Midwestern states are starting to see surges in coronavirus cases, just as Southern and Western states are scrambling to contain their own outbreaks of COVID-19.

Missouri, Montana and Oklahoma are among those witnessing the largest percentage surge of infections over the past week, the Washington Post reported. At the same time, the number of new cases in Florida, Mississippi and Alabama still outpaced all other states.

Experts also see worrying trends in major East Coast and Midwest cities, the Post reported, and they anticipate major outbreaks in college towns when classes resume in August.

Still, President Trump continued his push to fully reopen schools on Monday. “Ideally, we want to open those schools. We want to open them,” Trump said during a White House coronavirus task force briefing.

Dr. Anthony Fauci, the nation’s top infectious diseases expert, on Monday agreed with that sentiment, telling CNN that schools and college campuses across the country should be able to reopen, but officials need to make safety a priority.

The default position with kindergartens, grade schools and high schools should be to reopen them, Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN.

On college campuses, Fauci said plans should include testing people before they arrive on campus, when they arrive and quarantining them for 14 days.

“If done properly, it would not be a risk, but then again, you’ve got to be careful when you get people coming in from outside,” he said. “But I think if they maintain the guidelines that are put together for people coming back, then they should be fine.”

Regardless of what safety measures need to be taken to reopen schools this fall, many students need the psychological and nutritional benefits of being in school, Fauci added.

At the coronavirus task force briefing on Monday, Trump also announced that his administration is taking steps to give telehealth a broader role in Medicare, using an executive order that calls on Congress to make doctor visits via personal technology a permanent fixture of the government’s health insurance program for seniors.

The order is specific in its target: It applies to seniors living in rural communities. But administration officials told the Post that it signals that Trump is ready to back significant legislation that would permanently open up telehealth as an option for all people with Medicare.

Final stage vaccine trials underway

On the vaccine front, the final phases of testing for two potential COVID-19 vaccines have been launched.

In one trial, the first of 30,000 volunteers will be given either a vaccine developed by Moderna Inc. and the U.S. National Institutes of Health or a placebo shot, the Post reported.

Pharmaceutical giant Pfizer has also announced that it was starting a 30,000-person final phase vaccine trial, to be conducted at 120 sites globally.

Fauci predicted that researchers would probably be able to tell whether the Moderna vaccine was effective by November or December, although he added that it was a “distinct possibility” an answer could come sooner. Pfizer officials have said the company expects to be able to seek regulatory authorization or approval for its vaccine by October, the Post reported.

As cases have surged and testing delays have followed, contact tracing is becoming irrelevant in many parts of the country.

In many cities in Florida, a state which has seen soaring cases counts in the past month, officials have largely given up on tracking cases, and the situation is equally grim in California, the Times reported.

“I think it’s easy to say contact tracing is broken,” Carolyn Cannuscio, an expert on the strategy and an associate professor of family medicine and community health at the University of Pennsylvania, told the Times. “It is broken because so many parts of our prevention system are broken.”

By Tuesday, the U.S. coronavirus case count passed 4.7 million as the death toll neared 156,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Tuesday were: California with over 522,000; Florida with nearly 492,000; Texas with nearly 462,000, New York with over 421,500, and New Jersey with more than 184,400.

Nations grapple with pandemic

Elsewhere in the world, the situation remains challenging.

In Australia, the premier of Victoria declared a “state of disaster” on Sunday, announcing even stricter lockdown measures, introducing a nightly curfew and banning virtually all trips outdoors after Australia’s second largest state recorded 671 new infections in a single day.

“We have to do more, and we have to do more right now,” said Premier Daniel Andrews. “Where you slept last night is where you’ll need to stay for the next six weeks.”

Things continue to worsen in India. On Tuesday, the country passed 1.8 million infections and nearly 39,000 deaths, a Johns Hopkins tally showed. The surge comes weeks after a national lockdown was lifted, and it’s prompted some parts of the country to revert back to stricter social distancing measures. Only the United States and Brazil have higher caseloads.

Brazil is also a hotspot in the coronavirus pandemic, with over 2.7 million confirmed infections by Tuesday, according to the Hopkins tally. It has the second-highest number of cases, behind only the United States.

Cases are also spiking wildly in Russia: As of Tuesday, that country reported the world’s fourth-highest number of COVID-19 cases, at nearly 859,700, the Hopkins tally showed.

Worldwide, the number of reported infections passed 18.3 million on Tuesday, with nearly 695,000 deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.