Birx says U.S. has entered 'new phase' of pandemic as cases, deaths rise

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

Birx did not rule out an estimate from former Food and Drug Administration Commissioner Scott Gottlieb that virus deaths could top 300,000 by the end of the year, saying "anything is possible." Such an outcome would be far less likely, Birx said, if people practiced social distancing and avoided large gatherings.

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

House Speaker Nancy Pelosi, D-Calif., said Sunday that she did not have confidence in Birx. "I think the president is spreading disinformation about the virus, and she is his appointee," Pelosi said in response to a question from ABC News's Martha Raddatz. "So I don't have confidence there, no."

Birx defended her decisions in responding to the crisis. "I have tremendous respect for the speaker. I have tremendous respect for her long dedication to the American people," she told CNN, before adding that she has "never been called Pollyannaish or nonscientific or non-data-driven."

Birx and Anthony Fauci, the nation's top infectious-disease expert, have warned 20 states in the Sun Belt, the Midwest and the Pacific Northwest that the virus spread is accelerating within their borders. While Birx said mitigation efforts have helped in some places, she stressed that people need to practice strict social distancing and wear masks. Birx also raised concerns about the virus spreading within multigenerational households, urging people in those settings to "really consider" wearing masks inside their homes.

Birx's remarks came as the U.S. economy fails to build on signs that it had started to recover, and as millions of Americans continue to wait for an economic relief package that would restore their expired unemployment benefits.

Pelosi and Treasury Secretary Steven Mnuchin made clear in separate interviews Sunday that they remain far apart on a deal. Pelosi said the administration continued to resist a public health strategy to attack the virus. Mnuchin defended the administration's response and said Democrats' demand for $1 trillion in new state and local aid was a non-starter.

The stalled negotiations followed another week of grim signs for the country's pandemic response. The seven-day average for new coronavirus-related deaths rose in nearly half of states over the past week, pushing the national death toll past 150,000 and prompting health experts to warn that the trend was unlikely to reverse anytime soon.

Nationwide, the daily coronavirus death toll exceeded 1,000 for the sixth day in a row on Saturday, according to The Washington Post's data. The reported number of deaths on Sunday was 478 as of 8 p.m.

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 reopen fully in the fall.

"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," Birx said.

The stakes of school reopening decisions became clear last week as at least four schools reported that a student tested positive for the coronavirus during the first few days back in session. Corinth High School in Mississippi, Greenfield Central Junior High School in Indiana and two schools in Indiana's Greater Clark County Schools district reportedly instructed people who had been in contact with the infected individuals to self-quarantine.

The increase in deaths across the country has trailed a massive surge in coronavirus cases by several weeks. 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," Ellie Murray, an epidemiologist at Boston University, told The Post. "We cannot afford to pretend everything is fine and heading back to normal."

The Centers for Disease Control and Prevention's most recent analysis of pandemic fatalities shows weekly reports of new deaths increasing over the next month, with 5,000 to 11,000 new deaths projected in the third week of August. The national death toll could climb to more than 168,000 by that time, with a top estimate of 182,000, according to the CDC's review.

Amid the rise in deaths, President Donald Trump struck an optimistic note on Sunday, tweeting, "USA will be stronger than ever before, and soon!"

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

Asked Sunday about hydroxychloroquine on NBC News's "Meet the Press," 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."