Dr. Anthony Fauci, the top US infectious disease official, warned senators on Tuesday that states ending stay-at-home orders to reopen business widely across the country threatened to restart outbreaks of the deadly novel coronavirus.
Fauci, head of the National Institute of Allergies and Infectious Diseases and a prominent public health figure since the AIDS crisis of the 1990s, warned against states disregarding White House guidelines for when it is safe to reopen their economies in a hearing of the US Senate Committee on Health, Education, Labor, and Pensions, entitled "COVID-19: Safely Getting Back to Work and Back to School."
"There is a real risk that you will trigger an outbreak that you may not be able to control, which, in fact, paradoxically will set you back, not only leading to some suffering and death that could be avoided, but could even set you back on the road to trying to get economic recovery," Fauci said. "We will almost turn the clock back rather than going forward. That is my major concern."
Fauci gave voice to the fear, widespread among health experts, that increased contact among a population immunologically naive to a deadly infectious disease is a disaster in the making for the US. As of Tuesday, there have been more than 1.3 million confirmed novel coronavirus cases in the US, causing more than 80,000 COVID-19 deaths.
Widespread stay-at-home orders were issued by governors in March and April to limit contact between people to blunt the spread of the infectious respiratory disease, but more than 30 states have since reopened businesses or started limited reopening.
On Monday, administration officials said about 300,000 tests for coronavirus were now performed daily in the US, a tally reached in the last week. Public health experts have estimated that anywhere from 550,000 to 10 million tests would need to be performed daily to create effective monitoring of cases.
Adm. Brett Giroir, a senior HHS official, told lawmakers Tuesday that the US could perform 40 to 50 million coronavirus tests a month by September, about 1.3 million to 1.6 million tests a day.
Fauci added that assuring students hoping to reenter school in the fall that they will have a vaccine or treatment is "a bridge too far." A coronavirus vaccine development effort started in early January, days after the virus genome was released, is currently in Phase I trials.
He cautioned that time is needed for the testing required to show the vaccines actually work, and in the case of coronavirus, it needs to be demonstrated that they don't trigger worse illness. Still, he described himself as "cautiously optimistic" that a vaccine would be available by late fall or early winter, because the federal government is already investing in manufacturing capabilities. Testing multiple vaccine candidates provides "multiple shots on goal," he said. "It is more likely than not" that we will have a vaccine, Fauci said.
Sen. Patty Murray — who represents the state of Washington, where the first US case of the coronavirus was discovered in late January — condemned President Donald Trump’s calls for states to reopen despite his own administration's guidelines.
"President Trump is trying to ignore the facts, and ignore the experts who have been clear we are nowhere close to where we need to be to reopen safely," Murray said at the hearing.
Late in the hearing, Sen. Rand Paul of Kentucky told Fauci he was not the "end-all" in advising the country. Lauding the Swedish model of few restrictions on businesses, despite the fact that Sweden now leads its neighbors in coronavirus deaths, Paul criticized models that predicted the outbreaks we have seen and called for reopening schools in the fall.
Fauci responded that he only gave public health advice, not economic advice, and cautioned that doctors are seeing a deadly syndrome among children afflicted with the virus. "I think we need to be very careful with children," Fauci said.
At the end of the hearing, which largely turned to questions directed to the NIAID director, rather than the HHS, CDC, and FDA witnesses in control of approving tests and offering official federal guidance, Fauci clarified that he was not calling for keeping schools closed indefinitely until there is a vaccine. Rather, he suggested that in regions with adequate testing, few infections, and enough health workers to stop outbreaks from spreading, that opening schools might proceed.
"Going back to school would be more in the realm of knowing the landscape of infection," said Fauci.