Fauci Warns of Outbreaks, Unnecessary Deaths If COVID-19 Restrictions Aren't Gradually Lifted

More than 80,000 Americans have died of coronavirus disease 2019 (COVID-19). However, that number is likely an underestimate, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, in a hearing before the US Senate today.

As states continue to tackle challenges wrought by the COVID-19 pandemic, members of the White House Coronavirus Task Force testified in front of the Senate Health Committee to address the federal response to the pandemic and discuss re-opening the country.

Some states have already begun loosening social distancing guidelines in an effort to get back to a state of normalcy, contradicting phased guidelines developed by the CDC reportedly shelved by the White House last week.

If phased reductions of social distancing measures are not carried out, “there is a real risk that you will trigger an outbreak you may not be able to control,” Fauci testified. And this will set communities back, “not only leading to some suffering and death that could be avoided but could even set you back on the road to…economic recovery. It would almost turn the clock back rather than going forward.”

Testifying before the committee, Fauci laid out the National Institutes of Health’s 4-point plan to combatting the pandemic: improve fundamental knowledge of the virus and the disease it causes, develop new point-of-care diagnostics, characterize and test therapeutics, and develop safe and effective vaccines. Robert Redfield, MD, director of the CDC; Stephen Hahn, MD, commissioner of the FDA; and ADM Brett Giroir, MD, assistant secretary of health, also testified in front of the committee.

Senators, in person and over video call, laid out their constituents’ concerns, which ranged from access to tests, adequate care, and treatment to the economic and social impacts of the pandemic. Although assessment of the Trump Administration’s response was largely split along party lines, the overarching theme of the hearing was the senators’ calls for increased testing capacity.

“Widespread screening of entire campuses, schools, or places of work will help identify those who are sick and trace down those who are exposed. That, in turn, should help persuade the rest of us to go back to school and go back to work,” said Lamar Alexander, R-Tennessee, chairman of the Senate Health, Education, Labor and Pensions Committee. “All roads back to work and back to school lead through testing, tracking, isolation, treatment, and vaccines.”

This notion is in contrast to statements President Trump made earlier this week that the United States had “prevailed” when it comes to COVID-19 testing.

However, on May 9, the FDA expanded authorization of the first diagnostic test for COVID-19 that uses saliva samples people can collect at home, in addition to granting emergency use authorization to the first antigen test to aid in rapid detection.

According to Giroir, the United States will be able to conduct up to 50 million tests per month by September, if they are needed. This is up from the established monthly target of over 12 million tests predicted to be available by June.

Although the Task Force offered no concrete numbers on testing goals, rises in cases are expected as states continue to ease social restrictions. “If states prematurely open up without having the capability to respond effectively and efficiently, my concern is that we will start to see little spikes that might turn into outbreaks,” Fauci said.

When it comes to therapeutics, in addition to Gilead Sciences’ remdesivir, a potential COVID-19 treatment that received an emergency use authorization earlier this month, Fauci noted “there are a number of broad spectrum antivirals that are in various stages of testing.” As far as distributing therapeutics, Hahn explained a “data-driven” approach would be utilized to determine which hospitals and patients receive newly approved treatments.

Convalescent plasma, or plasma from individuals who have recovered from COVID-19, used in passive transfer for prevention or treatments, along with hyperimmune globulin, immune-based therapies, host modifiers, monoclonal antibodies, and repurposed drugs are all being actively investigated.

As encouraging as new advancements in testing and treatment may be, vaccine development was on the forefront of many senators’ minds. Currently, 8 vaccines are in clinical development. But when asked if any would be ready to ensure a normal start to the school year, that’s “a bit of a bridge too far,” Fauci said.

“We don’t see a vaccine playing [into] the ability of individuals going back to school this term,” Fauci added. Testing vaccines for safety and efficacy can take months to years, but he notes he is “cautiously optimistic” that one vaccine will be effective and achieved within a year or two.