"It's extraordinarily widespread," Dr. Deborah Birx, the White House coronavirus response coordinator, told CNN on Sunday.

So far, more than 4.6 million Americans have been infected and at least 154,859 have died, according to Johns Hopkins University data. And the country's death toll is now projected to reach at least 173,000 by August 22, according to a new composite forecast from the US Centers for Disease Control and Prevention

To combat the rampant spread of the virus, health officials have worked with state leaders to provide tailored responses that combat the outbreak in each community, Birx said, adding that some mitigation efforts have begun to show positive results.

"But I want to be very clear," she said. "What we are seeing today is different from March and April. It is extraordinarily widespread. So everybody who lives in a rural area, you are not immune or protected from this virus and that is why we keep saying, no matter where you live in America, you need to wear a mask and socially distance."

The recommendations from health officials have remained the same for months -- yet despite a continuing climb in coronavirus cases, some Americans are still opting to attend large social gatherings, and refuse to wear face coverings.

There need to be stricter measures and -- in some communities -- another round of stay-at-home orders, said Dr. James Phillips, a physician and assistant professor at George Washington University Hospital.

"I'm concerned that the complacency that we've seen with coronavirus has led to these mass gatherings and a general disagreement with the science," he said. "People aren't wearing masks, they aren't distancing."

At least 30 states have paused their reopening plans or imposed new restrictions to combat a rise in cases, and at least 39 states have some kind of mask order in place. But the efforts to slow the spread come as some parts of the country are preparing to welcome students back to schools and college campuses.

"What I'm concerned about primarily is the fact that we haven't controlled this virus in a serious way, we're seeing rises in a lot of states and now we're talking about reopening schools and colleges in the midst of that which I think is going to compound our problem significantly," Phillips said.

These states require masks

As one school district reopens, 260 employees infected or exposed

In Gwinnett County, Georgia, where dozens protested a return to school last week, at least 260 Gwinnett County Public School employees tested positive for the virus or were in contact with a case, a spokeswoman for the district told CNN Sunday.

That announcement came days after teachers returned to class for in-person pre-planning, CNN affiliate WSB reported.

And in one Indiana school district that reopened for the new year, a student tested positive on the first day of class, prompting school officials to isolate the child and begin tracking who may have come into close contact.

School re

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