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Issue: June 2020
Disclosures: Alexander, Fauci and Paul report no relevant financial disclosures.
May 12, 2020
3 min read

Fauci tells Senate not to underestimate COVID-19’s effect on children

Issue: June 2020
Disclosures: Alexander, Fauci and Paul report no relevant financial disclosures.
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It would be a mistake to underestimate the effect that COVID-19 has on children, particularly in light of recent reports of children experiencing a serious inflammatory syndrome that has been linked to SARS-CoV-2 infection, Anthony S. Fauci, MD, said Tuesday.

Fauci testified remotely during a hearing of the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) called “Safely Getting Back to Work and Back to School.”

The director of the National Institute of Allergy and Infectious Diseases responded to comments from Republican Sen. Rand Paul of Kentucky, who noted that the mortality rate from COVID-19 among children in hard-hit New York “approaches zero.”

“I think it’s a huge mistake if we don’t open schools in the fall,” Paul said.

The hearing was held days after New York announced the death of three children from a serious illness that may be related to the coronavirus. The illness, which has been called “pediatric multi-system inflammatory syndrome associated with COVID-19,” has symptoms that resemble Kawasaki disease and toxic shock syndrome. Dozens of cases have been reported in other countries and areas of the United States.

“We don’t know everything about this virus, and we really better be very careful — particularly when it comes to children — because the more and more we learn, we’re seeing things about what this virus can do that we didn’t see from the studies in China or in Europe,” Fauci, also a White House advisor on the pandemic, responded to Paul.

“I think we better be careful [that] we are not cavalier in thinking that children are completely immune to the deleterious effects,” Fauci continued. “You’re right in the numbers that children — in general — do much, much better than adults and the elderly, particularly those with underlying conditions. But I am very careful, and hopefully humble, in knowing that I don’t know everything about this disease and that’s why I am very reserved in making broad predictions.”

Paul and others have expressed concerns about keeping schools closed for much longer. The AAP recently issued guidance on reopening schools that spelled out several factors it said should be considered with any decision, including the possibility that they would need to be closed intermittently because of the virus.

Fauci said a rebound or second wave of infections in the fall is “entirely conceivable,” and that it is unlikely that SARS-CoV-2 will simply disappear.


“That is just not going to happen, because it’s such a highly transmissible virus, that even if we get better control over the summer months, it is likely that there will be virus somewhere on this planet that will eventually get back to us,” Fauci said. “My concern is that we will start to see little spikes that will turn into outbreaks.”

He said the hope is that, with robust testing, contact tracing and infection prevention and control measures “we will be able to deal with it very effectively to prevent it from becoming an outbreak.”

Other highlights from the hearing:

  • Fauci said the U.S. death toll, which has surpassed 80,000, is likely an underestimate, noting that some people who died at home from COVID-19 may not have been counted among the official numbers. “Most of us feel that the number of deaths is likelier higher than that number,” Fauci said.
  • “All roads back to work and back to school run through testing,” said HELP committee chairman Sen. Lamar Alexander, a Republican from Tennessee. Alexander cited a Johns Hopkins University report showing that more than 9 million tests have been conducted in the U.S. so far. “What our country has done so far on testing is impressive, but not nearly enough,” he said.
  • Fauci said the idea that treatments or a vaccine for COVID-19 would be available by the fall “would be a bit of a bridge too far. Even at the speed that we’re going, we don’t see a vaccine playing in the ability of individuals to get back to school this term.” He said an NIH-directed vaccine trial will enter phase 2/3 in late spring or early summer, with results possible by late fall or early winter. The hope is that there will be multiple vaccine candidates, or “multiple shots on goal,” Fauci said. He has said in the past that getting a vaccine to patients might be possible in 12 to 18 months. “The big unknown is efficacy: Will it be present or absent and how durable will it be?” he said Tuesday.

Alexander appeared remotely after one of his staffers tested positive for the coronavirus. Fauci, CDC Director Robert R. Redfield, MD, and FDA Commissioner Stephen M. Hahn, MD, also appeared remotely after recent exposures to the virus. Paul, who tested positive for the coronavirus and has recovered, did not wear a mask during the hearing. Other members wore masks and were separated by at least 6 feet in the hearing room.


U.S. Senate Committee on Health, Education, Labor and Pensions. Live hearing. Accessed May 12, 2020.