WASHINGTON A new internal watchdog report finds that hospitals were unprepared for the coronavirus and are still scrambling to find equipment and deal with a shortage of tests problems critics say could have been averted had President Donald Trump taken the pandemic seriously from the beginning.

From a lack of enough protective gear to fears of not having enough ventilators to worries about keeping staff healthy to financial concerns, hospitals are struggling to keep up with a fast-moving pandemic, according to a report Monday from the Department of Health and Human Services own inspector general.

Hospitals reported that their most significant challenges centered on testing and caring for patients with known or suspected COVID-19 and keeping staff safe, the report said.

Trump downplayed the severity and extent of the coronavirus for two months, falsely claiming that his travel restrictions against China had kept the disease from coming to the United States. He did not declare a national emergency until mid-March, which finally sent a signal to local governments and hospitals that federal funds would help them deal with the crisis.

I think by the first or second week of February it was clear they needed to be prepping, said Jeremy Konyndyk, who worked on the Ebola outbreak response under former President Barack Obama . But the signal from the United States government never came.

The report from HHS was self-generated, not requested by Congress. It points out that some of the issues it found are already being addressed by new guidance from HHS and the $2 trillion emergency legislation passed by lawmakers last month.

The office declined to comment on how things might have been different if the federal government had urged hospitals to prepare a month earlier as that question was not in the scope of the report.