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Top federal health officials warned Tuesday that surges in coronavirus infections in more than a dozen states could worsen without new restrictions, and contradicted President Trump’s recent claims that he told officials to slow testing so the country would record fewer cases.

Anthony S. Fauci, the nation’s top infectious-disease expert and director of the National Institute of Allergy and Infectious Diseases, said the country is still in the grip of the pandemic’s first wave, including a “disturbing surge” of new cases in Southern and Western states, including Florida, Texas and Arizona.

“That’s something I’m really quite concerned about,” Fauci said. “A couple of days ago, there were 30,000 new infections. That’s very disturbing to me.”

The hearing came on the same day that Arizona reported record-high new coronavirus cases, and both Texas and Arizona reported record hospitalizations. Trump held a campaign rally in Phoenix on Tuesday, days after his trip to Tulsa, another site of surging infections. Last week, Texas, Florida, Arizona and at least seven other states reported their highest weekly infection-rate averages.

On Tuesday, the United States recorded 33,730 new cases, the highest total since April 25. At least 119,000 deaths had been reported in the nation as of Tuesday afternoon, along with more than 2.3 million infections. Worldwide, there have been more than 9 million confirmed cases of the virus.

All four health officials testifying before the House Energy and Commerce Committee denied they had ever been directed to reduce testing after Trump told rally goers in Tulsa that he had charged officials to “slow the testing down.” White House officials have insisted Trump was speaking in jest.

Yet on Tuesday, Trump undercut that defense, telling reporters, “I don’t kid,” and elaborated further on Twitter.

“Cases are going up in the U.S. because we are testing far more than any other country, and ever expanding,” he tweeted ahead of the hearing. “With smaller testing we would show fewer cases!”

Fauci; Centers for Disease Control and Prevention Director Robert Redfield; Food and Drug Administration Commissioner Stephen Hahn; and Brett Giroir, assistant secretary for health at the Department of Health and Human Services, all replied “no” when asked whether they had ever received a directive to conduct fewer tests.

“I know for sure none of us have ever been told to slow down on testing,” Fauci said. “That just is a fact. In fact, we will be doing more testing.”

Giroir told the committee that he expects the country to be able to conduct 40 million to 50 million tests a month by the fall, and that officials are working to increase the nation’s testing capacity, as well as the quality of the tests.

Trump, Vice President Pence and other White House officials have dismissed the recent increase in confirmed infections, insisting the increase is largely due to boosts in testing. However, there is a broad consensus among public health experts that the outbreaks are occurring as states reopen and people congregate in confined spaces without observing social distancing measures, or consistently wearing masks.

Fauci and Giroir said the outbreaks in much of the country were being driven by increased community transmission. Fauci also said the country was still in the middle of the first wave because it had not decreased infections or deaths to a low enough level.

The health officials also warned of a difficult fall and winter because the U.S. health-care system will probably battle two highly contagious, respiratory viruses then: the novel coronavirus and the seasonal flu. They also said it was inevitable the country would see more cases as states continued to reopen and emphasized the importance of getting the outbreak under control to allow local health officials to isolate confirmed cases and conduct contact tracing to prevent cases from spiraling out of control.

Fauci implored the public — but especially younger people — to wear masks when out in public. More young people have been contributing to the increase in cases in recent weeks, he said.

He said he had never seen a virus that produced such a wide range of symptoms and severity of disease, ranging from people who have no symptoms at all, to those requiring ventilators, to others who spend weeks in the hospital and end up dying. Even though most people recover from the coronavirus, Fauci said healthy people who are infected but show no symptoms or have mild symptoms still end up contributing to the outbreak by potentially infecting the most vulnerable.

Many of the health officials’ statements during Tuesday’s hearing contradicted or undercut the sunny messages from Trump, Pence and other White House officials. Pence last week penned a Wall Street Journal op-ed with the headline “There isn’t a Coronavirus ‘Second Wave,’ ” which touted the administration’s progress. Trump has said outbreaks in specific areas are “embers” of the virus that can quickly be stamped out.

Fauci was upbeat on one front: He told lawmakers he was “cautiously optimistic” that a vaccine would be available by the end of the year, or in early 2021, based on early clinical data. Hahn vowed to let science and data dictate whether the FDA would grant a limited or full approval of a vaccine and said he had never come under political pressure to make a decision, as critics have alleged.

In response to questioning from Rep. Jerry McNerney (D-Calif.), Fauci and Redfield said they were not directly consulted about the decision to withdraw the United States from the World Health Organization.

Last month, Trump said the United States would be “terminating our relationship” with the WHO, arguing the organization is effectively controlled by Beijing. He said that the annual U.S. contribution of more than $400 million to the organization would be diverted to other health groups.

Asked by McNerney whether he has any concerns about the president’s plans, Fauci replied, “Yes, I do.”

He added: “Despite any policy issues that come from higher up in the White House, we at the operational level continue to interact with the WHO in a very meaningful way … literally on a day-by-day basis.”

The hearing at one point turned confrontational. Rep. David B. McKinley (R-W.Va.) asked Fauci whether he regretted that he had not more forcefully urged people to wear masks in late March, when the administration was advising the public there was no consensus on whether they were effective.

Fauci appeared displeased with the question.

“Okay, we’re going to play that game,” he said. “Let me explain to you what happened back then.”

After McKinley told him that he sought a simple yes or no, Fauci shot back, “No, there’s more than a yes or no, by the tone of your question. I don’t regret that, because let me explain to you what happened.”

He continued: “At that time, there was a paucity of equipment that our health-care providers needed. … We did not want to divert masks and PPE away from them to be used by the people. Now that we have enough, we recommend” wearing masks.

In response to another question, Fauci said he had never personally directed Trump to wear a mask. The president is notoriously resistant to wearing one in public despite federal guidelines recommending it to help slow the virus’s spread.

Rep. Kathy Castor (D-Fla.) asked Redfield how often he interacts with Trump about the coronavirus — a question Redfield refused to answer directly.

The issue has come to the fore recently as Trump appears to be spending less time seeking the advice of the administration’s leading health experts. Fauci said in a radio interview last week that he had not spoken directly to Trump in two weeks.

“Well, I have regular interactions as part of the White House task force, as a member,” Redfield said, referring to the group led by Pence. “As it relates to my interactions directly with the president, I’m going to keep those between myself and the president.”

Find live updates about Fauci’s testimony below.

8:46 p.m.
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Fauci doesn’t think the U.S. has ‘prevailed’ in the fight against covid-19

Rep. Nanette Barragán (D-Calif.) asked Fauci whether he thinks the United States has “prevailed” — a word President Trump used in the past month — in the fight against covid-19.

“I wouldn’t use the word ‘prevail,’ ” Fauci responded. “I would say that we’re still in the middle of a serious outbreak. There is no doubt about that.”

At a White House news conference in May, Trump said, “We have met the moment, and we have prevailed.” He later clarified that he meant the United States had “prevailed” in terms of testing.

8:02 p.m.
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As cases spike in Texas, Trump administration has ‘sunsetted’ some testing sites

Texas on Tuesday reported more than 5,000 new confirmed coronavirus cases, an all-time high — and a milestone that comes as the federal government has stopped supporting some testing sites in the state.

Asked by Rep. Joe Kennedy (D-Mass.) about the decision, Brett Giroir, assistant secretary for health, confirmed that the Trump administration has “sunsetted” 13 testing sites, seven of which are in Texas. The move was done “with the full agreement of the governors,” he said.

“We’re not withdrawing the support for well over 2,000 sites,” Giroir said. “We’re just transitioning those 13.”

Democrats in Texas, meanwhile, are blaming the state’s governor, Greg Abbott (R), for the recent spike.

“The record-breaking number of COVID-19 cases today and the fact that Texas has seen 12-straight days of record hospitalizations is because of Greg Abbott’s failure to lead,” Texas Democratic Party Communications Director Abhi Rahman said in a statement.

6:57 p.m.
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Fauci says he hasn’t personally directed Trump to wear a face mask

Trump has been notoriously resistant to wearing a face mask in public, and Fauci acknowledged Tuesday that he has not personally advised the president to wear one — even though federal guidelines state that wearing a face covering can help slow the pandemic’s spread.

“I have not directly recommended to the president to wear a mask, but I think it's very clear to anybody in the country — because I talk about it so often — of the importance of having physical distance with a mask,” Fauci said in response to a question from Rep. Paul Tonko (D-N.Y.). “And if you are going to be — either beyond your control, or by your own choice — in a crowd, that it is imperative to wear a mask at all times."

Asked what he thinks about Trump's decision not to wear a mask, Fauci declined to say.

“You know, I don’t think I can comment on … the multiple factors that go into the president’s not wearing a mask,” he said. “Certainly, I wear a mask in public all the time, not only because I want to protect others and to protect myself, but also to set an example."

Tonko ended his round of questions by voicing concern that the “message coming from the White House undermines the message coming from public health experts.”

6:32 p.m.
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Fauci, Redfield say they were not consulted about U.S. withdrawal from World Health Organization

In response to questioning from Rep. Jerry McNerney (D-Calif.), Anthony S. Fauci and Robert R. Redfield said they were not directly consulted about the decision to withdraw the United States from the World Health Organization.

“I was not specifically consulted about the withdrawal, or the attempt to withdraw,” Fauci said.

Last month, Trump said the United States will be “terminating our relationship” with the WHO, arguing that the organization is effectively controlled by Beijing. He said that the organization’s more than $400 million annual U.S. contribution will be diverted to other health groups.

Asked by McNerney whether he has any concerns about the president’s plans, Fauci replied, “Yes, I do.”

He added: “Despite any policy issues that come from higher up in the White House, we at the operational level continue to interact with the WHO in a very meaningful way … literally on a day-by-day basis.”

6:02 p.m.
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Fauci says he doesn’t regret not pushing Americans to wear face masks earlier

In a heated exchange, Rep. David B. McKinley (R-W.Va.) asked Fauci about the Trump administration’s belated guidance to Americans to wear face coverings to slow the spread of the coronavirus.

In late March, McKinley noted, the administration was advising the public that there was still no consensus on whether masks were effective.

“Do you now regret not advising people more forcefully to wear masks earlier?” McKinley asked.

Fauci did not appear to be pleased with the question.

“Okay, we’re going to play that game,” he said. “Let me explain to you what happened back then.”

After McKinley told him that only a simple “yes” or “no” was required, Fauci shot back, “No, there’s more than a yes or no, by the tone of your question. I don’t regret that, because let me explain to you what happened.”

He continued: “At that time, there was a paucity of equipment that our health-care providers needed. … We did not want to divert masks and PPE away from them to be used by the people. Now that we have enough, we recommend” wearing masks.

Fauci also had a tense exchange with McKinley earlier, when the Republican lawmaker asked him whether he believes Trump is being treated fairly by the media regarding his handling of the pandemic.

Fauci first objected to the question, dismissing it as “unfair.”

He eventually responded in broad terms, without mentioning the president specifically. “It depends on what you mean. … I work in the White House, and I believe that everyone there is doing everything they possibly can,” Fauci said.

5:32 p.m.
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Redfield won’t say how often he talks to Trump

Redfield declined to say how often he is interacting directly with President Trump about the coronavirus when pressed during the hearing by Rep. Kathy Castor (D-Fla.).

“Well, I have regular interactions as part of the White House task force as a member,” Redfield said, referring to the group led by Vice President Pence. “As it relates to my interactions directly with the president, I’m going to keep those between myself and the president.”

Redfield has made a practice of not answering similar questions directly. But the issue has come to the fore recently as Trump appears to be spending less time seeking the advice of the administration’s leading health experts.

Fauci said in a radio interview last week that he had not spoken directly to Trump in two weeks.

5:02 p.m.
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Fauci says country is seeing ‘disturbing surge’ of infections

Fauci said several states, including Texas, Florida and Arizona, were seeing a “disturbing surge” of new coronavirus infections, adding that the next couple of weeks “are going to be critical in our ability to address those surges.”

Contrary to statements from President Trump and Vice President Pence that the recent increase in infections was largely due to an increase in testing, Fauci said the surges in more than a dozen states were largely attributable to an increase in community transmission.

“A couple of days ago, there were 30,000 new infections. That’s very disturbing to me,” Fauci said.

Fauci also told lawmakers he had never seen a single virus that produced such a wide range of symptoms and disease severity in its victims. Some people infected with covid-19 have no symptoms, Fauci said, while others have mild symptoms, and still others require weeks in a hospital on a ventilator or die as a result of the virus.

At a June 23 House hearing, Rep. Pete Olson (R-Tex.) brought up the issue of some young people not taking covid-19 seriously. (Reuters)

Fauci urged young people who might be tempted to resume their normal lives because they believe it is unlikely they will get seriously ill from the virus to consider the impact they could have on the outbreak across the country.

“Even though the overwhelming majority then do well, what you can’t forget is if you get infected and spread the infection, even though you do not get sick, you are part of the process of the dynamics of an outbreak,” Fauci said. “What you might be propagating, perhaps innocently, is you infect someone, who infects someone, who then infects someone who is vulnerable.”

4:56 p.m.
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Fauci, Redfield say decisions on whether to reopen schools will be made on local level

Rep. Brett Guthrie (R-Ky.) asked a question that is on the mind of many Americans: “What’s it going to look like in August, and are kids going to go back to school?”

Redfield and Fauci responded that the decision on whether to reopen schools will need to be made by local jurisdictions based on their own situation.

Contact tracing, Redfield said, is going to be “critical.” He added that the Centers for Disease Control and Prevention will be issuing guidance on reopening schools in the coming days.

Fauci noted that “you don’t want to make one-size-fits-all for the United States."

“You want to tailor it to the degree of viral dynamics in the particular location that you’re talking about,” he said.

4:47 p.m.
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Fauci says institutional racism has contributed to disproportionate virus impact on African Americans

Rep. Bobby Rush (D-Ill.) asked June 23 whether Fauci thought institutional racism contributed to the disproportionate impact of covid-19 on African Americans. (Reuters)

Fauci said in response to a question from Rep. Bobby L. Rush (D-Ill.) that he believes institutional racism has contributed to the disproportionate impact of the coronavirus on African Americans.

“Well, I mean, obviously the African American community has suffered from racism for a very, very long period of time,” Fauci told Rush, who was appearing remotely. “And I cannot imagine that that has not contributed to the conditions that they find themselves in economically and otherwise. So the answer, congressman, is yes.”

Data has shown that minorities account for a disproportionate number of cases and deaths from the virus. The CDC has said that more widespread underlying medical conditions and a greater number of racial minorities living in densely populated areas contribute to the phenomenon.

4:10 p.m.
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Fauci, three other health officials deny they have ever been told to slow down testing

Rep. Greg Walden (R-Ore.) asked witnesses at a June 23 hearing whether President Trump instructed them to slow down testing — as he claimed during a rally. (The Washington Post)

All four health officials testifying before the House committee on Tuesday said they had never been instructed to slow down testing for the coronavirus.

When asked by Rep. Greg Walden (Ore.), the committee’s top Republican, whether Trump had ever instructed any of them to slow down testing — as Trump claimed during his rally in Tulsa on Saturday — Fauci, Hahn, Redfield and Giroir all said no.

White House officials have said that Trump was joking during the rally. But Trump on Tuesday said, “I don’t kid,” when a reporter asked him whether he was, in fact, joking.

“I know for sure none of us have ever been told to slow down on testing. That is just a fact,” Fauci said. “In fact, we will be doing more testing.”

Fauci also said the country was seeing a “disturbing surge” of infections in several states. While he said some parts of the country had been effective in bringing down infections, including New York, others such as Florida, Texas and Arizona were seeing concerning surges.

“The next couple of weeks are going to be critical in our ability to address those surges in Texas, Florida and other states,” Fauci said.

4:05 p.m.
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Giroir announces $40 million partnership with Morehouse School of Medicine to combat coronavirus among minority communities

Brett Giroir, assistant secretary for health, announced that the Morehouse School of Medicine will be part of a $40 million initiative to combat covid-19 among racial and ethnic minorities and other vulnerable communities.

In the first year of the agreement, the medical school at Morehouse College, a historically black college, will receive $15 million, he said.

Through the program, the school will partner with the federal government to “develop and implement a strategic network of national state, territorial, tribal and local organizations to deliver covid-19-related information to communities hardest hit by the pandemic,” according to Giroir.

4:00 p.m.
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Hahn says data and science will determine FDA approval of treatment

Hahn said his agency intends to use “appropriate flexibility” in employing regulatory tools to provide guidance to researchers and companies working on vaccines and drugs for covid-19. But he said “data and science will dictate” when the FDA approves safe and effective products to prevent and treat the disease.

Hahn also said the agency has launched a “comprehensive” review of all its responses to date involving the coronavirus. The goal, he said, is to keep “what is working well” and to adjust policies that are not producing the desired result.

The FDA has been criticized for initially being slow to clear diagnostic tests for covid-19 from academic laboratories and then being too lenient on antibody tests. The agency has since adjusted both policies.

3:56 p.m.
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Fauci says he is ‘cautiously optimistic’ that vaccine will be available by early 2021

In his opening statement, Fauci told members of Congress he was “cautiously optimistic” that an effective vaccine will be available to the American public by the end of this year or the beginning of next year.

The government is providing extensive financial support to 14 vaccine candidates.

“Although you can never guarantee at all the safety and efficacy of a vaccine until you test in the field, we feel cautiously optimistic based on the concerted effort and the fact that we are taking financial risks to be able to be ahead of the game so that when … we get favorable candidates with good results, we will be able to make them available to the American public” within a year of when officials began researching a vaccine in mid-January, Fauci said.

3:46 p.m.
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CDC director urges Americans to maintain social distancing, wear face coverings

Calling the covid-19 pandemic the “greatest public health crisis” that the United States has faced in more than a century, Redfield urged Americans to continue social distancing, hand-washing and use face coverings to prevent and control the spread of the coronavirus, calling them the “most powerful weapons” health officials currently have.

He said the rise in the number of cases in many states is driven by several factors, including increased community transmission.

His comments undercut what the president has said, that the increase in cases is the result of increased testing.

When states first began lifting coronavirus lockdown measures in the summer, tensions around face masks had been mounting since the CDC first recommended them. (The Washington Post)

Redfield said Americans need to take the preventive measures to protect not only themselves, but vulnerable groups, including people with underlying medical conditions, such as heart disease, diabetes and lung disease, and racial and ethnic minorities who have been disproportionately hit by the pandemic.

In preparing for the possibility of covid-19 and influenza hitting at the same time this fall, Redfield also urged Americans to embrace flu vaccinations.

“This single act will save lives,” he said.