 Welcome to Thursday’s Overnight Health Care. Ohio Gov. Mike DeWine (R) tested positive for COVID-19, Deborah Birx privately warned of case increases in nine cities, and President Trump issued a "buy American" executive order for essential drugs and said a COVID-19 vaccine would be ready in time for Election Day. We'll start in Ohio: Ohio governor tests positive for COVID-19 ahead of Trump's visit Ohio Gov. Mike DeWine (R) tested positive for coronavirus on Thursday ahead of President Trump's visit to the state. DeWine was tested as part of the required protocol before meeting Trump at the airport in Cleveland. The governor will return to Columbus and plans to quarantine at his home for 14 days, his office said. The governor currently has no symptoms of the disease, according to a release from his office. DeWine also tweeted from his personal account noting his positive test results. “As part of the standard protocol to greet President Trump on the tarmac in Cleveland, I took a COVID test. I tested positive. I have no symptoms at this time. I’m following protocol and will quarantine at home for the next 14 days,” he wrote. Small ironies: DeWine had cancelled a previously scheduled Thursday coronavirus briefing in order to meet Trump on the tarmac. Lessons: The coronavirus is spreading virtually unchecked through most parts of the country, and DeWine only found out he was infected because he was supposed to meet with Trump. The daily testing protocol afforded to Trump is not available elsewhere in the country, but it shows just how many cases can be identified with adequate testing. Also: wear a mask, and assume everyone has COVID-19. Read more here. US shows signs of coronavirus peak, but difficult days lie ahead The number of new coronavirus infections across the United States is showing signs of easing, but remains at a discouragingly high plateau that underscores the difficulty the country has ahead of it in getting the pandemic under control. Over the last three days, the United States has confirmed about 50,000 new cases every 24 hours. States like Arizona, Florida, Texas and the Carolinas that suffered the worst of June and July have now seen their case counts fall for two weeks from peaks in mid- and late July, when more than 70,000 cases were identified on a typical day. But though the drops are potentially positive signs that newly enforced social distancing and economic lockdown measures are working, Florida confirmed more than 63,000 new cases over the last week, Texas reported 57,000 new cases and counts are still rising in states like Georgia, Missouri, Tennessee and Virginia. Going forward though, major testing delays, data reporting problems, and Hurricane Isias-related closures of testing sites could muddy the numbers. “We’re still in the first wave, and we’re the highest that we’ve been since the beginning. I don’t think we are going down the back side yet,” said Scott Lindquist, Washington state’s chief epidemiologist for communicable diseases. “There are some indications that we have reached a peak.” Read more here. Trump: COVID-19 vaccine may be ready 'right around' Election Day President Trump played into the fears of scientists, public health experts and Democrats when he said he thinks it's possible there will be a COVID-19 vaccine ready around Election Day in November. "I think in some cases, yes, possible before, but right around that time," Trump said on Geraldo Rivera's radio show when asked if he thought a vaccine would be ready by Nov. 3. Trump told reporters this week that politics will not play any role in the science behind vaccine development, and administration officials have made similar assurances. But Trump has repeatedly insisted a vaccine could be ready in the near future, citing Operation Warp Speed, a government initiative to expedite the development, manufacturing and distribution of a possible COVID-19 vaccine. The science: It would be incredibly difficult for a vaccine to be proven safe and effective as soon as November. While there have been some initial positive results in clinical trials, nothing has been scaled up even close to the magnitude needed to prove a vaccine is ready for the public, even on an emergency basis. But still: The FDA is facing a huge moment. Commissioner Stephen Hahn wrote an op-ed in the Washington Post on Thursday, and didn't deny that there has been "inappropriate pressure." He is trying to convince the public that pressure won't affect how the agency makes a decision on a potential vaccine. Read more here. McConnell signals senators can head home until negotiators get a coronavirus deal Coronavirus negotiations in Congress remain deadlocked. Majority Leader Mitch McConnell (R-Ky.) said on Thursday that the Senate will technically be in session next week but signaled he's letting senators leave Washington, D.C., until an agreement is reached on a fifth coronavirus relief package. "I will not be adjourning the Senate for our August recess today as has been previously scheduled. I've told Republican senators they'll have a 24-hour notice before a vote, but the Senate will be convening on Monday and I'll be right here in Washington," McConnell said from the Senate floor. The White House and congressional Democrats have said they want a deal this week, but there are few signs that they will be able to meet a self-imposed Friday deadline. House members left town last week, and Majority Leader Steny Hoyer (D-Md.) said at the time that he would call members back with a 24-hour notice once they get an agreement. Read more here. Trump to sign order seeking to boost domestic drug manufacturing President Trump signed an executive order on Thursday to require government agencies to "Buy American" for certain essential medicines, and encourage U.S. manufacturing of drugs. The White House billed the order — which Trump will sign during a trip to Ohio, a swing state in the coming election — as part of the president's efforts to boost U.S. manufacturing. White House adviser Peter Navarro, who is spearheading the order, also said it would reduce U.S. dependency on other countries like China to manufacture drugs that the U.S. relies on, especially during emergencies like the current coronavirus pandemic. It remains unclear just how broadly the order will be implemented — the executive order does not specify what drugs it covers. The order merely requires the federal government to develop a list of "essential" medicines, and then requires that agencies like the Department of Veterans Affairs, Department of Health and Human Services and Department of Defense purchase U.S.-made versions of those drugs. Executive pattern: The move is part of a recent push from Trump to use executive orders to implement parts of his agenda before November. The effort is intended to pile up Trump’s list of accomplishments as he seeks reelection against the backdrop of the coronavirus pandemic and a fractured economy. Read more here. Birx warns of uptick in coronavirus cases in 9 cities White House coronavirus task force coordinator Deborah Birx privately warned of an uptick in coronavirus cases in nine U.S. cities. “Many of the Sun Belt states have made substantial progress with their mitigation efforts,” Birx told state and local officials on Wednesday, according to a copy of the call obtained the Center for Public Integrity, referring to a slew of Southern states that experienced surges earlier this summer. But Birx said that the percentage of coronavirus tests coming back positive is increasing in nine U.S. cities as well as California's Central Valley. "We are concerned that both Baltimore and Atlanta remain at a very high level. Kansas City, Portland, Omaha, of course what we talked about in the Central Valley,” Birx said. "We are seeing a slow uptick in test positivity in cases in places like Chicago, Boston and Detroit and D.C.” Birx also said that Nebraska and California have moved into the red category, with more than 10 percent of tests coming back positive. And she noted that while Los Angeles saw improvements, there was significant movement of the virus up California's Central Valley. Read more here. What we’re reading: Major U.S. health insurers report big profits, benefiting from the pandemic (The New York Times) Health care workers of color nearly twice as likely as whites to get COVID-19 (Kaiser Health News) Early coronavirus vaccine supplies likely won’t be enough for everyone at high risk (The Wall Street Journal) State by state: Utah to close health, dental clinics serving the underinsured as part of pandemic budget cuts (The Salt Lake Tribune) ‘The photo does not look good’: Georgia school’s crowded halls go viral (New York Times) 'We are no less American': Deaths pile up on Texas border (Associated Press) Almost 100 people in Ohio were infected with coronavirus after man attended church service (CNN) From The Hill's opinion page: Can seaweed really help us fight COVID-19? | 
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