The US government's top infectious diseases expert, Anthony Fauci, warned on Tuesday that the coronavirus was not under control in America.
In his first appearance on Capitol Hill in two months, he delivered a message to Congress at odds with statements by President Donald Trump, who has pushed for a rapid reopening of the economy.
“If you mean do we have it under control? No,” Dr Fauci said in answer to a question from Senator Elizabeth Warren.
He said numbers in some parts of the US were coming down and the country was “going in the right direction".
"But it does not mean by any means that we have it under control,” Dr Fauci said.
He warned that ending lockdowns too soon could lead to new and uncontrollable outbreaks of the coronavirus.
Dr Fauci, who has advised six US presidents, told a Senate panel that federal authorities had developed guidelines on how to safely ease restrictions, with a sustained 14-day decrease in cases the crucial first step.
"If a community or a state or region doesn't go by those guidelines and reopens, the consequences could be really serious," he said.
Dr Fauci said that if sufficient systems were not put in place for testing, contact tracing and other measures by autumn, there would “inevitably” be a second wave of illness.
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Groom Sanjib Mandal, right, and bride Soma Roy wear masks as they perform rituals on their marriage ceremony at a Hindu temple amid the nationwide lockdown against the coronavirus, in Siliguri. AFP -
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Drivers and passengers are screened by healthcare workers from the DeKalb County Board of Health at a free swabbing site at The House of Hope Atlanta church in Decatur, Georgia, US. EPA -
An elderly woman holds a French flag as residents of Saint Mande celebrate the end of containment measures and thank medical and health care personnel amid the ongoing coronavirus pandemic in Saint Mande, near Paris, France. France begins a gradual easing of lockdown measures and restrictions although the Covid-19 epidemic remains active. EPA -
Health personnel from the Villa Nueva National Hospital stand in front of the entrance of the hospital to address a press conference in Villa Nueva, Guatemala. The health personnel treating coronavirus patients threatened to 'enter a permanent session', in which certain areas of service will receive reduced attention, within 48 hours if they do not receive help from the authorities because of the lack of human resources. EPA -
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People practice social distancing inside an elevator as they head to their work places at World Trade Centre, after the government announced that private and state companies will reopen after almost two months of lockdown to contain the coronavirus, in Colombo, Sri Lanka. Reuters -
A migrant workers' family desperate to reach their home in neighbouring Madhya Pradesh state hitchhike behind a lorry in India's commercial capital Mumbai that will take them to the outskirts of the city. India’s train network, closed in late March, will gradually restart operations on Tuesday as the country eases its lockdown amid a steep rise in the coronavirus infections. AP Photo
"There is a real risk that you will trigger an outbreak that you may not be able to control," he later said.
That, Dr Fauci said, would cost lives and lead to a greater economic setback.
He said the number of US coronavirus deaths were probably higher than the official toll of about 82,000.
This was because many people, particularly in New York, died at home before they could be admitted to a hospital, Dr Fauci told Senator Bernie Sanders.
Although colleges have started to announce plans to restart classes in autumn, Dr Fauci said it was "a bridge too far" to expect vaccines or treatments might be ready in time to ease students' fears.
The antiviral drug remdesivir was recently shown in a clinical trial to speed up the recovery time for Covid-19 patients, but Dr Fauci said the results were "modest" and from patients in hospital.
He said the treatment closest to wide use by autumn might be blood plasma from recovered patients.
Dr Fauci said he was "cautiously optimistic" about the prospects of a vaccine.
Clinical trials were being conducted on eight possibilities, including one made by Moderna, a company that is closely collaborating with the National Institutes of Health, of which he is a director.
"We have many candidates and hope to have multiple winners," Dr Fauci said. "In other words, it's multiple shots on goal."
He has become the trusted face of the federal government's virus response and was one of four top medical experts testifying online to the Senate health, education, labour and pensions committee.
Dr Fauci was in "modified quarantine" after Vice President Mike Pence's spokeswoman, with whom he had no close contact, tested positive.
The Centres for Disease Control and Prevention later said he, CDC director Robert Redfield and Food and Drug Administration commissioner Stephen Hahn could return to work if they checked their temperatures and wore masks.
There has been frequent speculation that Dr Fauci's forthright approach has irked Mr Trump, who has been accused of playing down the crisis as he pushes to restart the economy.
Mr Trump had earlier wrote on Twitter: "Numbers are coming down in most parts of our country, which wants to open and get going again. It is happening, safely."
The US has reported almost 1.4 million infections.
While the situation has improved in New York, and the daily nationwide death toll has dipped markedly in recent days, the rate of new cases has yet to drop off dramatically.
The White House has outlined a three-phase approach to help state and local officials reopen their economies while observing medical advice on limiting the spread of the virus.
As well as the two-week "downward trajectory" of cases, it calls for strong testing of at-risk healthcare workers, screening of asymptomatic cases and contacts of positive cases traced.
Mr Trump has been criticised for leaving states to grapple with their outbreaks alone and even bid against each other to obtain critical medical equipment.
