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Fauci: Rising positive test rates are a 'good predictor' states should pause reopenings

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As coronavirus cases continue to rise across much of the US, top infectious disease expert Dr Anthony Fauci warned that states need to heed the warning signs when the percentage of people testing positive each day starts to tick upward. 

And when it does, they may need to reconsider their reopening schedules, warned Dr Fauci in an interview with JAMA editor-in-chief Dr Howard Bauchner. 

‘There’s a real potential pattern,’ Dr Fauci said. 

‘It’s become clear now that…if you look back at the states that in the Southern region have surged up and accounted for the 60,000-70,000 cases a day [we’ve been seeing]…prior to the surging, you could detect an early increase for any given state.’ 

He noted that those increases might be as slight as one to one-and-a-half percentage points. 

‘It doesn’t tend to spontaneously come own, it just continues going up…it’s a good predictor of that surge,’ said Dr Fauci.

‘When what we’re seeing is that same insidious increase in percent positive that we’ve seen and pointed out…the critical issue is when you see that, you’ve got to take a look at where you are in the process of reopening. 

‘You may need to pause or drop back a little.’ 

His words of caution come as the US nears 4.7 million cases of coronavirus and surpasses 155,000 deaths – but shows no sign of stopping schools from opening for the fall semester. 

Dr Anthony Fauci (right) warned that even a small increase in the rate of people testing positive for coronavirus should tell states to reconsider their reopening timelines in a Monday interview with JAMA editor-in-chief Dr Howard Bauchner (left)

Dr Anthony Fauci (right) warned that even a small increase in the rate of people testing positive for coronavirus should tell states to reconsider their reopening timelines in a Monday interview with JAMA editor-in-chief Dr Howard Bauchner (left)

‘You’ve got to take a look at where you are in the process of trying to reopen and take a good serious look at what you need to do,’ said Dr Fauci. 

‘I don’t think you necessarily have to revert, to go back all the way to closing, but you’ve got to intensify what I consider five or six fundamental things that we know from experience help to blunt resurgences and prevent resurgences.’ 

These of course are the familiar commandments of the coronavirus pandemic: ‘consistent’ proper mask-wearing, avoiding crowds, social distancing, avoiding places where people congregate (namely, bars) and hand-washing. 

‘It sounds really simple, but it can be really effective,’ said Dr Fauci.

‘It’s in our hands…it’s not inevitable that we’re going to see surges if you handle it properly.’ 

But of course, not everyone has handled it ‘properly’ by the measures Dr Fauci articulated.    

In total, nearly half (44 percent) of Americans report ‘always’ wearing a mask outside their homes, according to a recent Gallup poll. Another 28 percent ‘very often’ wear masks. 

But those rates vary dramatically from region to region and demographic group to demographic group. 

More than half of Northeasterners report always wearing masks, but in the Midwest, only a third of people said they do the same. Nearly a quarter of Midwestern respondents said they never wear a mask in public. 

The rates of mask-wearing were about the same among Republicans: 24 percent said they always wear masks in public, and 27 percent said they never do. 

Combined, evidence that masks work to slow the spread of coronavirus and evidence that many Americans don’t comply have led high-profile experts like Dr Fauci and Centers for Disease Control and Prevention director Dr Robert Redfield to call for universal masking. Other politicians and public health experts have gone a step further and said the US should go a step further and mandate masks. 

‘The trouble with mandating is that you can have a counter-reaction against it,’ said Dr Fauci.  

‘In other words, people who push back on authority are going to push back more.’ 

When Dr Bauchner questioned him on the possibility of aerosol transmission of coronavirus – meaning the possibility that one could catch coronavirus not from a nearby coughing person, but simply by inhaling viral particles hanging in the air – Dr Fauci admitted he simply isn’t sure. 

Recent evidence has suggested that infectious particles of the virus can linger in the air even longer and travel even further than previously thought. 

And Dr Fauci said physicists who study the way things travel through the air had even reached out to him and said larger particles may be able to stick around longer than most public health advice has suggested. 

‘So maybe size is something we need to be examining,’ Dr Fauci said.   

‘One thing it tells you,’ Dr Fauci said of the uncertainty surrounding what size particles can transmit the virus,’ is you’d really better wear a mask.’ 

The distance coronavirus can travel is one of myriad things about the still-new pathogen scientists thought they had largely figured out, but has only grown more complicated over time. 

When asked about what he felt the US has done wrong and right throughout the pandemic, Dr Fauci praised the decisions to shut down travel from China and then Europe (the latter of which, CDC director Dr Redfield recently admitted came too late) and President Trump’s ’15 days to slow the spread’ and its extension to 30 days. 

It was a markedly different tone from the one Trump has recently taken when speaking about Dr Fauci. 

When asked about the mistakes the US had made, Dr Fauci refused to take the bait. 

He didn’t deny that mistakes had been made, but emphasized looking forward optimistically, rather than back, critically. 

‘Let’s be humble enough to say we all could have done better,’ Dr Fauci said.  

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