8 key exchanges from the testimony of the nation's top infectious disease expert who warned the US outbreak is going to 'get worse'

• Top public health officials including Dr. Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, testified before Congress on Wednesday about the novel coronavirus, COVID-19.
• There are now over 1,080 reported cases and 31 deaths from the coronavirus reported in the United States throughout 38 states and Washington, DC as the US has been relatively slow to respond.
• Dr. Fauci's testimony laid out a stark and sobering picture of what the United States faces in the coming days and weeks as he warned things will get worse before they get better. Here are some key moments.
• Visit Business Insider's homepage for more stories.

On Wednesday, March 11, top public health officials including Dr. Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, testified before the House Committee on Oversight and Government Reform about the government response to the novel coronavirus, COVID-19.

The outbreak of the new coronavirus, first identified in China, has now spread to 118 countries and regions, infecting an estimated 121,500 people with over 4,300 deaths reported worldwide. On Wednesday, the World Health Organization officially declared the coronavirus a pandemic.

There are now over 1,080 reported cases and 31 deaths from the coronavirus reported in the United States throughout 38 states and Washington, DC, many of which have declared a state of emergency over the diseases' rapid spread.

The US has been relatively slow to respond to the coronavirus compared to other nations, testing far fewer people per capita for the coronavirus and dispatching far fewer coordinated resources to combat its spread as President Donald Trump has publicly downplayed its severity.

Dr. Fauci, a legendary figure in public health and an infectious disease expert, has served under six presidents since 1984 in various capacities.

Fauci has consistently been one of the most public-facing and trusted voices on the coronavirus crisis - sometimes at odds with the White House's more optimistic messaging in doing so.

His testimony laid out a stark, sobering picture of what the United States faces in the coming weeks and months. Here are the important exchanges, with bolding to highlight key points:

Fauci said the US is still a long way off from deploying a vaccine

Right at the outset of his testimony, Dr. Fauci laid out the timeline for a possible coronavirus vaccine, estimating a "deployable vaccine" will not be available for at least another year to a year in a half.

"We are going to go into a phase one clinical trial to determine if one of the candidates - and there are more than one candidate, there are probably ten or so that are at various stages of development. The one that we're talking about is a platform called messenger RNA. It really serves as a prototype for other types of vaccines that are simultaneously being developed," Fauci explained.

"Getting it into phase one in a matter of months is the quickest that anyone has ever done literally in the history of vaccinology. But the process of developing a vaccine is one that is not that quick. It will bring us three or four months down the pike and then you go into an important phase called phase two to determine if it works," he continued. "That will take at least another eight months or so."

Fauci said the worst of the virus is still yet to come

Chairwoman Rep. Carolyn Maloney asked: "Is the worst yet to come, Dr. Fauci?"

Dr. Fauci responded: "Yes, it is."

Rep. Maloney: "Can you elaborate?"

Dr. Fauci: "Whenever you have an outbreak that you can start seeing community spread, which means by definition that you don't know what the index case is and the way you can approach it is by contact tracing, when you have enough of that, then it becomes a situation where you're not going to be able to effectively and efficiently contain it."

"Whenever you look at the history of outbreaks, what you see now in an uncontained way, and although we are containing it in some respects, we keep getting people coming in from the country that are travel-related. we've seen that in many of the states that are now involved. and then when you get community spread, it makes the challenge much greater. So I can say we will see more cases and things will get worse than they are right now. How much worse we'll get will depend on our ability to do two things, to contain the influx of people who are infected coming from the outside, and the ability to contain and mitigate within our own country. Bottom line, it's going to get worse."

Fauci told the committee that the federal government is looking to massively expand testing, including surveillance

Rep. Maloney: "Well, bottom line, Mr. Fauci, if we don't test people then we don't know how many people are infected. Is that correct?

Dr. Fauci: "That is correct. As I'm sure Dr. Redfield will tell you, looking forward right now, as commercial entities get involved in making a large amount of test kits available, there are two aspects of testing. One, a person comes into a physician and asks for a test because they have symptoms or a circumstance, which suggests they may be infected. The other way to do testing is to do surveillance, where you go out into the community and not wait for someone to come in and ask for a test, but you actively, proactively get a test. We are pushing for that, and as Dr. Redfield will tell you, that the CDC has already started that in six sentinel cities and will expand that in many more cities. You're absolutely correct. We need to know how many people, to the best of our ability, are infected, as we say, under the radar screen."

Fauci said he 'never held back' in telling the president the facts:

Rep. Stephen Lynch: "When the president's economic director says we've got this contained, not quite airtight but almost there, we need you - we need you, our public health officials, to step up and say that is not true, that is hurting us. that is making the spread of this virus more extended, more prolific and more possible. The American people need to step up here and make sure they're aware of the dangers. Dr. Fauci?"

Dr. Fauci: "I appreciate your comments, but I can tell you absolutely that I tell the president, the vice president and everyone on the task force what exactl the scientific data is and what the evidence is."

Rep. Lynch: "I don't doubt that."

Dr. Fauci: "I have never, ever held back telling exactly what is going on from a public health standpoint. Thank you."

Fauci said 'it would be nice' if the Trump administration hadn't eliminated the National Security Council's global health unit

Rep. Gerry Connolly: "Was it a mistake, Dr. Fauci, do you believe, to dismantle the office within the National Security Council charged within global health and security?"

Dr. Fauci: "I wouldn't necessarily characterize it as a mistake. I would say we worked very well with that office. It would be nice if the office was still there."

Fauci pushed back on Trump's false and misleading assertions about the virus

Rep. Jamie Raskin: "I want to quickly clear up a few things that have been said over the course of this process. One was by the president in early February when he said, 'It looks like by April you know in theory when it gets a little warmer it miraculously goes away.' Is there any scientific reason to believe that?"

Dr. Fauci: "The basis for any surmising that that might happen is based on what we see every year with influenza, which actually as you get to March and April and May, it actually goes way down. And other non-novel coronavirus but common cold coronaviruses often do that. So for someone to at least consider that that might happen is reasonable, but, underline, we do not know what this virus is going to do. We would hope that as we get to warmer weather it would go down, but we can't proceed under that assumption. We've got to assume that it's going to get worse and worse and worse."

Rep. Jamie Raskin: The president predicted there could be a vaccine in a few months. I think you contradicted that today and at that time. Is there any chance we will have a vaccine in a few months?

Dr. Fauci: "No, I made myself clear in my statement."

Fauci said the novel coronavirus is 'ten times more lethal than the seasonal flu'

Rep. Michael Cloud: "Dr. Fauci, can you by way of comparison, briefly explain how does COVID-19 compare to other previous health situations? SARS? H1N1, things like that?"

Dr. Fauci: "Well, SARS was also a coronavirus in 2002. It infected 8,000 people, and it killed about 775. It had a mortality of about 9 to 10%. That's only 8,000 people in about a year. In the two and a half months that we've had this coronavirus, as you know we now have multiple multiples of that. So it clearly is not as lethal. And I'll get to the lethality in a moment, but it certainly spreads better. Probably for the practical understanding of the American people, the seasonal flu we deal with every year has a mortality of 0.1%. The stated mortality overall of this when you look at all the data, including China, is about 3%, it first started off as 2 and now 3. I think if you count all the cases of minimally symptomatic or asymptomatic, that probably brings the mortality down to around 1%. Which means this is ten times more lethal than the seasonal flu. I think that's something that people can get their arms around and understand."

Rep. Cloud: "I'm trying to help the American people figure out where to appropriately set their gauge."

Dr. Fauci: "Set their gauges that this is a really serious problem, we have to take seriously. People always say, 'well, the flu, you know, the flu does it, the flu does that.' The flu has a mortality of 0.1%. This is ten times that. That's the reason I want to emphasize we have to stay ahead of the game."

Fauci warned that 'we've got to change our behavior' as a country to combat the virus before its too late:

Rep. Harley Rouda: "I think we're concerned that we're not getting the full understanding or modeling that has taken place that would suggest the true impact of this virus across the United States as well as potential models for deaths. Can you elaborate a little bit? I get that there's no perfect model. But can you be helpful in helping us understand what we're really looking at here?"

Dr. Fauci: "Yeah. If you look at the curves of outbreaks historically that are similar to this, the curve looks like this and then it goes up exponentially. That's the reason why it depends on how you respond now. So if we wait until we have many, many more cases, we will be multiple weeks behind. You know, I use the analogy at the press conference yesterday and I'll use it today. It's the old metaphor that the Wayne Gretzky approach, you skate not to where the puck is but to where the puck is going to be."

He continued: "If we don't do very serious mitigation now, that what's going to happen is that we're going to be weeks behind and the horse is going to be out of the barn. And that's the reason we've been saying, even in areas of the country where there are no or few cases, we've got to change our behavior. We have to essentially assume that we are going to get hit. And that's why we talk about making mitigation and containment in a much more vigorous way. People ask, why would you want to make any mitigation? We don't have any cases. That's when you do it. Because we want this curve to be this, and it's not going to do that unless we act now."

Read more:

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This hearing has been remarkable. Dr. Fauci publicly contradicting talking points from WH and VP's office. Really underlying the severity of the situation we're in right now. Turning point, in my mind. First public appearance where we're really getting somewhat of a full picture.

- Erin Banco (@ErinBanco) March 11, 2020