Anthony Fauci, the nation’s top infectious disease specialist, told senators at a hearing on Tuesday that if states prematurely lift social and economic restrictions, cases of COVID-19 could spike again.
Fauci, the director of the National Institutes of Allergy and Infectious Diseases, said the "consequences could be really serious" if states don't reopen according to the guidelines laid out by the White House's plan to reopen America.
"If some areas, cities, states or what have you, jump over those various checkpoints and prematurely open up, without having the capability of being able to respond effectively and efficiently, my concern is we will start to see little spikes that will turn into outbreaks," Fauci told the Senate Health, Education, Labor and Pensions Committee.
Fauci’s warning comes as many states have already begun to partially reopen and as President Donald Trump has shifted his focus to lifting restrictions and jumpstarting the economy. Several states that began to reopen did not meet the criteria proposed in the White House’s guidelines for doing so, which proposed that states reopen only after seeing a downward trajectory of documented cases within a 14-day period or a downward trajectory of positive tests as a percentage of all tests, among other things.
Public health officials say that new outbreaks are expected when social distancing restrictions are eased, but that states need to ensure that they have the capacity to deal with those outbreaks.
Centers for Disease Control and Prevention Director Robert Redfield told Sen. Christopher S. Murphy, D-Conn., that the agency would “soon” post a broader guidance for states to consider when lifting restrictions but did not specify a timeline.
Murphy said state leaders would have a harder time keeping social distancing restrictions in place if Trump is urging against them or downplaying the challenge of the pandemic.
“You say that states shouldn’t open too early but then you don’t give us the resources to succeed,” Murphy said. “You work for a president who is frankly undermining our efforts to comply with the guidance that you’ve given us. And then the guidance that you have provided is criminally vague.”
Fauci told Sen. Elizabeth Warren, D-Mass., that the national trends appear to be improving overall, although the number of reported cases are spiking in some parts of the country. “The curve looks flat with some slight coming down,” he said.
He also told Sen. Bernie Sanders, I-Vt., that the death rate from COVID-19 is likely higher than is currently being reported, but said he didn’t know how much higher.
“There may have been people who died at home who did have COVID, who are not counted as COVID because they never really got to the hospital,” he said, noting that may have been particularly the case in New York City.
Tuesday’s hearing turned out to be a mostly virtual affair given that members of the Trump administration and Alexander are quarantining after being in contact with a White House staff member and a congressional staffer who both tested positive for the coronavirus that causes COVID-19. Several senators asked questions remotely.
Vaccine and treatment outlook
Fauci said officials have at least eight possible candidates for a COVID-19 vaccine but warned none are likely to be widely available by the fall.
He said officials hope to know by late fall or early winter whether any of the options would be successful.
"This will be important because this will be good for global availability if we have more than one successful candidate,” he said.
Pharmaceutical companies plan to begin manufacturing vaccines at risk, before it is clear whether a vaccine will be proven to work, which could make it easier to quickly distribute a vaccine when it's available.
Fauci told HELP Chairman Lamar Alexander, R-Tenn., that colleges and universities hoping to have students on campus this fall would likely have to do so without a widely available treatment or vaccine.
"The idea of having treatments available, or a vaccine, to facilitate the re-entry of students into the fall term would be something that would be a bit of a bridge too far," Fauci said.
Fauci later added that he did not mean to suggest that schools could not re-open in the fall, but that returning to school would be based on being able to track outbreaks through greater testing capabilities.
Republican Sens. Bill Cassidy of Louisiana and Rand Paul of Kentucky pressed Fauci on the nation’s plans to reopen schools, warning of the challenges for children missing months of education and, for many, meals provided through schools. Paul said school closures should be decided by district.
“If we keep kids out of school for another year, what’s going to happen is the poor and underprivileged kids who don’t have a parent who’s able to teach them at home are not going to learn for a full year,” he said.
Fauci warned it would be “cavalier” to assume that children were immune from the virus.
“We really better be very careful, particularly when it comes to children, because the more and more we learn, we’re seeing things about what this virus can do that we didn’t see from the studies in China, or in Europe,” he said.
Brett Giroir, the assistant secretary for health, testified that colleges would be able to test students for the virus, which could help in tracking and shutting down potential campus outbreaks.
Criticisms about testing came from both sides of the aisle. Utah Republican Sen. Mitt Romeny said the U.S. may now lead the world in testing, but was slow to get to that point.
“I find our testing record nothing to celebrate whatsoever,” he said.
During his opening remarks, Alexander praised the administration for improving the nation's testing capacity, but said that millions more tests are needed to ensure that people feel safe returning to work, school and colleges and universities.
“Staying at home indefinitely is not the solution to this pandemic,” Alexander said.
Sen. Patty Murray, D-Wash., the panel's ranking member, criticized the administration for not having a national strategic testing plan, but said far more is needed to lift restrictions, such as more protective gear and guidelines for employers. She also called on Congress to work on another relief package, which Senate Republicans have said they don't want to move ahead with right now.
“We need to work quickly on another aggressive relief package—and we need to make sure our priorities in that bill are protecting workers, students, and families, and addressing this public health crisis, not bailing out corporations and protecting big business from accountability," she said.