Fauci: Some are taking a ‘significant risk’ by easing restrictions

LOS ANGELES, CALIFORNIA - APRIL 21: A man is asked to cough into his arm as part of testing for COVID-19, by a member of the Los Angeles Fire Department wearing personal protective equipment (PPE) in Skid Row, amidst the coronavirus pandemic on April 21, 2020 in Los Angeles, California. 43 people tested positive for COVID-19 at one nearby Skid Row homeless shelter. (Photo by Mario Tama/Getty Images)

(CNN) — More than 30 states will have started easing social distancing restrictions for coronavirus by week’s end — and some are taking a “really significant risk” in doing so, the nation’s top infectious disease expert says.

That warning comes as a team of pandemic experts predicted in a new report that the novel virus is likely to keep spreading for at least another 18 months to two years.

COVID-19 has killed more than 63,000 people in the United States and infected over 1 million nationwide, according to Johns Hopkins University.

Some governors last week started loosening social distancing restrictions set up to combat the pandemic. By Saturday, at least 32 states will have eased them somewhat, ranging from simply opening state parks to allowing some businesses to restart.

But some states are reopening without having met federal guidelines, including a decrease in cases over a 14-day period and a return to pre-crisis conditions in hospitals, said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases.

That could lead to a jump in cases and more deaths than predicted, health experts have said.

“There are some states, some cities … kind of leapfrogging over the first checkpoint. And, I mean, obviously you could get away with that, but you are making a really significant risk,” Fauci said during CNN’s town hall on coronavirus Thursday night. “I hope they can actually handle any rebound that they see.”

States are knowingly reopening against medical experts’ advice and are making “a judgment call … that there’s an acceptable level of risk and harm because of need or desire to open up,” CNN national security analyst Juliette Kayyem said Friday.

“There will be more dead people. Just say it,” Kayyem told CNN’s “New Day.” “It’s an experiment we’re living in real time.”

Experts have warned against the dangers of reopening a country that’s facing testing shortages, which they’ve called crucial to returning to normal life.

This is where each state stands on reopening

Other states are imposing new restrictions

The governors’ approaches have differed significantly. Even as some states prepare to ease coronavirus restrictions, others are imposing new ones or extending those already in place.

Louisiana has extended the state’s stay-at-home order through May 15. Though starting Friday, stores can offer curbside delivery, and restaurants can offer outdoor seating.

New York, like many other states, will keep school buildings closed through the rest of the academic year — though remote instruction will continue, Gov. Andrew Cuomo said Friday.

Some of the measures states have taken include:

• Georgia’s general shelter-in place order expired Friday, though “medically fragile and elderly” people are to remain at home through June 12. Some businesses were allowed to reopen in the last few days, and they’re required to observe strict social distancing measures until at least May 13.

• Texas‘ general stay-at-home order ended Thursday. Starting Friday, retail stores, restaurants, movie theaters, malls, museums, and libraries can reopen, but must limit their capacity to 25% of their listed occupancy until at least May 16.

• Ohio’s stay-at-home order goes until May 29, but certain businesses are expected to reopen in phases through the month. Starting Friday, previously restricted outpatient health procedures can move forward, and dentist and veterinarian offices can reopen. On Monday, manufacturing, distribution and construction companies and general offices may reopen with certain health guidelines.

• Arizona‘s stay-at-home order runs until May 15,but elective surgeries can resume Friday. And starting Monday, businesses can sell through delivery, curbside delivery, takeout and drive-through.

• Florida has two approaches: Restaurants and retail shops can let customers inside, at reduced capacity, starting Monday. But there’s an exception in South Florida’s populous Palm Beach, Broward and Miami-Dade counties, home to 6 million people.

• West Virginia’s dentists were allowed back to work Thursday, while its restaurants, churches and other services like salons must wait until Monday.

• Some states are easing less. New Jersey opens state and county parks and golf courses Saturday, and Virginia is allowing elective surgeries and dental procedures to resume Friday. But both states are expected to keep general stay-at-home orders for weeks.

• California Gov. Gavin Newsom ordered Orange County beaches and parks closed and said reopening of schools and businesses is weeks away.

Two more years of pandemic misery predicted

As states grapple with the most efficient way to reopen their economies, experts are warning that relief may not be coming any time soon.

Coronavirus will likely keep spreading for another 18 months to two years — until 60% to 70% of the world’s population has been infected, a team of pandemic experts predicted Thursday in a new report.

The United States should prepare for a worst-case scenario that includes a second big wave of coronavirus infections in the fall and winter, the report said. Even in a best-case scenario, people will continue to die from the virus.

“This thing’s not going to stop until it infects 60 to 70% of people,” said Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota. “The idea that this is going to be done soon defies microbiology.”

Osterholm has written about pandemics for 20 years and served as an adviser to several presidents. He said it’ll take nearly two years for herd immunity to gradually develop among humans.

A vaccine could help, the report said, but isn’t expected quickly. “The course of the pandemic also could be influenced by a vaccine; however, a vaccine will likely not be available until at least sometime in 2021,” the report reads.

Drugmaker checking whether remdesivir can be used for less severe COVID-19

Researchers are chasing not only a vaccine but also potential COVID-19 treatments.

Earlier this week, researchers released preliminary findings that the experimental drug remdesivir might help patients recover more quickly from the infection.

On Friday, the CEO of remdesivir maker Gilead Sciences said the company is “moving very quickly” with the US Food and Drug Administration to get authorization for the antiviral drug.

“The collaboration with the FDA and with Commissioner (Dr. Stephen) Hahn and the team has been terrific, and I expect that they are going to act very quickly,” Gilead CEO Daniel O’Day said in an interview on NBC’s “Today” show.

Gilead is prepared “to make sure we get this medicine to as many patients as possible as soon as possible after that approval,” O’Day added.

While Gilead has studied remdesivir as a possible treatment option for patients hospitalized with severe COVID-19, research is underway to investigate whether the medication can be used earlier in the course of illness, such as when the disease is still “moderate,” O’Day told “Today.”

Though remdesivir currently is administered to COVID-19 patients through an IV, researchers are examining whether it could be delivered as a subcutaneous injection or orally.

That would be “with the intention that maybe we can treat patients earlier — earlier in the hospital setting and perhaps even outside of the hospital setting,” O’Day said.

An effective vaccine is still months away

There are 102 potential coronavirus vaccines in development worldwide, according to the World Health Organization. The US National Institutes of Health was among the first to start conducting human trials.

Doctors testing experimental coronavirus vaccines may look for local infection clusters to try out potential immunizations, Fauci said.

“If we get in there and there are a number of infections, you can get an efficacy signal right away, which means you may know right ahead of time whether or not you have something that works,” Fauci said.

When the first phase of safety testing shows the vaccine is safe, possibly by summer, the second and third phases of testing can start, he added.

With this approach to testing, the US can invest “hundreds of millions of dollars” to start developing a vaccine, even before researchers prove it works.

“You don’t have to wait five or six months to scale up to get enough doses, to give to a meaningful number of people,” Fauci said. “That’s a risky financial circumstance, but it certainly, certainly is worth the risk given what’s at stake.”

Assuming the vaccine is safe, effective and can be produced quickly, it could be available by January, but it’s not guaranteed, he said.

January is a lofty goal, but one that should be tried, Dr. Kathryn Edwards, a fellow with the Infectious Diseases Society of America, said Friday.

“Everything has to go well if we’re going to get something in January,” another IDSA fellow, Dr. Walter Orenstein, said Friday. “That may not be the case. Then we need to bear for it being longer if we don’t get the data we need on safety.”