By Jeff Overley

Law360 (May 12, 2020, 10:40 PM EDT) -- Members of the Senate health committee on Tuesday prodded Dr. Anthony Fauci and other top health care officials on drug development, testing expansion and the risks of new coronavirus hot spots as the nation eyes workplace reopenings during the COVID-19 pandemic.

The U.S. Senate Committee on Health, Education, Labor and Pensions hearing ran about 3½ hours, playing out largely via videoconference as several key attendees self-quarantined following interactions with people who've tested positive for the novel coronavirus.

Chairman Lamar Alexander, R-Tenn., presided over the session from his home while his dog — a Cavalier King Charles spaniel named Rufus — dozed in the background. Fauci, the nation's leading infectious disease official, answered the bulk of lawmakers' questions. The other witnesses were coronavirus testing czar Brett Giroir, U.S. Food and Drug Administration Commissioner Stephen Hahn and Centers for Disease Control and Prevention Director Robert Redfield.

Here are three highlights to know from the hearing.

'Little Spikes' Could Become Big Problems

Fauci, testifying remotely, repeatedly warned against a hasty resumption of economic activity. He cited White House guidelines — rarely emphasized these days by President Donald Trump — that were released last month and told cities and states to wait for sustained declines in infections before phasing in business reopenings.

"If some areas ... jump over those various checkpoints and prematurely open up ... my concern is that we will start to see little spikes that might turn into outbreaks," Fauci told Sen. Patty Murray, D-Wash., after she asked for his most important message to communities.

As of Tuesday evening, the U.S. had roughly 1.35 million confirmed infections and more than 82,000 deaths from COVID-19, according to Johns Hopkins University.

Fauci, the longtime leader of the National Institute of Allergy and Infectious Diseases, specifically cautioned lawmakers against thinking that improvement in certain hard-hit areas — such as New York City and New Orleans — means the nation as a whole is getting better.

"In other parts of the country, we are seeing spikes," he said.

Fauci, who has won bipartisan acclaim for his performance during the pandemic, encountered little pushback Tuesday.

"You persuasively argue that the risk of reopening prematurely is great," Sen. Bill Cassidy, R-La., told the doctor.

But Sen. Rand Paul, R-Ky., who recently recovered from a COVID-19 infection, was a conspicuous exception.

"As much as I respect you, Dr. Fauci, I don't think you're the end-all. I don't think you're the one person that gets to make the decision," Paul said. "We can listen to your advice, but there are people on the other side saying there's not going to be a surge" of new infections.

Fauci replied, "I have never made myself out to be the end-all and only voice in this."

U.S. Testing Capacity Grows, Belatedly

Giroir, an assistant secretary at the U.S. Department of Health and Human Services, said Tuesday the nation by September will have the ability to perform 40 million to 50 million diagnostic tests per month. Testing is key to identifying and isolating infected individuals before they can spread the virus to other people.

Giroir's announcement came amid a concerted campaign by the White House to trumpet the expansion of tests. On Monday and Tuesday, the U.S. for the first time performed more than 300,000 coronavirus tests on consecutive days, according to researchers at the COVID Tracking Project.

The U.S. has cumulatively conducted more than 9 million tests, which is "a number far greater than any other country and double the per-capita tests performed to date in South Korea," Giroir said.

Not everyone was impressed. Sen. Mitt Romney, R-Utah, noted Tuesday that South Korea's testing infrastructure far outstripped America's diagnostic capacity in the pandemic's early days and that the East Asian country has recorded fewer than 300 coronavirus fatalities.

"I find our testing record nothing to celebrate whatsoever," Romney told Giroir.

Vaccine Timeline, Preventive Drugs Come Into Focus

The official U.S. unemployment rate has soared to almost 15% from below 4% during the pandemic and might be worsening by the day. Major economic healing may not occur until after a vaccine is available, experts say.

Fauci said Tuesday there's "no guarantee" that an effective vaccine will be created anytime soon, but declared that he's "cautiously optimistic" about success by late fall or early winter — a development timeline that would be very fast by historical standards.

Sen. Mike Enzi, R-Wyo., quizzed the witnesses about potential shortages of needles and vaccines needed to administer vaccines — an issue that an HHS whistleblower spotlighted in a recent complaint.

FDA Commissioner Hahn called that "a really important point," saying that "it's not just about the vaccines ... that are developed, it's also about the supplies that are needed, as well as an operational plan for administering the vaccine."

Until a vaccine to prevent COVID-19 is available, the focus is on finding drugs to treat infections. Distribution of Gilead Sciences Inc.'s antiviral remdesivir has commenced, but Fauci noted Tuesday that the drug has only shown a roughly 30% improvement in recovery time and little if any survival benefit.

"We hope to build on this modest success with combinations of drugs and better drugs," Fauci said.

Sen. Jacky Rosen, D-Nev., inquired at one point about whether monoclonal antibodies — the active ingredients in many of the world's best-selling biologic drugs — could be used to prevent COVID-19 infections before a vaccine is found.

Fauci called that "an excellent question." He said that the preventive use of monoclonal antibodies, as well as so-called convalescent plasma from the donated blood of recovered COVID-19 patients, is "feasible and will be pursued in parallel with the development of a vaccine."

Fauci noted that some of the antiviral drugs used to treat HIV/AIDS are "exquisitely effective" at preventing HIV infections in the first place.

"I believe that will be a part of our effort at the same time as we're putting on a full-court press on trying to get a vaccine," Fauci said.

--Editing by Breda Lund.

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