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Deborah Birx, the physician overseeing the White House coronavirus response, warned Sunday that the United States had entered a “new phase” of the pandemic and urged people to take extreme health precautions as infections and deaths rise sharply nationwide.

“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 are 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.

Here are some significant developments:

  • In an interview on CBS News’s “Face the Nation,” White House Chief of Staff Mark Meadows said congressional leaders were still far from reaching a consensus on a coronavirus relief package. “I’m not optimistic that there will be a solution in the very near term,” he said.
  • Texas health officials have not been publicly reporting the results of coronavirus tests that deliver results in less than 30 minutes, suggesting that the state has at least tens of thousands more confirmed cases than announced, an investigation by the Houston Chronicle found.
  • Sturgis, S.D., is bracing for more than 250,000 bikers to descend on the city next week for a motorcycle rally that the Associated Press reported could be the largest event so far during the pandemic. More than 60 percent of residents surveyed by the city said the rally should be delayed, but local businesses persuaded the council to move forward, according to the AP.

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 does 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.”

She and Anthony S. 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. Although Birx said mitigation efforts have helped in some places, she stressed that people need to practice strict social distancing and wear masks. She 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 country tallied 478 deaths Sunday, down slightly from the 566 fatalities reported on the same day last week. But some states — including Texas, which has been averaging nearly 300 deaths per day — had not reported their statistics as of Sunday evening, suggesting that the true number of new deaths was higher.

As the daily case and death totals remain bleak, the economy is still not building on signs that it had started to recover, and 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 the states over the past week, pushing the national death toll past 150,000 and prompting health experts to warn that the trend is unlikely to reverse anytime soon.

Numerous states reported record daily fatalities in recent days, including California, which reported 219 on Saturday, according to tracking by The Washington Post. Florida reported a record 257 deaths on Friday, and seven-day averages for new deaths reached new highs in states across the South, the West and the Midwest.

Florida’s soaring coronavirus hospitalizations and deaths continue as Tropical Storm Isaias closes in on the state. The storm is expected to unleash strong wind gusts, heavy rain and possibly storm-surge flooding along Florida’s eastern shores from south to north through Sunday night.

Nationwide, the daily coronavirus death toll exceeded 1,000 for the sixth day in a row on Saturday, according to The Post’s data. The 1,198 new fatalities marked the most that officials have counted on a Saturday, when death reports tend to be lower than those tallied midweek, since May 9.

With the new academic year starting soon in many communities, Birx 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 fully reopen 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 decisions about whether to reopen districts became clear last week as at least five schools reported that a student or employee tested positive for the coronavirus during the first few days back in session. A high school in Mississippi and four schools in Indiana reportedly instructed people who had been in contact with the infected people to self-quarantine. One of the schools, Elwood Junior Senior High School in Indiana, said it will close this week.

The increase in deaths nationwide has trailed a massive surge in coronavirus cases by several weeks, as health experts predicted when infections started trending upward in June.

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 high estimate of 182,000, according to the CDC’s review.

Amid the rising deaths, Trump struck an optimistic note Sunday, tweeting, “USA will be stronger than ever before, and soon!”

Despite reports Saturday that Trump’s renomination this month will be held in private, the Republican National Committee on Sunday said no final decision had been made. A convention spokesperson previously told the Arkansas Democrat-Gazette and other news organizations that restrictions on crowd size during the pandemic would prevent reporters from attending. Two RNC officials, however, insisted Sunday that they were still working through the logistics and media coverage options.

Eli Rosenberg, Felicia Sonmez, Joseph Marks and Jacqueline Dupree contributed to this report.