On outbreak, official warns of 'new phase'

Virus’s wide reach causes concern as cases, deaths rise

Catholic priest Fr. Ian Espartero distributes communion during Mass to only a few parishioners as a measure to prevent the spread of COVID19 at the Our Lady of Consolation Parish on Sunday, Aug. 2, 2020, in Quezon city, Philippines. Coronavirus infections in the Philippines continues to surge Sunday as medical groups declared the country was waging a losing battle against the contagion and asked the president to reimpose a lockdown in the capital. (AP Photo/Aaron Favila)
Catholic priest Fr. Ian Espartero distributes communion during Mass to only a few parishioners as a measure to prevent the spread of COVID19 at the Our Lady of Consolation Parish on Sunday, Aug. 2, 2020, in Quezon city, Philippines. Coronavirus infections in the Philippines continues to surge Sunday as medical groups declared the country was waging a losing battle against the contagion and asked the president to reimpose a lockdown in the capital. (AP Photo/Aaron Favila)

The physician overseeing the White House's coronavirus response warned Sunday that the United States has entered a "new phase" of the pandemic, and she urged people to take extreme health precautions as infections and deaths rise sharply.

"I want to be very clear what we're seeing today is different from March and April," Deborah Birx said on CNN's "State of the Union," noting that cases were increasing in rural and urban areas. "It is extraordinarily widespread."

Asked about an estimate from former Food and Drug Administration Commissioner Scott Gottlieb that virus deaths could top 300,000 by the end of the year, Birx said that "anything is possible." She said such an outcome would be far less likely if people practiced social distancing and avoided large gatherings.

Birx has faced mounting criticism over her handling of the coronavirus response after a New York Times report last month stated that her optimistic outlook on the pandemic's trajectory helped justify reopening decisions that preceded new outbreaks.

In a Sunday morning interview on ABC News, House Speaker Nancy Pelosi, D-Calif., was asked whether she had confidence in Birx.

"I think the president is spreading disinformation about the virus, and she is his appointee," Pelosi said. "So I don't have confidence there, no."

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Politico had reported that Pelosi criticized Birx during a closed meeting Friday with Treasury Secretary Steven Mnuchin and White House Chief of Staff Mark Meadows.

"Deborah Birx is the worst. Wow, what horrible hands you're in," Pelosi said at the meeting, according to Politico.

Birx on Sunday defended her decisions.

"I have tremendous respect for the speaker. I have tremendous respect for her long dedication to the American people," Birx said on CNN. "It was unfortunate The New York Times wrote

this article without speaking to me. ... I have never been called Pollyanna-ish or nonscientific or non-data-driven, and I will stake my 40-year career on those fundamental principles of utilizing data to really implement better programs to save more lives."

The Times article centered on the administration's discussions in April and described Birx as "a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing."

In contrast, White House officials came to view Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, as "a purveyor of dire warnings but no solutions," according to the newspaper.

Speaking to CBS on Sunday, Rep. James Clyburn, D-S.C., faulted the White House for a "piecemeal approach" to the pandemic, with medical experts talking about facts while President Donald Trump puts forth "a political agenda."

Trump on Sunday struck an optimistic note, tweeting, "USA will be stronger than ever before, and soon!"

DEATHS ON RISE

The remarks came after another week of grim signs regarding the country's pandemic response.

The seven-day average for coronavirus-related deaths rose in nearly half of U.S. states over the past week, pushing the national death toll near 155,000 and prompting health experts to warn that the trend was unlikely to reverse anytime soon. According to Johns Hopkins University, the nation has more than 4.6 million confirmed cases.

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Numerous states have reported record daily fatalities recently, including California and Florida, according to tracking by The Washington Post. Seven-day averages reached new highs in states across the South, West and Midwest.

Nationwide, the daily coronavirus death toll exceeded 1,000 for the sixth-straight day Saturday at 1,198, according to The Post's data.

Birx and Fauci have warned 20 states in the Sun Belt, the Midwest and the Pacific Northwest that the virus spread is accelerating within their borders.

Mitigation efforts have helped in some places, Birx said, but people need to practice strict social distancing and wear masks. She also raised concerns about the virus spreading within multigenerational households, urging people in those settings to "really consider" wearing masks inside their homes.

The increase in deaths has trailed a big surge in coronavirus cases by several weeks, as health experts predicted when infections started trending upward in June.

The time lag was greater than in the pandemic's early months, when deaths followed infections more closely. Experts say the change may be because many of the new outbreaks have started among young, healthy adults who passed the virus to older, more vulnerable people and because expanded testing has allowed health workers to identify cases closer to the time of infection.

"Overall, what this tells us is that now that deaths have started to increase, we can expect them to increase for several more weeks," said Ellie Murray, an epidemiologist at Boston University. "We cannot afford to pretend everything is fine and heading back to normal."

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AAP

People shop at Queen Victoria Market hours before a citywide curfew is introduced in Melbourne, Sunday, Aug. 2, 2020. The premier of Australia’s hard-hit Victoria state has declared a disaster among sweeping new coronavirus restrictions across Melbourne and elsewhere from Sunday night. (Erik Anderson/AAP Image via AP)

With the new academic year starting soon in many communities, Birx also suggested that schools avoid in-person instruction in places where infections are rising -- a departure from recent demands by Trump and Education Secretary Betsy DeVos that schools fully reopen in the fall.

At least four schools -- Corinth High School in Mississippi, Greenfield Central Junior High in Indiana and two schools in Indiana's Greater Clark County district -- reported that a student had tested positive for the coronavirus during the first week back in session, forcing people who had been in contact with those students to self-quarantine.

"We need to stop the cases," Birx said. "If you have high caseload and active community spread -- just like we're asking people not to go to bars, not to have household parties, not to create large spreading events, we're asking people to distance-learn at this moment so we can get this epidemic under control."

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Trump and other prominent Republicans have continued to promote the drug hydroxychloroquine as a silver-bullet solution to covid-19, the disease caused by the novel coronavirus, despite evidence that it does not help patients recover.

Asked about hydroxychloroquine on NBC's "Meet the Press" on Sunday, Adm. Brett Giroir, the official in charge of the administration's testing efforts, stressed that the drug was not an effective treatment.

"At this point in time, there has been five randomized, controlled, placebo-controlled trials that do not show any benefit to hydroxychloroquine," Giroir said. "So at this point in time, we don't recommend that as a treatment. There's no evidence to show that it is."

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AROUND THE WORLD

Governments worldwide have reported more than 687,000 deaths and nearly 18 million cases, according to Johns Hopkins.

• India's 54,735 new cases were down from the previous day's record 57,118 but raised the total to 1.75 million. July accounted for more than 1.1 million of those cases. The major cities of New Delhi and Mumbai might have passed their peaks, said a government expert, Randeep Guleria.

• The Philippines will put its capital back on stricter lockdown as cases surged more than fivefold after curbs were eased in June. President Rodrigo Duterte approved his Cabinet's proposal to tighten restrictions in metro Manila and nearby provinces for 15 days, following doctors' recommendation in the face of an overwhelmed health care system. Virus cases rose by a daily record of 103,185 on Sunday.

• In Japan, the government reported 1,540 new cases, close to Friday's record of 1,579. The spike in infections, mostly in people in their 20s and 30s, prompted warnings that young people were letting their guard down. Gov. Yuriko Koike of Tokyo said she might declare an emergency to contain the outbreak.

• In Australia, Premier Daniel Andrews of Victoria announced an 8 p.m.-to-5 a.m. curfew on Melbourne, a city of 5 million people. Schools statewide are to return to home-based teaching, and day care centers were closed. Andrews said there were seven deaths and 671 new cases since Saturday. "If we don't make these changes, we're not going to get through this," he said.

• China had 49 new confirmed cases, up from the previous day's 45. Thirty were in Xinjiang, where authorities are trying to contain an outbreak focused on the regional capital, Urumqi. Three cases were found in students who returned from Russia to Wuhan, the Chinese city where the pandemic began in December and where the government declared victory over the disease in March.

• Hong Kong reported 125 new infections as authorities tried to find the source of the latest outbreak. The Chinese government said a team of seven testing experts was sent to the city to help.

• South Korea reported 30 new cases, raising its total to 14,366 with 301 deaths, but it said only eight were acquired in the country. The government warned that case numbers would rise as people arrive home from other countries with outbreaks. Authorities say cases from abroad are less threatening because arrivals are quarantined for two weeks.

• In Italy, the number of reported new cases dipped below 300 for the first time.

• In Austria, an employee in the chancellery tested positive for the virus. But the person hadn't worked directly with Chancellor Sebastian Kurz, the Austria Press Agency reported.

• South Africa has surpassed 500,000 confirmed cases -- more than 50% of the total in Africa's 54 countries -- but President Cyril Ramaphosa said Sunday that he sees "promising signs." "After a rapid rise in infections over the last two months, the daily increase in infections appears to be stabilizing," Ramaphosa said. Hospitals have been stretched to the limit, but in most provinces they are succeeding, he said.

Information for this article was contributed by Derek Hawkins, Eli Rosenberg, Felicia Sonmez, Joseph Marks and Jacqueline Dupree of The Washington Post; by Tony Czuczka and Andreo Calonzo of Bloomberg News; and by Ashok Sharma, Joe McDonald, Andrew Meldrum and staff members of The Associated Press.

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