.

Kaveh Javanshirjavid came to the United States from Iran seven years ago to study for his doctorate in agriculture. He was supposed to start a lab job in January but needs employment authorization and his application is on hold.

The 41-year-old said he’s borrowing from friends to pay rent and relying on his wife’s doctorate stipend for basic necessities. But he doesn’t know how long that will last because she’s also Iranian and will need work authorization to get a job after graduating this summer.

“The whole of my life is on hold,” he said.