Dr. Deborah Birx warned on Sunday that the coronavirus pandemic has entered "a new phase" in the U.S. and said the virus is "extraordinarily widespread" in rural areas that missed earlier waves.
"What we are seeing today is different from March and April," Birx, the White House coronavirus task force coordinator, said in an interview with CNN. "It is extraordinarily widespread. It's into the rural as equal urban areas." The virus has now infected more than 4.6 million Americans.
"To everybody who lives in a rural area, you are not immune or protected from this virus," she added.
Birx said that all Americans, no matter where they live, should follow the guidelines of wearing masks, practicing social distancing and maintaining good hygiene, such as regular hand washing. But she pointed out a special risk for rural residents and said some should already assume they have the virus.
"If you're in multi-generational households, and there's an outbreak in your rural area or in your city, you need to really consider wearing a mask at home — assuming that you're positive, if you have individuals in your households with comorbidities," Birx said.
President Trump appeared to take issue with Birx's warnings about the virus and accused her of capitulating to House Speaker Nancy Pelosi's criticism of her.
"So Crazy Nancy Pelosi said horrible things about Dr. Deborah Birx, going after her because she was too positive on the very good job we are doing on combatting the China Virus, including Vaccines & Therapeutics," he tweeted. "In order to counter Nancy, Deborah took the bait & hit us. Pathetic!"
The CDC says that rural areas face several distinct challenges during the pandemic, including "long-standing systemic health and social inequities." Rural Americans "tend to have higher rates of cigarette smoking, high blood pressure, and obesity as well as less access to healthcare," the CDC reports.
As of Monday afternoon, the U.S. has reported more than 4,675,000 coronavirus infections and 155,000 deaths, according to Johns Hopkins University. The southern and western regions of the U.S. are now the hot spots with the virus, with Florida, California and Texas leading the nation in cases.
Birx said the federal government has been working with state officials for "dramatically tailored" reports on what each community needs to handle the virus. And she said her recently travels to several states left her concerned about how the virus is still spreading.
"As I traveled around the country, I saw all of America moving," she told CNN. "If you have chosen to go on vacation into a hot spot, you really need to come back and protect those with comorbidities and assume you're infected."