 Welcome to Friday's Overnight Health Care. President Trump wants houses of worship to reopen immediately, despite the health risks from too many people gathering in the same place. Anthony Fauci said he thinks it's possible for a vaccine to be developed, manufactured and distributed before the end of the year – so long as it works. And a new study casts further doubt on any possibility hydroxychloroquine is a treatment for COVID-19. We'll start with Fauci: The Hill interview: Fauci on why a vaccine by end of year is 'aspirational' Our colleague Reid Wilson chatted with Anthony Fauci on Friday and got some potentially positive news about a vaccine, if it’s shown to work: Fauci said 100 million doses could be ready by the end of the year. Fauci said he was "fairly certain" that if production is started this summer and ramped up, "you could have 100 million doses by the end of the year and maybe a couple of hundred million doses by the beginning of next year." "I mean that's aspirational," he said. "The companies think that they can do that with the right financial backing." Caveat: Fauci noted that many more vaccine candidates fail than succeed. He also did not say what level of success a potential vaccine could offer – will one get approved if it doesn't prevent the disease 100 percent in all populations? Just sometimes? Will it merely lessen the severity? Other highlights from the interview: On states reopening: Follow the guidelines or face risk of resurgence, Fauci says. "It is prudent for states who are at various levels of infection to follow the guidelines that have come out about reopening or opening America again. And that is to get past the gateway criteria and then go into the various phases at the rates that are prescribed by the guidelines. Obviously if some states don't do that, there is always a risk that you may have a resurgence," Fauci said. On deaths: He said one model he had quoted had projected between 100,000 and 240,000 deaths. "Hopefully it doesn't get significantly more than that, but that will depend on how well we respond to the inevitable rebounds that you will see as you pull back," he said. "If you respond well, you may keep that number relatively low." Read more here. Related: Esper doubles down on coronavirus vaccine this year: 'We will deliver Trump demands governors allow churches to open President Trump on Friday ordered governors to allow houses of worship to open immediately, declaring them “essential” to American life during COVID-19. “The governors need to do the right thing and allow these very important essential places of faith to open right now, this weekend,” Trump said during brief remarks at the White House that his press shop had touted as a briefing. Trump took no questions, however, and left immediately after his brief statement. “If they don't do it I will override the governors. America, we need more prayer, not less," he said. While Trump is legally unable to override these state orders, the Department of Justice (DOJ) has been pressuring governors to treat houses of worship the same as secular institutions in reopening plans. Read more here. News for DC locals: Birx says metro area has highest positivity rate for coronavirus White House coronavirus task force coordinator Deborah Birx said Friday that the Washington, D.C., metro area currently has the highest COVID-19 positivity rate out of all cities across the country, and infections are not declining. Birx said that the D.C. metro area, which includes Northern Virginia and Montgomery and Prince George’s counties in Maryland, currently leads the country in the percentage of positive cases compared to the total number of people tested for the novel coronavirus. The D.C. metro region is followed by Baltimore, Chicago and Minneapolis, Birx said. “These are the places where we have seen really a stalling or an increase of cases,” Birx told reporters at an afternoon White House briefing. Birx said that the areas with the largest percentage of cases — Maryland, D.C. and Virginia — all have positivity rates under 20 percent, compared to 42 states where positivity rates are under 10 percent. Public health experts and the World Health Organization generally say the goal for states should be to have less than 10 percent of tests come back positive. Reopening anyway: D.C. Mayor Muriel Bowser (D) on Thursday outlined plans for the city to lift its stay-at-home order and begin a phased reopening of certain businesses beginning next Friday. Northern Virginia is shut down until at least next Thursday. Read more here. Trump to send $5B to nursing homes for COVID-19 help The Trump administration announced Friday it will send nearly $5 billion to help nursing homes respond to COVID-19, which has already killed thousands of individuals in those facilities throughout the U.S. since February. The funding distributed to nursing homes by the Department of Health and Human Services can be used to increase testing capacity, purchase protective equipment for staff, hire more workers and cover other pandemic-related expenses. The funds will also help make up for lost revenue caused by the pandemic and cover other COVID-19–related expenses. But trade groups representing nursing homes and long-term care facilities said $5 billion isn’t enough money. Context: COVID-19 has ravaged long-term care facilities, leaving at least 28,100 residents and workers dead, according to a New York Times tally. The money could be used to slow the spread, by allowing nursing homes to buy more protective equipment and hire more staff, but the nature of those facilities makes it hard to stop infectious diseases once they get in. Read more here. New study: Anti-malaria drug touted by Trump has high death risk in COVID-19 patients Hospitalized COVID-19 patients who were treated with hydroxychloroquine, an anti-malaria drug touted by President Trump, had a much higher risk of death than those who were not, according to a new observational study of 96,000 patients. The study, published Friday in the medical journal The Lancet, found that patients who were treated with hydroxychloroquine or chloroquine also faced a much higher risk of abnormal heartbeats, called arrhythmias, which could result in cardiac arrest. The researchers suggested that the drugs shouldn’t be used to treat coronavirus patients outside of clinical trials for now, because there is no evidence of their effectiveness. Key limitations: As an observational study looking at medical records only, the analysis doesn't have the impact of a clinical trial, controlled with a placebo group. There are such clinical trials ongoing. But 96,000 patients, even in an observational study, is the largest analysis on the effects of hydroxychloroquine to date. Trump factor: President Trump has promoted the use of hydroxychloroquine for months. This week, he claimed he has been taking it as a preventative measure, even though there is no evidence it works. Read more here. Related: VA gave hydroxychloroquine for COVID-19 to 1,300 veterans What we’re reading 1 in 5 adults in England think the coronavirus is a hoax (NPR) Hospitals are rationing Remdesivir (Wall Street Journal) Congress is moving to another round of coronavirus relief. Here are the battle lines. (NBC News) The feds gave a former White House official $3 Million to supply masks to Navajo hospitals. Some may not work. (ProPublica) Moderna unveiled encouraging coronavirus vaccine results. Then top execs dumped nearly $30 million of stock (CNN) Russian ventilators reached U.S. states without FDA oversight (Reuters) The world may also be overestimating the power of COVID-19 vaccines (STAT) State by state All Pennsylvania counties will be in ‘yellow’ coronavirus reopening phase by June 5, Wolf announces (Philadelphia Inquirer) Michigan Gov. Whitmer extends stay-home through June 12 (The Hill) Alabama AG says nursing homes can’t take stimulus money from residents on Medicaid (al.com) 'The disease is ripping through': why coronavirus is devastating California's Pacific Islanders (The Guardian) | 
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