BOSTON (State House News Service) — Federal health officials expect to ramp up COVID-19 testing capabilities to the point that 40 million to 50 million tests can be conducted per month by September, but Dr. Anthony Fauci classified it as "a bridge too far" to imagine a vaccine or treatment playing a role in bringing students back to college and K-12 campuses this fall.
Fauci, the head of the National Institute of Allergy and Infectious Diseases, and other top doctors testified before a U.S. Senate committee Tuesday, where he warned of "really serious" consequences and "little spikes that would turn into outbreaks" if states and cities try to reopen economic activity before they've experienced sustained declines in COVID-19.
Gov. Charlie Baker on Monday broadly outlined a four-phased approach to reopening the Massachusetts economy, and an advisory board he convened is slated to produce a full plan by May 18.
Fauci said that even if states pursue reopening at an "appropriate pace" that matches the local dynamics of the contagious disease, their ability to respond to future cases will be what determines "whether you can continue to go forward as you try to reopen America."
Centers for Disease Control and Prevention director Dr. Robert Redfield said testing, early identification and isolation of new cases, contact tracing and social distancing are all important parts of slowing the spread of COVID-19.
"Rapid, extensive and widely available, timely testing is essential for reopening America," Redfield said.
Increasing state, local and tribal contact tracing capacity is also "critical," he said.
Redfield said the CDC is working on a disease surveillance program that will look at asymptomatic infections and vulnerable populations, like people in long-term care facilities or those who are homeless.
Long-term care centers, including nursing homes, have been a major hotspot for COVID-19 cases in deaths both in Massachusetts and nationally. More than 3,000 people in Massachusetts long-term care facilities have died of COVID-19, representing 60 percent of the 5,108 fatalities that had been reported as of Monday.
Sen. Maggie Hassan of New Hampshire asked Fauci what steps should be taken to protect nursing home residents, asking if the mask requirements and daily testing in place at the White House should be implemented in long-term care settings.
"I think there should be a system in place for the optimal protection of people in nursing homes, and that would not necessarily be testing every person every day," Fauci replied. "That's one approach that might not be practical when you think of all the nursing homes in the country, but very strict regulations and guidelines about who is allowed to go into the nursing home, and the staff, I believe, needs to be monitored very carefully with intermittent testing to be sure that we don't have introduction into the nursing home of infected individuals."
Since March 12, more than 9 million COVID-19 tests have been performed in America, said Admiral Brett Giroir, a pediatrician who serves as assistant secretary for health at the U.S. Department of Health and Human Services.
Giroir said states and territories established a collective goal of conducting 12.9 million tests over the next few weeks, and, to support that effort, the federal government plans to ship out 12.9 million testing swabs in May.
He projected that by September, there will be national capacity to conduct "at least 40 to 50 million tests per month if needed at that time," and said that number could be higher depending on new technologies.
As of Monday afternoon, a total of 394,728 tests had been performed in Massachusetts, and Gov. Charlie Baker said Tuesday that the state has been "on a global hunt for swabs" to make sure community health centers, hospitals and other providers have the tools they need as testing ramps up.
Redfield, Fauci, and Food and Drug Administration Commissioner Dr. Stephen Hahn, all members of the White House coronavirus task force, each appeared via video before the Senate Health, Education, Labor and Pensions Committee. The three men are in versions of self-quarantine after possible exposure to COVID-19.
Fauci said that as an essential worker, his quarantine is different from the strict model most people have become familiar with. He said he was at the White House on Monday and "will likely perhaps even be there today."
Tennessee Republican Sen. Lamar Alexander, who chairs the committee and also participated by video from his home, asked Fauci and Giroir what they'd say to college administrators and school principals "about how to persuade parents and students to return to school in August."
Fauci said that while vaccine development is happening at a "top speed," he doesn't see it playing into efforts to return to campuses and classrooms in the fall.
"The idea of having treatments or a vaccine to facilitate the reentry of students into the fall term would be something that would be a bit of a bridge too far," he said.
Giroir said testing strategies on college campuses will depend on what community spread of COVID-19 is like at the time, but that a campus would "technically" have the ability to test all its students. Surveillance strategies that involve testing groups of students at different times are more likely, he said.
Giroir also said there are other strategies and experimental approaches that need validation, like pooling samples so that one test can be used on multiple samples, or testing the wastewater from a dorm to see if the sewage contains the coronavirus.
By Katie Lannan, State House News Service