The US government's top infectious diseases expert warned Congress Tuesday that ending lockdowns too soon could trigger fresh and uncontrollable outbreaks of COVID-19.
In his first appearance on Capitol Hill in two months, Anthony Fauci delivered a cautionary message at odds with the rhetoric of President Donald Trump, who has pressed for rapid steps to rekindle the devastated economy.
The respected scientist told a Senate panel that federal authorities had developed guidelines on how to safely reopen activities, with a sustained 14-day decrease in cases as a vital first step.
"If a community or a state or region doesn't go by those guidelines and reopens… the consequences could be really serious," said Fauci.
"There is a real risk that you will trigger an outbreak that you may not be able to control," he later added, warning that would not only cost lives "but could even set you back on the road to trying to get economic recovery."
Responding to a question from Senator Bernie Sanders, Fauci acknowledged that US coronavirus deaths are likely higher than the official toll of roughly 80,000.
This, he said, was because many people — particularly in hardest-hit New York — died at home before they could be admitted to a hospital.
Some colleges meanwhile have begun announcing plans to restart classes in fall, but Fauci argued it was "a bridge too far" to expect vaccines or treatments might be ready in time to assuage student fears.
The antiviral remdesivir was recently shown in a clinical trial to speed up the recovery time for COVID-19 patients, but Fauci said the results were "modest" and concerned hospitalized patients. He added that the treatment closest to wide use by the fall might be blood plasma from recovered patients.
Fauci said he was "cautiously optimistic" about the prospects of a vaccine, with eight candidates undergoing clinical trials, including one made by the firm Moderna which is closely collaborating with the National Institutes of Health where he is a senior official.
Its efficacy could be determined by late fall or early winter, he said.
"We have many candidates and hope to have multiple winners," Fauci added. "In other words, it's multiple shots on goal."
Remote testimony
Fauci, who has become the trusted face of the federal government's virus response, was one of four top medical experts testifying remotely to the Senate Health, Education, Labor and Pensions Committee.
The director of the National Institute of Allergy and Infectious Diseases, Fauci was in "modified quarantine" after Vice President Mike Pence's spokeswoman — with whom he had no close contact — tested positive.
A statement issued later by the Centers for Disease Control and Prevention (CDC) said Fauci, CDC director Robert Redfield and Food and Drug Administration (FDA) commissioner Stephen Hahn could return to work if they check their temperatures and wear masks.
There has been frequent speculation that Fauci's forthright approach has irked Trump, who has been accused of downplaying the crisis as he pushes to restart the economy.
Fauci appeared in Congress hours after Trump renewed that message on Twitter, writing: "Numbers are coming down in most parts of our Country, which wants to open and get going again. It is happening, safely!"
The US has reported more than 80,000 deaths and 1.3 million infections.
While the situation has improved in New York, and the daily nationwide death toll has dipped markedly in recent days, the rate of new cases has yet to drop off dramatically.
Though widely respected by lawmakers in both major parties, Fauci came under fire from Republican Rand Paul, who said that because the mortality rate in children is low, schools could be reopened faster in certain districts.
"As much as I respect you, Dr. Fauci, I don't think you're the end-all," said Paul. "I don't think you're the one person who gets to make the decision."
Fauci responded that he only offered scientific advice, but warned not to be "cavalier in thinking that children are completely immune to the deleterious effects" of COVID-19, given growing reports of children suffering from a related autoimmune syndrome.
The White House has outlined a three-phase approach to help state and local officials reopen their economies while observing medical advice on limiting the virus' spread.
As well as a two-week "downward trajectory" of cases, it calls for robust testing for at-risk healthcare workers, with asymptomatic cases screened as well, and contacts of positive cases traced.
Trump has been criticized for leaving states to grapple alone with their outbreaks and even bid against each other to obtain critical medical equipment.
