Coronavirus could roar back if states lift restrictions too soon, top U.S. health officials warn

The nation’s top health officials warned Tuesday that the United States risks new coronavirus outbreaks and possibly a broad resurgence nationwide if states and cities reopen too quickly, setting up a potential conflict with President Trump and his deepening view that the country must lift restrictions and spark the moribund economy.

Anthony S. Fauci, the nation’s top infectious disease expert, predicted Americans would experience “suffering and death that could be avoided,” as well as additional economic damage, if states ignore federal guidelines, including delaying reopening of most businesses until they see dramatic declines in cases.

Most states already are ignoring at least some of the federal guidelines. Pennsylvania, where Trump announced he will travel this week for an event meant to cheer on economic revitalization, is among states Trump says are moving too slowly.

“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 that we will start to see little spikes that might turn into outbreaks,” said Fauci, director of the National Institute of Allergy and Infectious Diseases. “I have been very clear in my message — to try, to the best extent possible, to go by the guidelines, which have been very well thought-out and very well-delineated.” 

Also Tuesday, House Democrats unveiled a coronavirus rescue bill that would direct more than $3 trillion to state and local governments, health-care systems, a second round of stimulus checks and a range of other priorities. Republicans rejected the legislation before they saw it.

And the White House instituted new restrictions internally, with Trump and Vice President Pence for the time being likely to keep away from each other, White House press secretary Kayleigh McEnany confirmed Tuesday. Two people in Trump’s and Pence’s orbits tested positive in recent days, and most White House officials will be asked to wear masks or face coverings in public spaces.

In his first congressional testimony since Trump declared the coronavirus pandemic a national emergency on March 13, Fauci bluntly laid out the dangers of ignoring federal reopening guidelines. Rather than the small “flare-ups” that Trump said last week might be an inevitable cost of reopening, Fauci warned that the virus could again spread largely unimpeded.

a group of people looking at a screen: Sens. Lisa Murkowski (R-Alaska), left, Mike Braun (R-Ind.) and Rand Paul (R-Ky.) listen as Anthony S. Fauci answers questions during a hearing about the novel coronavirus on Tuesday.© Toni L. Sandys/The Washington Post Sens. Lisa Murkowski (R-Alaska), left, Mike Braun (R-Ind.) and Rand Paul (R-Ky.) listen as Anthony S. Fauci answers questions during a hearing about the novel coronavirus on Tuesday.

Fauci and two federal government colleagues cautioned that neither a vaccine nor surefire treatments would be available when schools are slated to reopen in the fall — a grim reminder that it is unlikely life will soon return to normal even if Americans try to resume their routines.

Fauci also contradicted Trump’s claims of last week that the virus would die out of its own accord — without a vaccine — and said the true U.S. death toll is probably higher than the 80,000 tallied by Tuesday morning. The total rose above 81,000 later in the day, with the daily death count again rising above 1,500 nationwide.

“That is just not going to happen,” Fauci said Tuesday of a possible sudden end to the crisis. “It’s a highly transmissible virus. It is likely there will be virus somewhere on this planet that will likely get back to us.”

Trump tweeted about his “Transition to Greatness” economic plan but stayed out of public view Tuesday. He announced a visit to Allentown in eastern Pennsylvania, where he is expected to visit medical manufacturing firm Owens and Minor. 

Trump has been critical of Pennsylvania’s Democratic governor, Tom Wolf, who began lifting some stay-at-home limits this month. Pennsylvania is a swing state Trump hopes to win in November in a reelection bid imperiled by recession and soaring unemployment linked to the pandemic.

“If you look at Pennsylvania as an example, if you look at various other states, I won’t get into them, the people want to go back,” Trump said Monday. “The numbers are getting to a point where they can, and there just seems to be no effort on certain blue states to get back into gear, and the people aren’t going to stand for it. They want our country open. I want our country open, too; I want it open safely, but I want it open.”

a person holding a sign: White House press secretary Kayleigh McEnany speaks during a news briefing in the White House on Tuesday.© Jabin Botsford/The Washington Post White House press secretary Kayleigh McEnany speaks during a news briefing in the White House on Tuesday.

McEnany played down any disconnect between the guidelines developed by Fauci and others as part of a White House task force. The guidelines call for strict controls on movement and commerce at least until states chart two weeks of declining cases, a benchmark few have yet met.

Trump “has encouraged states to follow the guidelines. That’s still consistently our recommendation today, that you should follow the phased approach to reopening as outlined in the data” McEnany said.

“I do want to stress, as the president has stressed, that we do want to reopen this country.”

Fauci’s comments came during a contentious Senate hearing as lawmakers of both parties pressed him and other federal health officials on whether the country is ready to reopen. The panel’s chairman and all four witnesses appeared remotely because they all recently came into contact with people with confirmed infections — a testament to how the virus has transformed life even within Washington’s corridors of power.

Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health, Education, Labor and Pensions Committee, which held the hearing, is self-isolating at home after a staff member tested positive for the virus. Fauci; Stephen Hahn, head of the Food and Drug Administration; Robert Redfield, director of the Centers for Disease Control and Prevention; and Brett Giroir, an assistant secretary in the Department of Health and Human Services, all testified remotely after coming into contact with a White House aide who tested positive.

a group of people sitting at a desk: Sens. Tim Kaine (D-Va.) and Richard Burr (R-N.C.) greet each other with an elbow bump before Tuesday’s hearing.© Toni L. Sandys/The Washington Post Sens. Tim Kaine (D-Va.) and Richard Burr (R-N.C.) greet each other with an elbow bump before Tuesday’s hearing.Giroir, who oversees the U.S. testing strategy, told senators the country could be performing up to 50 million tests a month by September — but that would still amount to fewer than the 2 million to 3 million tests a day that experts have said are needed to ensure that people returning to work are infection-free. 

The health officials also warned that a surge of cases in the fall could be especially challenging, when a coronavirus outbreak could coincide with flu season — in contrast to the president’s statements that the fall season would not be worse.

Redfield said the United States would need a five- to tenfold increase in its capability to conduct contact tracing by the fall to identify all the known contacts of someone who tests positive for the novel coronavirus to prevent an outbreak. He warned that individuals need to remain vigilant in practicing social distancing measures for the next several months.

The hearing often became combative, with Democrats criticizing Trump’s response to the pandemic and even Sen. Mitt Romney (R-Utah) scolding Giroir at one point for politicizing testing numbers. Romney said Giroir “celebrated” the fact that the country is conducting more tests per capita than South Korea in a Rose Garden news conference on Monday but ignored the fact that South Korea had far greater testing capacity than the United States at the beginning of its outbreak.

“I find our testing record nothing to celebrate whatsoever,” Romney said.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases is seen in a frame grab from a video feed as he testifies remotely from his home during a U.S. Senate Committee for Health, Education, Labor, and Pensions hearing on the coronavirus disease (COVID-19) in Washington, U.S., May 12, 2020. U.S. Senate Committee for Health, Education, Labor, and Pensions Committee/Handout via REUTERS© Thomson Reuters Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases is seen in a frame grab from a video feed as he testifies remotely from his home during a U.S. Senate Committee for Health, Education, Labor, and Pensions hearing on the coronavirus disease (COVID-19) in Washington, U.S., May 12, 2020. U.S. Senate Committee for Health, Education, Labor, and Pensions Committee/Handout via REUTERSMcEnany returned to the South Korea comparison Tuesday, saying every U.S. state is in a better position than South Korea.

McEnany’s statement is accurate when it comes to testing per capita, but it ignores the fact that South Korea began expanding testing much faster and earlier than the United States and was able to hold down deaths. South Korea has had fewer than 300 covid-19 deaths, while 29 U.S. states had surpassed that number as of Monday. The United States has far more confirmed cases and far more virus-related fatalities than any other country.

The Trump administration has faced criticism that it is not testing enough Americans, with health experts arguing that far more testing is necessary. Trump has been dismissive about the need for testing, calling it “somewhat overrated” last week.

On Monday, the president claimed that his administration is besting the world in testing and that it will help states expand such efforts, which are a key element of lifting the safety restrictions that have shuttered much of the economy since March.

Trump’s claims about U.S. testing benchmarks do not account for what health experts have criticized as the slow pace of testing capability in the United States this spring, a delay that some say contributed to the rapid spread of the virus, the mounting death toll and uncertainty about the way forward.

States still do not have what they need to meet their testing requirements. Michigan Gov. Gretchen Whitmer (D), who has criticized the Trump administration for not supplying enough personal protective equipment to her state, said in an interview Tuesday that she has been receiving testing materials from the Federal Emergency Management Agency but that the state — which has had one of the worst outbreaks in the country — still is not at the level of testing it needs.

“FEMA sent us swabs today. We need more and they are committing to sending us swabs through the end of May at least,” Whitmer said. “But we’re still not in a position to meet every need.”

© Olivier Douliery/AFP/Getty Images Health-care workers wait for patients to be tested at a walk-in site Tuesday in Arlington, Va.

In China on Tuesday, authorities in the city of Wuhan said they plan to test all 11 million residents by the end of next week in a massive push to extinguish any remnants of the virus from the outbreak’s original epicenter.

Sen. Rand Paul (R-Ky.), who recovered after becoming infected with covid-19 earlier this year, questioned aspects of the scientific consensus, telling Fauci that he was not the “end-all” for coronavirus decisions. Paul asserted that schools could reopen widely in the fall because the virus appears to be less dangerous to children.

“It’s not to say this isn’t deadly, but really, outside of New England, we’ve had a relatively benign course for this virus nationwide,” Paul said.

In addition to the outbreak in Northeastern states Paul apparently was citing, virus hot spots across the country have included areas of Louisiana, Florida, Michigan and Washington state. The worst outbreaks in the country were just outside of New England, in New York and New Jersey.

“I’ve never made myself out to be the end-all,” Fauci replied.

Fauci warned that while the numbers indicate the pathogen is less dangerous to children, “we don’t know everything about this virus.” He noted a spate of new cases of infected children presenting with a “very strange inflammatory syndrome.”

Fauci also dismissed the notion that there might be a cure or effective treatments in time for schools to reopen in the fall.

“The idea of having treatments available or a vaccine to facilitate reentry of students into fall term would be something that would be a bit of a bridge too far,” he said. “The drug that has shown some degree of efficacy was modest and in hospitalized patients” only, he added, referring to remdesivir, the Gilead antiviral drug that has been shown to reduce recovery time for people with covid-19. But Fauci said that remdesivir alone was not sufficient as a therapeutic. 

Asked by Sen. Elizabeth Warren (D-Mass.) whether the virus is contained in the United States, Fauci chose his words carefully. “I think we are going in the right direction,” he said. “But the right direction does not mean we have by any means total control of this outbreak.”

Sen. Chris Murphy (D-Conn.) pressed health officials over whether the Trump administration would release more detailed guidance to aid states beginning to reopen, adding that the guidance so far provided is “criminally vague.”

Redfield declined to commit to a specific timetable on when the CDC might issue more detailed guidance. Several media outlets reported last week that the White House rejected CDC guidance because it was overly proscriptive.

“You work for a president who is frankly undermining our efforts to comply with the guidance you gave us,” Murphy told the health officials. “The guidance you gave us is criminally vague. The plan to reopen America was to be followed by more nuanced, detailed guidance.”

Source: Washingtonpost.com

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