By Jeff Overley

Law360 (June 30, 2020, 10:57 PM EDT ) Leading public officials on Tuesday warned U.S. senators that COVID-19 infections could soar to previously unthinkable heights if Americans fail to take the disease seriously, and they raised the specter of the pandemic lasting longer because of an alarming distrust in vaccines.

The dire messages came from high-ranking officials within the U.S. Department of Health and Human Services who testified during a three-hour hearing at the Senate Committee on Health, Education, Labor and Pensions about efforts to get Americans safely back to workplaces and schools.

The hearing occurred as the U.S. hit a seven-day average of 41,000 new daily infections — a figure that has doubled since mid-June — and hospitalizations saw their highest rise since April, according to COVID Tracking Project numbers released Tuesday.

Here are three developments to know.

100K Daily Infections Possible, Fauci Warns

Dr. Anthony Fauci, the nation's top infectious diseases expert, delivered one of the most sobering assessments after Sen. Elizabeth Warren, D-Mass., asked how many infections and deaths the country should ultimately expect.

"I can't make an accurate prediction, but it is going to be very disturbing, I will guarantee you that ... I would not be surprised if we go up to 100,000 [infections] a day if this does not turn around," Fauci said.

Fauci didn't predict where fatality figures are headed. The virus has killed more than 127,000 Americans, according to Johns Hopkins University.

Average daily deaths have steadily decreased despite the spike in reported infections. That incongruity likely reflects greater COVID-19 prevalence among younger Americans who are less prone to serious complications with the respiratory disease.

But because cases were declining until very recently, it's also possible that it hasn't been long enough for the new infections to cause more deaths.

"Our death rates are going to get worse soon," Warren predicted.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said at Tuesday's hearing that hospitalizations are rising in 12 states and that daily deaths have begun to climb in Arizona, which has seen confirmed cases skyrocket in recent weeks.

Officials Renew Calls for Masks, Distancing

Lawmakers and witnesses on Tuesday spread blame widely for the coronavirus resurgence. Fauci chastised some states for "skipping over some of the checkpoints" that called for sustained declines in infections before restaurants, shops and other businesses began to slowly reopen.

But he added that even in states with relatively cautious governors, there have been lots of people "at bars not wearing masks" and "not paying attention to physical distancing" recommendations.

In a plea for altruism, Fauci reiterated that asymptomatic individuals can unwittingly infect the vulnerable, specifically citing "someone's grandmother, grandfather, sick uncle, or a leukemic child on chemotherapy."

In that same vein, several witnesses on Tuesday stressed that minor inconveniences, such as wearing a mask and avoiding crowds, aren't too much to ask, given the circumstances.

"We must take personal responsibility and be disciplined about our own behavior," Brett Giroir, an HHS assistant secretary, said Tuesday.

Redfield echoed that message, saying that "it is critical that we all take the personal responsibility to slow the transmission of COVID-19 and embrace the universal use of face coverings."

"Specifically, I'm addressing the younger members of our society," Redfield said.

There were also comments Tuesday that called attention to President Donald Trump's increasing isolation among prominent public officials in refusing to publicly wear a face mask. Vice President Mike Pence has been wearing a mask in public, as has Republican Gov. Greg Abbott of Texas, who in a recent statement said that "every Texan has a responsibility to themselves and their loved ones to wear a mask."

"Unfortunately, this simple lifesaving practice has become part of the political debate that says this: If you're for Trump, you don't wear a mask. If you're against Trump, you do," Sen. Lamar Alexander, R-Tenn., said Tuesday. "That's why I've suggested that the president occasionally wear a mask ... The president has plenty of admirers — they would follow his lead."

Alexander noted that he had to self-quarantine earlier this year after one of his staffers tested positive for COVID-19, but that he never tested positive himself, perhaps because the staffer had been wearing a mask.

Agencies Move to Strengthen Faith in Vaccines

Face masks and social distancing are stopgap measures to ease the pandemic until a vaccine is widely available, which could happen by early 2021 in what's currently seen as the best-case scenario. But officials on Tuesday fretted that suspicions about vaccine safety, once a fringe sentiment, are becoming jarringly mainstream.

"We know that some people are skeptical of vaccine development efforts," U.S. Food and Drug Administration Commissioner Stephen Hahn told lawmakers on Tuesday.

The FDA on Tuesday released guidance on its approval standards for a coronavirus vaccine. The document was chock full of elaborate details about clinical trial designs, and it said that the agency will expect a vaccine to prevent COVID-19 or reduce its severity in at least 50% of recipients.

But officials also signaled that the guidance was aimed as much at the general public as pharmaceutical companies.

"We firmly believe that transparency ... about the scientific data needed to support approval of safe and effective COVID-19 vaccines will help build public confidence," Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said in an announcement that accompanied the guidance.

Polls by major news organizations have found that at least one-fifth of Americans would be disinclined to get a COVID-19 vaccine, with additional Americans unsure. That's important because preventing community spread of a virus requires "herd immunity" in which at least 70% of residents are inoculated. 

Sen. Patty Murray, D-Wash., the committee's ranking member, pressed Redfield on whether the CDC will release a national vaccine plan that includes ideas to combat "misinformation and vaccine hesitancy."

Redfield replied that a plan related to vaccines is under development and should be released in the coming weeks.

"We're developing a plan as we speak ... to keep building on the efforts that we have to rebuild what I call 'vaccine confidence' in this country, which is really critical," the CDC director said.

--Editing by Jay Jackson Jr.

Correction: A previous version of this article mischaracterized the national increase in hospitalizations. The error has been corrected.

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