“Thank you all for being here, and we continue our relentless effort to defeat the Chinese virus,” Trump said near the top of his combative appearance before reporters at the White House.

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Trump’s use of the term has become a point of pride among some White House aides and supporters, and the president has used it more as his handling of the public health emergency has been increasingly faulted. A Washington Post photographer captured an image of a printed copy of Trump’s remarks that had the word “corona,” a medical term for a family of viruses, crossed out and the word “Chinese” put in its place with a black marker.

Trump’s shift to more fully blame China coincides with widening devastation from the virus in the United States and increasing criticism that his administration missed opportunities to prepare and respond. For weeks in January and February, Trump publicly dismissed the outbreak as of very little risk to Americans, even as he banned air travel for non-U.S. citizens traveling from China.

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After appearing sobered by the scale of the crisis earlier in the week, Trump on Thursday bitterly attacked reporters and news organizations he said had failed to accurately report his accomplishments in confronting the virus.

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“We were very prepared. The only thing we weren’t prepared for was the, the media. The media has not treated it fairly. I’ll tell you how prepared I was. I called for a ban from people coming in from China long before anybody thought it was — in fact, it was your network, I believe, they called me a racist because I did that,” Trump told a reporter for NBC News. “It was many of the people in the room. They called me racist and other words because I did that, because I went so early.”

Trump didn’t specify who called the decision to limit air travel from China racist, and in recent weeks he has exaggerated opposition to the move at the time he made it, while complaining he has not been given enough accolades for the action.

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The travel ban is credited with slowing the onset of widespread infection in the United States. But by the time Trump instituted it in February, the virus was already being passed person to person in some parts of the country.

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Asked whether he is considering “repercussions for China” or a realignment of the supply system in which some American manufacturers rely on Chinese labor or raw materials, Trump suggested he was open to the idea.

“I don’t want to comment on that right now,” Trump said.

Sen. Tom Cotton (R-Ark.), a Trump ally, introduced legislation Wednesday to end American reliance on Chinese drug manufacturing and encourage drug production in the United States.

“China unleashed this plague on the world, and China has to be held accountable,” Cotton said in an interview Wednesday evening with Fox News host Sean Hannity. “That’s why I’m introducing legislation that will say we’re no longer going to buy our basic pharmaceuticals from China. There will be a total ban on buying.”

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Trump has not commented directly on whether he supports the legislation.

He said he “inherited” a balky federal health system, a term he frequently uses when criticizing his predecessor, Barack Obama. Trump did not name the former president Thursday.

“The system is starting to work out very well, but we had to break a system, like breaking an egg, because the system we had was obsolete and didn’t work and that was the system we inherited,” Trump said. “And now we have something that’s really been very good and certainly going to be great for the future, too.”

Taken together, the accusations and implied threat marked the president’s harshest critique of China, an economic adversary with which he is trying to negotiate a broad trade agreement. It was also Trump at his most defensive and irascible.

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“It would have been much, much better if we had known about this a number of months earlier. It could have been contained in that one area in China where it started,” Trump said. “And certainly, the world is paying a big price for what they did.”

Trump had earlier appeared reluctant to point fingers, saying that the virus was no one’s fault and “one of those things that happen.” He has praised his friendly relationship with Chinese President Xi Jinping and, as recently as this week, predicted progress toward the second, larger phase of a trade deal that he holds up as a main accomplishment.

That began to shift this week as the spread of the disease slowed in Asia and as Europe became the new epicenter. China this week reported no new infections for the first time since December, although health experts warn there could be a second wave.

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“But now the whole world, almost, is inflicted with this horrible — with this horrible virus, and it’s too bad,” Trump said to make the point that China had allowed that to happen. “It’s too bad because we never had an economy as good as the economy we had just a few weeks ago, but we will be back, and I actually think we will be back stronger than ever before because we learned a lot during this period of time.”

The number of confirmed cases in the United States doubled Thursday. The dramatic increase stems in part from more testing but also indicates how much the virus has spread.

On Tuesday, there were just more than 5,700 confirmed coronavirus cases in the United States. That number climbed above 13,000 on Thursday night, and officials indicated that the number will continue to rise sharply as more test results become available.

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Meanwhile, the State Department warned Americans not to travel internationally and advised all Americans who are abroad to return to the United States or make preparations to shelter in place.

Trump’s recent criticism of China also aligns the president with the tougher message that Secretary of State Mike Pompeo and other members of his administration have voiced for weeks.

Trump went further Thursday, saying China could have stopped all spread beyond the Wuhan area but deliberately chose not to do so.

It is unlikely that China could have entirely prevented any spread outside that city or outside China’s borders, but global health experts have also faulted the country for a lack of transparency at the outset.

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The National Security Council on Wednesday tweeted a Wall Street Journal story about the early days of the Chinese response.

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“The Chinese Communist Party suppressed initial reports on the Chinese Virus and punished doctors and journalists, causing Chinese and international experts to miss critical opportunities to prevent a global pandemic,” the message from the NSC’s official Twitter account said.

After being egged on by a reporter from the pro-Trump One America News Network, Trump blamed the media for its coverage of the crisis and for accusations that his use of “Chinese virus” was racist or xenophobic.

The reporter asked Trump whether it was racist to use the term “Chinese food.” He said no and then transitioned to complaining that he doesn’t receive fair media coverage after saying earlier in the briefing that he wanted fewer reporters to attend his briefings.