Leading U.S. infectious disease expert Dr. Anthony Fauci warned Congress on Tuesday that a premature opening of the country's economy could lead to additional outbreaks of the deadly coronavirus.
The director of the National Institute of Allergy and Infectious Diseases warned a U.S. Senate panel that states should follow health experts' recommendations to wait for signs, including a declining number of new infections, before reopening.
U.S. President Donald Trump has been encouraging states to end a weeks-long shuttering of major components of their economies.
"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," Fauci said. "The consequences could be really serious."
Fauci, a member of Trump's coronavirus task force, told the Senate's health, education, labour and pensions committee that the country's efforts to battle the deadly virus and the COVID-19 respiratory disease it triggers should be "focused on the proven public health practices of containment and mitigation."
WATCH l Fauci warns U.S. Senate about reopening too soon:
The COVID-19 respiratory disease caused by the new coronavirus has infected more than 1.3 million Americans and killed over 81,000 people in the United States.
In response to questioning from Vermont Sen. Bernie Sanders, Fauci said the total is likely below the true tally due to a lag in reporting some deaths, and that the country will likely face a second wave of infections later in the year.
Asked whether college students can feel safe if classes resume on campuses in late August or early September, Fauci said that expecting a treatment or vaccine to be in place by then would be "a bridge too far."
Instead, schools and students would have to depend on expanded testing for coronavirus, tracing of those who have been in contact with infected people, and safe hygiene practices.
Could spike again
The veteran doctor, who has worked under Republican and Democratic administrations, noted progress in the fight against a virus that the medical world is still trying to understand.
He noted a slowing in the growth of cases in hotspots such as New York, even as other areas of the country were seeing spikes.
The wide gap in the U.S. death rate with Canada's has been narrowing in recent days, but some American experts are warning that U.S. cases could spike again — and that the country is courting trouble by reopening too quickly.
The damage will only become obvious this summer, according to Dr. Ezekiel Emanuel, who was an adviser to then-president Barack Obama and has informally advised Trump on health policy. Emanuel warned that people frequently, and mistakenly, assume they'll notice any new spike within two weeks.
But he said the trajectory of this illness shows that new outbreaks start as a blip, then build exponentially, becoming obvious in a couple of months.
"You've got to look to mid-July — that's likely when you'll see the effects of what we're doing today," Emanuel told CBC News.
"That's what people will recognize: 'Wow, now we've got 1,000 cases today; 3,000 cases tomorrow; 6,000 the next day."
Others testifying at the Senate's health committee include U.S. Centers for Disease Control and Prevention director Robert Redfield, assistant secretary for health Brett Giroir and Food and Drug Administration commissioner Stephen Hahn.
Fauci, Redfield and Hahn have been taking self-quarantine steps after coming into contact with someone who tested positive for the virus.
Committee chair wants to see more testing
Republican committee chair Sen. Lamar Alexander participated remotely. A member of the Tennessee senator's staff tested positive last week for the coronavirus, leading Alexander to self-quarantine for 14 days.
"All roads back to work and back to school run through testing, and … what our country has done so far on testing is impressive, but not nearly enough," said Alexander in his opening statement to Tuesday's hearing.
Trump has expressed ambivalence about the need to test extensively and his administration has largely left it to states to decide whether and how to reopen, even though several that are doing so haven't met the criteria previously set out by the White House to justify loosening restrictions. State governors are taking varying approaches, with a growing number relaxing tough restrictions enacted to slow the outbreak, even as opinion polls show most Americans are concerned about reopening too soon.
Washington Sen. Patty Murray, the senior Democrat on the committee, criticizing aspects of the administration's response to the pandemic, said Americans "need leadership, they need a plan, they need honesty and they need it now, before we reopen."
'I don't think you're the end-all'
Republican Kentucky Sen. Rand Paul said there are too many unknowns so far with COVID-19 to express confidently that reopening the economy in some regions will lead to a wave of new infections, pointing to states that haven't experienced anything close to pandemic levels of positive cases.
Paul himself tested positive for the coronavirus and has since recovered. Last week, Paul, who is a doctor, said he had immunity from the virus, though scientists have yet to establish a consensus on whether immunity exists or for how long.
"I don't think you're the end-all," Paul said to Fauci. "I don't think you're the one person that gets to make the decision."
Fauci, 79, pushed back, advising that Trump and the administration have a whole host of advisers engaged on the challenge of the pandemic, including economic experts.
"We don't know everything about this virus," Fauci, the director of the National Institute of Allergy and Infectious Diseases, said. "And we'd really better be very careful, particularly when it comes to children.
"I think we'd better be careful that we are not cavalier in thinking that children are completely immune to the deleterious effects."
Fauci referred to a rare inflammatory syndrome believed to be linked to the novel coronavirus, which has killed at least three children in New York and afflicted dozens of others.
WATCH | Many unknowns 2 months into lockdowns:
Giroir told the Senate that the U.S. could be performing at least 40 million to 50 million tests per month by September.
That would work out to between 1.3 million and 1.7 million tests per day, but Harvard researchers have said the United States must be doing 900,000 by this Friday in order to safely reopen.
Trump claimed Monday the country was up to 300,000 tests per day, though federal data suggests the average the past week is closer to 250,000.
Republican Sen. Mitt Romney of Utah, who has clashed with Trump in the past, did so again on Tuesday, when he said during the hearing, "I find our testing record nothing to celebrate whatsoever."
With files from CBC's Alexander Panetta and The Associated Press