WASHINGTON — While President Donald Trump spent Monday trying again to reassure voters that the U.S. is “rounding the turn” in the pandemic and that concerns about COVID-19 would vanish from headlines immediately after the election, one of his top coronavirus advisers sounded the alarm in an internal memo about just how dire the situation has become, according to reports.

What You Need To Know

  • Dr. Deborah Birx sent an internal memo Monday warning that the U.S. is entering "the most concerning and most deadly phase of this pandemic," according to reports

  • The White House coronavirus response coordinator's blunt warning contradicts President Trump's message that the country is "rounding the turn" in the pandemic

  • Birx wrote that “consistent messaging about uniform use of masks, physical distancing and hand washing with profound limitation on indoor gatherings” is “essential"

Dr. Deborah Birx, the White House coronavirus response coordinator, wrote in the memo, first obtained by The Washington Post: “We are entering the most concerning and most deadly phase of this pandemic. 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.”

The United States is in its third wave of coronavirus infections — and its worst yet. The country had more than 84,000 new cases Monday, according to data from Johns Hopkins University. On Friday, there were more than 99,000 new cases, the most recorded by any country since the pandemic began.

Hospitalizations are at their highest point in nearly three months, according to The COVID Tracking Project, and a rise in deaths, which generally lag a couple weeks behind spikes in cases, are expected soon.

As he has sought reelection in the face of criticism about his handling of the pandemic, Trump has continued to downplay the virus. In addition to telling rally crowds that conditions are improving, he has cast doubts on the effectiveness of masks, insisted those who are infected will recover and falsely claimed the COVID-19 death toll is inflated because doctors are paid more to list the virus as the cause of death.

The president also has repeatedly blamed increased testing on the rise in cases, a claim Birx challenged in her memo. 

“Half of the United States is in the red or orange zone for cases despite flat or declining testing,” she wrote, referring to communities that are seeing at least 10 daily new cases per 100,000 residents. 

Birx wrote that “consistent messaging about uniform use of masks, physical distancing and hand washing with profound limitation on indoor gatherings” is “essential.”

Unlike her colleague on the White House Coronavirus Task Force, Dr. Anthony Fauci, Birx has kept a low public profile — and, as a result, stayed out of Trump’s crosshairs. The president and Fauci have butted heads over their conflicting messages about the virus, and Trump on Monday signaled to his supporters that he might fire Fauci, the director of the National Institute of Allergy and Infectious Diseases, after the election.

The White House has reportedly leaned less on the advice of Birx and Fauci in recent months. A top administration official told the Post that Birx has become increasingly frustrated with being “ignored” as she and others have warned about potentially second and third waves of the virus this fall and winter.

Meanwhile, Dr. Scott Atlas, a White House medical adviser with no experience in infectious diseases or public health, has had growing influence on Trump, according to reports. Atlas favors a “herd immunity” strategy for the virus and in a tweet removed by the social media company said last month masks do not work.

Also last month, White House chief of staff Mark Meadows said the administration is “not going to control the pandemic” and instead was focusing on developing vaccines and therapeutics.