WASHINGTON -- The U.S. is "going in the wrong direction" with the coronavirus surging severely enough that Dr. Anthony Fauci told senators Tuesday that some regions are putting the entire country at risk -- just as schools and colleges are wrestling with how to safely reopen.
With about 40,000 new cases being reported a day, Fauci said he "would not be surprised if we go up to 100,000 a day if this does not turn around."
"I am very concerned," he told a hearing of the Senate Health, Education, Labor and Pensions committee.
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Last weekend, the U.S. had a record daily number of confirmed new cases -- 44,792. That is 30% higher than the peak of 34,203 on April 25, the peak day in the original surge of coronavirus cases this spring.
Health authorities have recorded more than 10.4 million confirmed infections and a half-million deaths globally, including 2.6 million cases and more than 127,000 deaths in the United States.
At Tuesday's hearing, Fauci, director of the National Institutes of Health's National Institute for Allergy and Infectious Diseases, initially declined to directly answer a question by Sen. Elizabeth Warren, D-Mass., about how many deaths and infections Americans should expect before the pandemic ends.
"It's going to be very disturbing," Fauci replied. "I will guarantee you that, because when you have an outbreak in one part of the country, even though in other parts of the country they're doing well, they are vulnerable.... It puts the entire country at risk."
Fauci and other public health experts said Americans everywhere will have to start following key recommendations if they want to get back to more normal activities like going to school.
"We've got to get the message out that we are all in this together," by wearing masks in public and keeping out of crowds, Fauci said.
Connect the dots, he told senators: When and how school buildings can reopen will vary depending on how widely the coronavirus is spreading locally.
"I feel very strongly we need to do whatever we can to get the children back to school," he said.
The Centers for Disease Control and Prevention plans more guidelines for local school systems, Director Robert Redfield said.
But in recommendations for colleges released Tuesday, the agency said it won't recommend entry testing for all returning students, and faculty and staff members. It's not clear if that kind of broad-stroke testing would reduce the spread of the coronavirus, the CDC concluded. Instead, it urged colleges to focus on containing outbreaks and exposures as students return.
Lawmakers also pressed for what Sen. Patty Murray, D-Wash., the committee's top Democrat, called a national vaccine plan -- to be sure the race for the covid-19 vaccine ends with shots that really are safe, truly protect and are available to all Americans who want them.
"We can't take for granted this process will be free of political influence," Murray said. She cited how President Donald Trump promoted a malaria drug as a covid-19 treatment that ultimately was found to be risky and ineffective.
The Food and Drug Administration released guidelines Tuesday saying any vaccine that wins approval will have to be at 50% more effective than a dummy shot in the final, required testing. That's less effective than many of today's vaccines, but independent experts say that would be a good start against the virus.
FDA Commissioner Stephen Hahn said vaccine makers also must test their shots in diverse populations, including minority groups, the elderly, pregnant women and those with chronic health problems.
"We will not cut corners in our decision-making," Hahn told senators.
But a vaccine is at the very least many months away. For now, the committee's leading Republican stressed wearing a mask -- and said Trump, who notoriously shuns them, needs to start because politics is getting in the way of protecting the American people.
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"The stakes are too high for the political debate about pro-Trump, anti-Trump masks to continue," said Sen. Lamar Alexander of Tennessee, who chaired Tuesday's hearing.
Alexander said he had to self-quarantine after a staff member tested positive for the virus but that he personally was protected because his staff member was wearing a mask.
"The president has plenty of admirers. They would follow his lead," Alexander said. "The stakes are too high" to continue that fight.
The hearing took place as governors of hard-hit states have been rescinding reopening plans in the face of surging cases of the virus.
HARD-HIT STATES
States such as Florida, Arizona, Texas and California have reversed course on their reopening plans, closing or otherwise clamping down on bars, shutting down beaches, rolling back restaurant capacity, putting limits on crowds at pools, or taking other steps to curb a scourge that may be thriving because of such factors as air conditioning and resistance to wearing masks.
"Any time you have these reopenings, you're depending on people to do the right things, to follow the rules. I think that's where the weak spots come in," said Dr. Cindy Prins, a University of Florida epidemiologist. She warned that things are likely to get worse before they get better.
Hospitals in the new hot spots are already stretched nearly to the limit and are scrambling to add intensive-care beds for an expected surge in covid-19 cases in the coming weeks.
Newly confirmed cases in Florida have spiked over the past week, especially in younger people, who may be more likely to survive the virus but can spread it to the Sunshine State's many vulnerable older residents.
In hard-hit Arizona, hospitals are looking for ways to cram more beds into their facilities and hiring out-of-state nurses. State officials have authorized "crisis standards of care" telling hospitals which patients should get ventilators or other scarce resources if there is a shortage.
Dignity Health, which operates several hospitals in the Phoenix area, is converting more areas to treat covid-19 patients and preparing to put multiple patients in private rooms, spokeswoman Carmelle Malkovich said. It's taking nurses from underutilized hospitals in its system to Arizona, and hiring traveling nurses and respiratory therapists throughout July.
Alabama Gov. Kay Ivey on Tuesday extended a state health order that limits the number of people in restaurants and stores but didn't follow other states that have issued new restrictions as the pandemic worsens.
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Ivey announced that she was extending the state's "safer at home" order that, among other things, limits occupancy in stores and restaurants, limits nursing home visitation, prohibits non-work gatherings where social distancing can't be maintained, and requires safety measures at salons and other businesses. The Republican governor extended the order, which had been set to expire Friday, through the end of July.
In a news conference at the Alabama Capitol, Ivey expressed an aversion to issue new closure orders, saying "you can't have a life without a livelihood," but pleaded with people to voluntarily wear masks and take other precautions.
"Let me urge you, in the strongest manner I can, to incorporate covid-19 precautions into your daily routine," Ivey said.
In Puerto Rico, Gov. Wanda Vazquez on Tuesday announced strict new rules for all people flying into Puerto Rico in a bid to curb coronavirus cases as officials blame recent outbreaks on those who flew to the U.S. territory and were infected.
Starting July 15, all passengers have to wear masks and must take a molecular test 72 hours before their arrival and submit the results to officials at the airport. Those who refuse to do so, or test positive, or do not have the test results available, will be forced into a two-week quarantine. During that time, they have to undergo a molecular test and provide the results if they want to be released from quarantine, said Puerto Rico Health Secretary Lorenzo Gonzalez.
"If you don't want to be tested, stay home. Don't come here and complicate our situation," he said.
EU REOPENING
Elsewhere, the European Union will reopen today to visitors from 14 countries -- but not the U.S., which has barred most Europeans. The EU also kept its ban in place for visitors from China and from countries such as Russia, Brazil and India where infections are running high.
Americans make up a big share of Europe's tourism industry, and summer is a key period. More than 15 million Americans travel to Europe each year, while some 10 million Europeans head across the Atlantic.
"Americans were 50% of my clientele," lamented Paola Pellizzari, who owns a mask and jewelry shop on the Saint-Louis island in the heart of Paris and heads its business association. "We can't substitute that clientele with another."
Britain reimposed a lockdown in Leicester, a city of 330,000 people that officials said accounted for 10% of all new coronavirus cases in the nation last week. Stores closed, and schools prepared to send children home.
Local officials accused the U.K. government of being too slow to act in Leicester. They said a rise in local infections had been evident for almost two weeks, but the central government had not shared the data promptly with public health authorities in Leicester.
Information for this article was contributed by Tamara Lush, John Seewer, Lauran Neergaard, Jill Lawless, Danica Kirka, Danica Coto, Kim Chandler, Ricardo Alonso-Zaldivar, Matthew Perrone, Collin Binkley, Mike Stobbe and staff members of The Associated Press; and by Amy Goldstein of The Washington Post.