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White House coronavirus task force coordinator Dr. Deborah Birx on Tuesday provided some dire warnings for states that are in the task force-defined “yellow zone” for cases and test positivity, which she said are different from outbreaks across the country earlier this year. 

On a call Tuesday with Vice President Mike Pence and several governors, she said there has been “significant improvement” in “red zone” states Florida, California, Texas, and Arizona following orders to close bars, decrease indoor dining, and require the use of masks. The task force defines its “red zone” states as more than 100 cases per 100,000 people and more than 10% test positivity. 

But she said there are still rising cases and test positivity in other “red zone” states: Mississippi, Indiana, Tennessee, Virginia, Oklahoma, Georgia, Idaho, and Arkansas. 

Birx said “yellow zone” states, which the task force defines as having between 10 and 100 cases per 100,000 and 5-10% test positivity, have had a similar profile to “red zone” states: “Starting with the 20 to 30 year-olds presenting as a first wave.” 

“Remember, the majority of those are asymptomatic so if you expect to see hospitalizations, by the time you see hospitalization, your community spread is so widespread that you’ve flipped into a red state incredibly quickly,” Birx said. 

She said the task force is working with governors and mayors in the following places: Colorado, the District of Columbia, Indiana, Iowa, Kansas, Kentucky, Minneapolis, Missouri, North Carolina, Nebraska, Ohio, Utah, Washington and Wisconsin.

The task force, Birx said, is talking with these places “about increasing mitigation efforts now because if we wait until increased hospitalizations it is really way too late. Because what we are experiencing now is really different than March and April, it’s very different from the outbreaks of May that was typically contained. This widespread community spread in the younger age group both rural and very urban and urban areas so by the time you see it up to 80-90% of your counties already have more than 10%.” 

Birx expressed concern for major metros like Chicago and Philadelphia, as well as California’s Central Valley, and applauded Alabama Gov. Kay Ivey’s mask mandate, which she said is having a “significant impact.”

Pence reiterated that the administration does not want another closure — something, he said, “We don’t ever want to see again,” but pointed to studies that show that the use of masks, bar closures, limiting outdoor dining, and limiting social gatherings are having similar effect as sheltering in place earlier this year. He recommended governors in “yellow zone” states “take a hard look” at those four measures “whether it be on a county-by-county basis or a statewide basis.”

“We’ll support your decision, but I think your big message to these states that may be emerging is don’t wait,” Pence said. 

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