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Dr. Anthony Fauci says top U.S. college athletic programs and professional sports leagues are managing risks for COVID-19 infections far more professionally than the situation at the White House that led to President Donald Trump’s illness. (Oct. 6)

AP Domestic

The nation’s top infectious disease expert said the United States faces a “difficult situation” with a rise in positive coronavirus tests through a wide swath of northern states as the weather cools. 

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the share of positive coronavirus tests is increasing in the Northwest, Midwest and other northern states. 

The share of tests that detect the virus is a key indicator of whether the coronavirus is spreading or under control in a community. Public health officials want to see less than 3% of all tests return positive. An ideal rate is less than 1%, Fauci said Tuesday during a College of American Pathologists meeting.

“We’re starting to see a number of states well above that, which is often, and in fact invariably, highly predictive of a resurgence of cases,” Fauci said. A rise in the share of positive cases “we know leads to an increase in hospitalizations and then ultimately an increase in deaths.”

Data from the COVID Tracking Project shows 36 states have a higher rate of tests coming back positive than the previous week. Another 41 states have higher case counts in the past week compared to a week before, an analysis of Johns Hopkins University data shows.

As the fall weather cools and people spend more time indoors, public health experts hoped “we had rather good control over infection dynamics in the country,” Fauci said. “As a matter of fact, unfortunately, that’s not the case.”

Fauci said the nation is averaging between 40,000 and 50,000 new cases every day. The United States has reported more than 7.8 million cases and 215,085 deaths.

A USA TODAY analysis of Johns Hopkins data through late Monday shows 16 states set records for new cases in a week, while Kansas, North Dakota and South Dakota had a record number of deaths in a week. 

Fauci said shutting down the nation again to slow the virus’ spread is something “we do not want to do.” and urged Americans to commit to public health recommendations to slow SARS-CoV-2, the virus that causes COVID-19. People should wear masks, maintain a distance of at least six feet from others, avoid crowds and wash hands frequently.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says a coronavirus vaccine could come earlier than expected. (Photo: AP)

The nation should know by the end of 2020 whether there is a safe and effective vaccine. With five vaccine candidates now in the late-stage clinical studies, Fauci said doses of any Food and Drug Administration-authorized vaccine could be shipped by the end of the year or early 2021, first to those who are most vulnerable.

And although the development has been speedy, he said the public should be confident any vaccine will be thoroughly vetted.

An independent group of doctors, ethics experts and statisticians examine data from each vaccine candidate being studied to determine whether trials should continue. These data safety monitoring boards investigate adverse events reported by patients and doctors.

For example, Johnson & Johnson on Monday paused its COVID-19 vaccine trial after an unexplained illness in a volunteer. Another study, run by AstraZeneca, was halted Sept. 8 after a second participant was diagnosed with a neurological condition.

More: Cheap, rapid, at-home tests could rival a vaccine in the fight against COVID-19. Why can’t Americans get them?

More: Coronavirus updates: Eli Lilly antibody trial paused; COVID-19 surges in 41 states; Dutch woman dies from reinfection

More: Johnson & Johnson pauses COVID-19 vaccine trial after unexplained illness, the second US trial now on hold

Fauci said monitoring boards generally can decide whether a vaccine appears to harm more people than it helps or, conversely, whether the vaccine appears to be safe and more effective than a placebo.

Should a company advance to the next step and seek FDA authorization, the regulatory agency also consults with an independent body to review data and decide whether the vaccine is ready for widespread use.

“There are a lot of checkpoints in that process that I believe the general public should feel comfortable a vaccine is not going to be made available unless it was agreed upon in an independent way to be safe and effective,” Fauci said. 

Contributing: Michael Stucka

Ken Alltucker is on Twitter as @kalltucker or can be emailed at [email protected]

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