Senators listen as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks remotely during a virtual Senate Committee for Health, Education, Labor, and Pensions hearing May 12 on Capitol Hill.

Senators listen as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks remotely during a virtual Senate Committee for Health, Education, Labor, and Pensions hearing May 12 on Capitol Hill. Win McNamee/Pool via AP

Federal Officials Detail Steps Agencies Must Still Take to Help States Reopen

Dr. Anthony Fauci and others caution that reopening too soon would lead to more uncontrollable outbreaks.

Federal agencies are working tirelessly to put states in a position to reopen shuttered businesses, schools and other parts of society, the top government officials leading the response to the novel coronavirus pandemic told lawmakers on Tuesday, though they noted many key steps are still months away. 

The officials collectively represented tens of thousands of federal employees on the frontlines of the fight against the COVID-19 outbreak as they work on containment, mitigation and treatment efforts. While agencies such as the Centers for Disease Control and Prevention, Food and Drug Administration and National Institutes of Health are developing and expanding ways to stop the spread of the coronavirus, officials warned lawmakers on the Senate Health, Education, Labor and Pensions Committee that ending stay-at-home orders too quickly would likely reverse the progress the country has made. Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said premature reopenings would lead to “little spikes that could turn into outbreaks.” 

"There is a real risk that you will trigger an outbreak that you will not be able to control, will set you back, on the road to economic recovery,” Fauci said. “It would almost turn the clock back."

As they have said for weeks, the officials stressed the need to ramp up testing and contact tracing to safely remove stay-at-home orders currently in place around the country. CDC Director Rob Redfield noted his agency is working with Americorps and the Census Bureau to bolster contact tracing efforts. 

“It is fundamental,” Redfield said. “People underestimate how important it is that we have a highly functional, comprehensive, aggressive contact tracing program so the next outbreak we have containment, we don’t have to switch to mitigation.”  

The director noted 4,000 CDC employees have been deployed “to every corner of this nation” and around the world to work on coronavirus response efforts. Adm. Brett Giroir, the Health and Human Services Department’s assistant secretary for health and who leads the U.S. Public Health Service, noted about 3,500 USPHS personnel have deployed to nursing homes, cruise ships, the Federal Emergency Management Agency, filed hospitals in hard-hit communities and other locations around the country. FDA Commissioner Stephen Hahn thanked all of his agency’s 18,000 employees for the “active role” they have taken in response to the pandemic. 

Giroir, who is serving as the Trump administration’s “testing czar,” said he expects the nation will be able to conduct 40-50 million tests per month by September. The U.S. has conducted about 9 million tests total since the outbreak began. Lawmakers and officials highlighted the timeline as critical to help schools and universities reopen in time for the next school year so entire campuses, or a sampling therein, can be tested and positive cases can be isolated. Giroir projected the country would conduct about 13 million tests in May. 

Fauci described an NIH effort to expand testing through private sector innovation as a “shark tank,” an initiative that would enable the agency to work with potential vendors and “get to success or failure quickly.” NIH is also collaborating with several pharmaceutical companies to develop a vaccine, with eight potential candidates currently in clinical trials. All of those are still in the first phase of development. Fauci noted it would be a “bridge too far” to expect a vaccine or therapeutic in time for the school year this fall. Hahn said FDA has been working to create an abbreviated regulatory framework under which therapeutic candidates can be approved and distributed if they are proven viable. 

Fauci, a long-time NIH official who has become a household name and the face of federal government’s scientific response to the pandemic, faced some criticism during the hearing. Sen. Rand Paul, R-Ky., told Fauci his opinion was not the only one that matters and that other officials thought it was already safe to send Americans back to work. 

"I have never made myself out to be the end all and only voice in this,” Fauci responded. “I'm a scientist, a physician and a public health official. I give advice according to the best scientific evidence.”

Sen. Richard Burr, R-N.C., meanwhile, criticized Redfield for CDC’s failure to expand its contact tracing program, noting Congress authorized 30 positions for surveillance last year that the agency never filled. Redfield said his agency was still working on hiring for those jobs, while adding CDC’s surveillance program was quickly overwhelmed due to the rapid spread of the virus and the need to move to mitigation rather than containment. 

“We had an aggressive contact tracing program but unfortunately as the cases [grew] it went beyond the capacity,” Redfield said. 

The Government Accountability Office recently reported that CDC, NIH and FDA have failed to use authority Congress granted the agencies to hire 2,000 biomedical scientists at higher rates of pay who could have assisted in the coronavirus response. 

Redfield responded to allegations that the White House buried detailed guidance for state and local governments to follow as they reopen by explaining the document is still going through the interagency review process. He said CDC is ready to provide assistance to any state that makes such a request and that the document will be posted on its website “soon.” 

As officials across the country have begun lifting stay-at-home orders and others consider the appropriate time to do so, Fauci warned that local, state and federal entities must remain prepared for another uptick in COVID-19 cases. 

“It’s not only doing it at the appropriate time with the appropriate constraints, but having in place the capability of responding when the inevitable return of cases occurs,” Fauci said.