Fauci says 'diversity of response' undermined US efforts to contain coronavirus

WASHINGTON (Sinclair Broadcast Group) — The nation’s top infectious disease expert said Friday inconsistent responses to the coronavirus pandemic across states and a failure to adhere to expert guidance prevented the United States from containing the outbreak as effectively as some countries in Europe that instituted more complete lockdowns.

“When you actually look at what we did, even though we shut down, even though it created a great deal of difficulty, we really functionally shut down only about 50% in the sense of the totality of the country," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said at a congressional hearing.

After most states shut down nonessential activities in the spring, Fauci noted many governors did not follow federal guidelines for reopening, easing restrictions much faster than he and other experts recommended. The U.S. is now struggling with a resurgence of the virus in many states, with the death toll topping 150,000 this week.

"I think there was such a diversity of response in this country from different states that we really did not have a unified bringing everything down," he told lawmakers.

New infections appear to be leveling off nationally, but close to 30 states are still seeing a rise in cases. Some governors have begun to re-impose social distancing restrictions and limits on public gatherings, and many states that initially resisted requiring residents to wear masks in public have issued new mandates.

"We need to pull out all the stops to get it down to baseline and to keep it there by doing the things that we've been talking about -- that I've been talking about -- consistently," Fauci said during a CNN town hall Thursday.

According to David Holtgrave, dean of the School of Public Health at the University at Albany, it is clear at this point what measures work to contain the coronavirus: physical distancing, face-coverings, hand-washing, testing, and contact tracing. That is how states like New York have succeeded in flattening the curve, at least for the moment.

“In some areas of the U.S. where businesses, recreational sites, and other venues opened very rapidly and while there was substantial community transmission occurring, some of these important tools have been largely or partially set aside,” he said. “In these areas it may be necessary to take a step back and go to a temporary pause again, or at least to an earlier phase of reopening.”

Holtgrave warned, however, that even communities that appear to have the virus under control now must remain vigilant and take precautions.

“It is as if a tourniquet has been applied to a wound; to keep the wound from again worsening, we must keep up the pressure,” he said.

Experts at the Johns Hopkins University Center for Health Security said in a report this week that the U.S. needs to “reset” its response to the pandemic. The report recommended a universal mask mandate, a federal effort to improve testing, and a return to stay-at-home orders in communities where transmission is high.

“The COVID-19 pandemic is a challenge far beyond what any one state, territory, or community can handle alone,” the report stated. “It is only our collective action that will generate the change necessary to regain control of this epidemic, avoid cascading crises in our healthcare system and economy, and save great numbers of lives throughout the United States.”

The Association of American Medical Colleges issued a report calling for “decisive, coordinated action” to keep the nation’s death toll from rising into the hundreds of thousands. The organization suggested establishing national standards for face coverings, local lockdown orders and reopening protocols, and safe school openings, as well as steps to address shortages in supplies and testing.

Reviving stay-at-home orders now could prove politically fraught, though, and many Americans have bristled at less extreme actions like mask mandates. Fauci told MSNBC it would be “psychologically” difficult for some to accept another lockdown, but he suggested some states should pull back their reopening plans and then open up again more carefully.

“People have, in some places, never fully experienced what a true quarantine meant, but that’s what has to happen if we’re really going to turn this around,” said Leslie Kantor, a professor at the Rutgers School of Public Health.

Fauci spent much of Friday’s hearing fending off political questions from lawmakers about President Trump’s tweets, research on hydroxychloroquine, and racial justice protests. As the pandemic has dragged on, attitudes toward the virus and steps taken to fight it have become increasingly polarized, and that presents an unwelcome complication for public health experts.

“The entire response has become so politicized... I think the narrative early on that it was something that was only a problem for New York and New Jersey made people in other parts of the country very, very impatient,” Kantor said.

To overcome public hostility to preventative measures, Holtgrave said officials must be clearer about why they are necessary and possibly use a wider array of spokespeople to communicate that. He pointed to past efforts to convince Americans to stop smoking and take precautions against HIV as examples of successful communication strategies.

“For people to be convinced that they should more completely embrace the current prevention measures, we have to be very clear about what COVID-19-related goals we are moving toward as a nation and how people can help contribute to the achievement of these goals,” Holtgrave said. “Unfortunately, we now seem adrift.”