Without a vaccine to halt the spread of the coronavirus, widespread testing and tracing of the illness will be essential to ensure public confidence that children can safely return to school in the fall, federal health officials told a Senate committee Tuesday.
Such testing will be necessary to determine if states are ready to ease restrictions that have shuttered schools and businesses and to trace inevitable reemergence of the coronavirus in some areas after schools welcome students back, Dr. Anthony Fauci, the nation’s chief epidemiologist, told the Senate Health, Education, Labor, and Pensions committee.
“I hope that if we do have the threat of a second wave, we will be able to deal with it very effectively to prevent it from becoming an outbreak,” with adequate preparation over the summer months, Fauci said.
It’s a “bridge too far” to suggest that a vaccine, which will take at least 18 months to develop, will be a factor in school reopening plans, Fauci said, so states should focus on developing testing procedures and the ability to trace contacts of those who contract the virus to quickly quarantine those affected.
The hearing came as governors and school superintendents around the country begin to set plans for reopening schools. And, while many of those discussions have focused on social distancing and remote learning strategies, school leaders will also play a role in helping to track the illness and guide local response efforts. Recently, a task force of former education officials called for schools to track factors like student fevers and family illness when they reopen.
“All roads back to work and school lead through testing,” Sen. Lamar Alexander, R-Tenn., the committee chairman, said. He participated remotely as a precaution after one of his staffers tested positive for the virus. So did the federal officials, who are self-isolating after they interacted with a White House aide who later tested positive.
Federal testing efforts so far are “impressive, but not enough,” Alexander said. He listed efforts to expand the quantity and methods of testing so that they could be quickly administered in a variety of contexts, even schools. Those include the development potential at-home saliva tests that could be self-administered, and rapid on-site testing. He also pointed to a “Shark Tank"-style program through which the National Insitutes of Health is rapidly reviewing new potential diagnostic methods.
Admiral Brett Giroir, assistant secretary for health at the U.S. Department of Health and Human Services, said his agency believes the country will have the capability to collectively test 40 million to 50 million people a month by September.
Asked by Alexander if that means a middle school principal or university president would be able to test every student on their campus, Giroir said that would be possible, but such expansive testing might not be necessary in all areas. Local health officials may be able to monitor community spread and prevalence of the virus by periodically testing a sample of individuals or even by monitoring the presence of genetic material in wastewater, he said.
Some senators pressed public health leaders who testified at the hearing for more specific guidance on what precautions schools should take and what an effective testing strategy would look like. Sen. Chris Murphy, D-Conn., said existing White House guidance is “criminally vague.” Education groups have said schools need more direction than the document provides, noting that it calls for schools to reopen in the same phase it cautions against crowds of more than 50 people.
Murphy pressed Robert Redfield, director of the Centers for Disease Control and Prevention, on reports that administration officials had shelved more specific CDC guidance.
“States are reopening right now, and we need that additional guidance to make these decisions,” Murphy said.
Sen. Bill Cassidy, R-La., pushed for more federal direction specifically about schools’ role in testing and what diagnostic strategies will be necessary to safely reopen them.
“Clearly there is going to need to be an integration of a testing strategy that is going to need to be different for different school settings,” Redfield said in response.
Sen. Patty Murray, D-Wash., the committee’s ranking member, cast doubt on promises of rapid testing expansion. The Trump administration “has had a record of bringing us broken promises” on when states would have adequate supplies, lab capacity, and personnel to trace the virus, she said.
The White House guidance calls for states to ease restrictions in a phased approach only after they ensure they have adequate testing, tracing, and hospital surge capacity and only after they’ve seen declining rates of the virus for 14 consecutive days. Schools would reopen in the second phase, after 28 days of declines.
But some states have opened businesses and public places without meeting some of those requirements, Fauci said, which could leave their residents vulnerable.
“My concern is that if some areas ... jump over those various checkpoints and prematurely open up—without having the capability of being able to respond effectively and efficiently—my concern is we will start to see little spikes that might turn into outbreaks,” he said.
His remarks stood in contrast to frequent boasts by President Trump that the nation outpaces other countries in testing. Trump touts overall numbers, not per-capita rates. He’s sparred with governors about who is responsible for expanding testing capacity, and they’ve pushed him to coordinate the complicated supply chain of diagnostic materials.
In a tense exchange, Sen. Rand Paul, R-Ky., told Fauci he wasn’t the “end-all” for decisionmaking about containing the virus. Given the low coronavirus mortality rate for children, he questioned cautions that there could be a surge in illness if schools reopen improperly.
“People are hurting, and we’re destroying our country,” Paul later told reporters.
In the hearing, Fauci said he didn’t view himself as the ultimate decisionmaker. Rather, he sees his role as humbly dispensing advice so officials can make informed decisions.
“I think we better be careful that we’re not cavalier in thinking that children are completely immune to the deleterious effects,” Fauci told Paul.
Medical officials have recently reported growth of a coronavirus-related severe inflammatory illness in children, and researchers are still studying children’s immunity to the virus and their ability to carry it asymptomatically and to spread it to more vulnerable adults.
Top photo: Sen. Tim Kaine, D-Va., listens to testimony before the Senate Committee for Health, Education, Labor, and Pensions hearing Tuesday on Capitol Hill. Senators wore face masks and witnesses testified remotely amid the coronavirus pandemic. --Toni L. Sandys/The Washington Post via AP, Pool
Second photo: Sen. Rand Paul, R-Ky., speaks during the Senate hearing.--Win McNamee/Pool via AP