White House health advisor Dr. Anthony Fauci told Congress on Tuesday that he’s worried some states are prematurely reopening businesses and may have ” little spikes” in coronavirus cases that erupt into full-blown outbreaks.

Fauci’s comments come as the virus continues to spread across the United States, infecting more than 1.3 million people and killing at least 80,684 as of Tuesday morning, according to data compiled by Johns Hopkins University. U.S. health officials say the true number of cases and deaths is likely much higher as some people infected with the virus go undetected.

In the U.S., some states are beginning to reopen businesses despite projections suggesting it will lead to a steady rise in the number of Covid-19 cases and deaths over the next couple of weeks.

Fauci said he’s worried that some states are loosening social distancing restrictions even as their Covid-19 cases continue to rise. The White House laid out a plan that allows states to gradually reopen local businesses as cases and hospitalizations decline and testing increases, among other “check points.” 

“What I’ve expressed then and again is my concern that if some areas, cities, states, what have you, jump over those various check points 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,” he testified at a hearing before the Senate Committee on Health, Education, Labor and Pensions.

Fauci repeated his call for a vaccine as essential to stopping the spread of the coronavirus and reducing the rate of deaths from the pandemic. He said he was optimistic they would find a workable candidate, but warned of potential pitfalls in developing any vaccine. He also said one won’t be ready for the school year starting this fall.

“Even at the top speed we’re going, we don’t see a vaccine playing in the ability of individuals to get back to school this term,” he said.

Until a vaccine is ready, Fauci said, the country’s “Covid-19 response currently is focused on the proven public health practices of containment and mitigation,” he said in written testimony submitted ahead of the hearing. Even though there are more than 100 potential vaccines under development, Fauci warned “there’s no guarantee that the vaccine is actually going to be effective.” 

Another worry among epidemiologists, Fauci said, is that the vaccine backfires and strengthens the virus.

There have been at least two vaccines in the past that have produced a “suboptimal response,” he said. “And when the person gets exposed, they actually have an enhanced pathogenesis of the disease, which is always worrisome. So we want to make sure that that doesn’t happen. Those are the two major unknowns.”

Dr. Anthony Fauci speaking during the U.S. Senate committee on Health, Education, Labor and Pensions hearing on May 12th, 2020.

CNBC

Fauci told The New York Times Monday he planned to publicly warn states that prematurely reopening their economies will cause “needless suffering and death.

“The major message that I wish to convey to the Senate HLP committee tomorrow is the danger of trying to open the country prematurely,” Fauci wrote in an email to New York Times health policy reporter Sheryl Gay Stolberg.

“If we skip over the checkpoints in the guidelines to: ‘Open America Again,’ then we risk the danger of multiple outbreaks throughout the country. This will not only result in needless suffering and death, but would actually set us back on our quest to return to normal,” Fauci wrote. 

Fauci, director of the National Institute of Allergy and Infectious Disease, has previously warned state officials against reopening their economies too early. While his written testimony didn’t address the issue, he was expected to address those concerns at the hearing.

Hopes to get a vaccine to market are high, but scientists are setting expectations low for how quickly it can happen. Developing, testing and reviewing any potential vaccine is a long, complex and expensive endeavor that could take years, global health experts say.

President Donald Trump has previously said there could a vaccine by the end of the year, contradicting predictions from his own U.S. health officials and scientists who say it will take a year to 18 months at the earliest.

Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, testifies about the measles outbreak in the United States before a House Energy and Commerce Oversight and Investigations Subcommittee hearing on Capitol Hill in Washington February 3, 2015.

Jim Bourg | Reuters

Fauci, in his written testimony Tuesday, touted the U.S. government’s vaccine partnership with biotech company Moderna, which is completing its phase one trial. The company’s potential vaccine contains genetic material called messenger RNA, or mRNA, that was produced in a lab. Last week, Moderna said it would soon begin phase two trials with 600 participants and was finalizing plans for a late-stage trial as early as this summer.

U.S. health officials are also working with several other groups, Fauci said, including researchers at the University of Oxford who are developing a vaccine candidate.

In the meantime, effective therapeutics are “critical” to treat patients infected with the virus, Fauci said. 

The Food and Drug Administration on May 1 granted so-called emergency use authorization for Gilead Sciences‘ remdesivir drug to treat Covid-19, meaning doctors will be allowed to use the drug on patients hospitalized with the disease even though the drug has not been formally approved by the agency to treat the coronavirus.

Besides remdesivir, Fauci said U.S. health officials are developing and testing other new and repurposed therapies, including monoclonal antibodies, which are proteins created in a lab that attack specific antigens. 

They are also planning clinical trials to evaluate anti-malaria drug hydroxychloroquine and azithromycin in patients with mild to moderate Covid-19, and hyperimmune intravenous immunoglobulin for treatment of the disease, he said. 

The National Institutes of Health is also supporting an effort by the Department of Health and Human Services to promote the development of diagnostic tests to detect the virus, Fauci said.

Last week, NIH Director Dr. Francis Collins told Congress that the U.S. will work with companies to make millions of “accurate and easy-to-use” coronavirus tests by the end of the summer, and even more before the flu season, as states ease social distancing measures and Americans head back to work.

“These efforts will improve our response to the current pandemic and bolster our preparedness for the next, inevitable emerging disease outbreak,” Fauci said Tuesday.

— CNBC’s Christina Wilkie and Lauren Feiner contributed to this article.

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