(CNN) — The US has topped 4.2 million infections and 148,000 deaths since the pandemic began, and a leading expert says thousands more Americans could lose their lives in the coming months.
"If you look at the deaths as they're occurring right now -- about 1,000 per day -- unless we get our arms around this and get it suppressed, we are going to have further suffering and further death," said Dr. Anthony Fauci, the nation's top infectious disease expert. "That's the reason why, as I've often said many, many times, there are things that we can do right now in the absence of a vaccine that can turn us around," he added.
While there's still no guarantee the vaccines being developed will prove effective, at least one vaccine trial in the US has entered its third phase. In the meantime, health officials are urging states to implement stricter measures after weeks of surges in new cases following reopenings that mostly began in May. Nationwide, there have been more than 1,000 deaths five times in the past week. And in hospitals throughout several states, doctors report more incoming patients and maxed out ICUs.
While President Donald Trump said Monday some governors should be quicker about reopening states, White House coronavirus response coordinator Dr. Deborah Birx said over the weekend there are states showing a concerning increase in positivity rates and new cases. Those states include Indiana, Ohio, Kentucky, Tennessee and Virginia. Health experts, she said, recommending "100% of people" wear masks in all indoor public places and that social and indoor gatherings are limited to less than 10 people.
Across the US, at least 27 states hit a pause or rolled back those reopening plans and imposed new restrictions. More than 40 states have some kind of mask requirement in place.
In some places, the efforts seem to be working. In states including Arizona, Texas and Florida, which reopened without effective safety protocols and saw rapid case spread since June, new cases have flattened or slightly decreased recently. But that doesn't mean the states are out of the woods just yet, and it's still too early to tell how long the trend will last.
Birx said that among the states officials are tracking, there seems to be a "household" pattern of infections that starts with young people, usually less than 30 years old. Those residents, who are usually asymptomatic, then transmit the virus to their parents who then transmit it to other, older residents, she said.
In Mississippi, about 80% of surveyed coronavirus patients said they had attended a social gathering, including funerals and birthday parties, where people weren't adhering to social distancing. And in New Jersey, health officials said they have seen multiple outbreaks arising from gatherings of young people.
To stop those infections, states have cracked down on congregate settings -- like bars --- and pleaded with younger groups to heed guidelines including wearing masks and social distancing.
In Columbus, Ohio, the city council approved legislation that would require bars and restaurants to close at 10 p.m. each night starting Tuesday.
"Our city like many others across the country are seeing an increase in COVID-19 cases, and there is clear evidence of community spread -- especially indoors in places where groups are gathering," Mayor Andrew Ginther said in a statement. "We're also seeing a clear increase among younger people, and we know that bars and nightclubs have been the source of outbreaks locally."
In Kentucky, the governor also imposed new restrictions on restaurants, shut bars down for the next two weeks and recommended schools postpone in-person instruction until late August.
Despite new restrictions, some local leaders have voiced their opposition to the mandates and others -- like sheriffs -- have said they won't be enforcing the rules.