Fauci explains the 'insidious increase' that has officials worried about new COVID-19 surges

Top infectious disease expert Anthony Fauci, M.D., warned the signs indicate more states could experience serious jumps in COVID-19 cases in the next month, following in the footsteps of a handful of southern states that have been hit with surges of the virus in recent weeks.

In recent days, Deborah Birx, M.D., the White House coronavirus response coordinator, warned the U.S. is entering a new phase in terms of the spread of the pandemic. In a discussion on Monday with JAMA's Editor-in-Chief Howard Bauchner, Fauci reiterated his concern of what could happen in the next month in light of figures showing new cases in the U.S. topping 60,000 per day. 

"It's become clear now as you look back at the states in the southern region that have surged up, accounting for the 60,000 to 70,000 new cases per day you just mentioned, that prior to the surge you could detect an early increase in the percent positive for any given state," Fauci said. "Even if it goes up by one to one and a half percentage points, and it continues to go up. It generallly does not spontaneously come down. It means it's a good predictor of a surge."

Multiple states are showing that same "insidious increase in percent positive" including states like Tennessee, Kentucky, Ohio and Minnesota, he said. 

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"The critical issue is, when you see that, 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," Fauci said. "You may need to pause, you may need to drop back a little bit. I don't think you necessarily have to revert to going all the way back to closing but you have to intensify what I consider five or six fundamental things that we know from experience help to blunt resurgences and can prevent resurgences from occuring."

Among those steps are the consistent, correct wearing of masks, avoiding crowds, physical distancing of six feet or more, staying away from places like bars where people congregate, prioritizing outdoors over indoors, and following adequate hand hygiene, he said.

"That sounds really simple, it's not rocket science. But it's really effective," Fauci said. "You have the dynamics of the virus which, if left to its own devices, is going to keep resurging. The only way to stop it by what we do is a countermeasure in trying to stop it. It can be done. It's not inevitable you're going to see these resurgences if you handle it properly." 

Watch below to see more about what else Fauci had to say about calls for mask mandates, what he thinks about face shields and goggles and what's changed in terms of our understanding about the spread of the disease among children.