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'Deadly' Phase of Pandemic Looms, White House Advisor Birx Warns

By Ernie Mundell and Robin Foster HealthDay Reporters

TUESDAY, Nov. 3, 2020 (HealthDay News) -- The pandemic is entering a new and "deadly" phase and the United States needs to adopt a more aggressive approach to curbing the spread of COVID-19, White House coronavirus response coordinator warned Monday.

The warning, expressed by Dr. Deborah Birx in a private memo to White House officials, was a direct contradiction to President Donald Trump's repeated claims that the pandemic is "rounding the corner," the Washington Post reported.

Birx's memo painted a grim picture: "Cases are rapidly rising in nearly 30 percent of all USA counties, the highest number of county hotspots we have seen with this pandemic," it said. "Half of the United States is in the red or orange zone for cases despite flat or declining testing."

The memo went further, and suggested that Trump and his advisers were spending too much time focusing on preventing lockdowns and not enough time on controlling the virus.

"We are entering the most concerning and most deadly phase of this pandemic," Birx wrote. "This is not about lockdowns — it hasn't been about lockdowns since March or April. It's about an aggressive balanced approach that is not being implemented."

Until now, Birx has not criticized Trump or his administration in public, the Post reported. But her sharp critique mirrors a growing dread among government scientists and public health experts that the worst of the pandemic is yet to come.

Birx now contradicts Trump on numerous points, the Post reported:

--While he holds large campaign rallies, she warns against them.

--While he blames rising cases on more testing, Birx says testing is "flat or declining" in many areas where cases are rising.

--While he says the country is "rounding the turn," Birx notes the country is entering its most dangerous period yet and will see more than 100,000 new cases a day this week.

The latest case counts suggest Birx is right: More than 9.2 million Americans have been diagnosed with COVID-19, and the seven-day average of new daily coronavirus infections in the United States hit a new high of 81,740 in Sunday, the Post reported.

Meanwhile, hospitals are scrambling to find enough nursing help — especially in rural areas and at small hospitals, the Associated Press reported.

Nurses are being trained in fields where they have limited experience, hospitals are scaling back other medical services, and health systems are turning to short-term travel nurses to help fill the gaps, the AP reported.

Adding to the strain, experienced nurses are "burned out with this whole [pandemic]" and some are quitting, said Kevin Fitzpatrick, an emergency room nurse at Hurley Medical Center in Flint, Mich., where several left just in the past month to work in hospice or home care or at outpatient clinics.

States say they don't have enough money to distribute a COVID vaccine

Meanwhile, state health officials say they are frustrated about a lack of financial support from the federal government as they face orders to prepare to receive and distribute the first doses of a coronavirus vaccine by the unlikely target date of Nov. 15, the Post reported. And these officials stress that they don't have enough money to pay for the massive undertaking.

State officials say they have been planning distribution efforts even though no one knows which vaccine will be authorized, what special storage and handling may be required, and how many doses each state will receive.

Even so, the U.S. Centers for Disease Control and Prevention sent a letter this week asking states to provide by Tuesday critical information, including a list of each jurisdiction's top five sites capable of receiving and administering a vaccine that must be stored at extremely cold temperatures of minus-94 Fahrenheit, the Post reported. The letter refers to the vaccine only as Vaccine A, but industry and health officials say it is the Pfizer vaccine.

"We acknowledge that you are being asked to do unprecedented work," wrote Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, which is leading the CDC's role in vaccine distribution. She added: "This is a new planning ask," the Post reported.

State officials say they have been trying to raise the issue with federal officials but have received little response.

"It is absolutely ridiculous that the administration, after spending $10 billion for a Warp Speed effort to develop a vaccine, has no interest in a similar investment in a Warp Speed campaign to get the vaccine to every American as quickly as possible after it is approved," said Michael Fraser, executive director of the Association of State and Territorial Health Officials.

"The now accelerated timeline underscores the need to address the issue of funding for state and territorial health agencies to make this all work," Fraser said. "There are many other costs that have no clear way to be paid for at this point."

States and territories have received $200 million from the CDC to do planning, the Post reported.

Recruiting and training workers for coronavirus vaccination campaigns will cost at least $3 billion. Another $1.2 billion will be needed for cold supply chain management, $1 billion for arranging additional vaccination sites and $500 million for data information system upgrades, the Post reported.

COVID-19 continues to spread around the globe

By Tuesday, the U.S. coronavirus case count passed 9.3 million while the death toll passed 231,000, according to a New York Times tally.

According to the same tally, the top five states in coronavirus cases as of Tuesday were: Texas with nearly 965,000; California with over 944,000; Florida with over 812,000; New York with over 516,000; and Illinois with over 431,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

Many European countries are tightening restrictions, the AP reported. France began a nationwide lockdown Friday, Germany began a partial lockdown on Monday and Austria started one Tuesday as government officials across the continent scramble to slow a sharp rise in infections that threatens to overwhelm their health care systems.

England will follow suit on Thursday, while Italy, Greece and Kosovo also announced new measures, the AP reported.

Things are no better in India, where the coronavirus case count has passed 8.2 million, a Johns Hopkins tally showed.

More than 123,000 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India's younger and leaner population.

Still, the country's public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil passed 5.5 million cases and had over 160,000 deaths as of Tuesday, the Hopkins tally showed.

Cases are also spiking in Russia: The country's coronavirus case count has passed 1.6 million. As of Tuesday, the reported death toll in Russia was over 28,600, the Hopkins tally showed.

Worldwide, the number of reported infections passed 46.9 million on Tuesday, with over 1.2 million deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: Washington Post; The New York Times; Associated Press

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