 Welcome to Tuesday’s Overnight Health Care. There are more than 2.6 million confirmed cases of COVID-19 in the U.S., including 127,000 deaths. Anthony Fauci issued a stark warning to members of Congress about the coming weeks and months if the U.S. does not alter the trajectory of the pandemic. And the FDA released its requirements for approving a COVID-19 vaccine, as officials sought to reassure the public about the agency's independence. We'll start with Fauci: Fauci predicts 100,000 new COVID-19 cases per day if US can't control outbreaks Anthony Fauci, the nation’s top infectious disease expert, warned members of Congress on Tuesday that the U.S. could reach 100,000 new COVID-19 cases per day if the country does not get a handle on the pandemic. Speaking before the Senate health committee, Fauci said the country is heading in the “wrong direction" as the average number of daily cases continues to go up. “We need to do something about that and we need to do it very quickly," said Fauci, the director of the National Institute of Allergy and Infectious Diseases. The U.S. is now recording 40,000 new cases per day, surpassing previous records set in April when New York was the epicenter of the outbreak. States started recording increases after Memorial Day when many states lifted restrictions on businesses and activities that had been in place to slow the spread of the virus. Fauci said while more than half of the new cases are coming from four states, they put the whole country at risk. Read more here. Trump officials seek to reassure about safety of potential coronavirus vaccine Top Trump administration health officials want to reassure the public that any potential coronavirus vaccine will only be approved if it is safe, and the fast-track process won't be influenced by political pressure. Democratic lawmakers and public health experts have expressed concern that President Trump's focus on developing a vaccine will pressure the Food and Drug Administration (FDA) into approving a vaccine before it's safe. To assuage some of that concern, the agency on Tuesday released a guidance that outlines conditions for approving a COVID-19 vaccine. The guidelines: Among other provisions, any vaccine needs to be at least 50 percent more effective than a placebo in preventing the disease, and drug companies must enroll at least 30,000 people in a clinical trial, including racial and ethnic minorities. Caveat: The guidelines are applicable to full approvals, which generally require more evidence. FDA could issue emergency use authorizations to get a drug to market quickly, especially during a national public health emergency. What they said: "I want the American people to hear me when I say we will use the science and data from those trials, and will ensure that our high levels of standards for safety and efficacy are met," FDA Commissioner Stephen Hahn said during the hearing. Read more here. Harvard analysis: Only 17 states and DC are meeting testing targets The U.S. is still not testing enough for the coronavirus, a new analysis from the Harvard Global Health Institute finds. According to the analysis, 14 states along with Washington, D.C., are doing enough testing to mitigate the spread of the virus: Connecticut, Delaware, Idaho, Illinois, Indiana, Maine, Massachusetts, Montana, New Hampshire, New Jersey, New York, Oklahoma, West Virginia and Wyoming. The three states meeting the higher goal of suppression-level testing are Vermont, Hawaii and Alaska, with West Virginia, Montana, and New Jersey close behind, the analysis finds. Big picture: The United States is conducting about 500,000 tests per day, a significant improvement from earlier in the outbreak. But the Harvard estimate states that given how large the current outbreak is, the country needs about 1 million tests per day to mitigate the spread of the virus, and about 4 million tests per day to go even further and suppress the virus. Read more here. Biden hits Trump over coronavirus response: 'It's not working' Presumptive Democratic presidential nominee Joe Biden hit President Trump over his handling of the coronavirus pandemic in a speech on Tuesday, stressing the need for a uniform nationwide response. "We need real plans, real guidelines with uniform nationwide standards to help us chart our economic reopening," the former vice president told reporters during an address in Wilmington, Del. "Whatever it is that we're doing now, it's not working. The state-by-state approach will only produce confusion and slow any progress." Biden went on to emphasize the need for all Americans to wear a mask amid the pandemic, which Trump has said should be decided by localities. "We need an absolute clear message from the top of our federal government that everyone needs to wear a mask. Period," Biden said. Read more here. GOP senator urges Trump to wear a mask Senate Health Committee Chairman Lamar Alexander (R-Tenn.) urged Americans to stop politicizing the use of masks to slow the spread of COVID-19, adding that it would help if President Trump wore one himself once in a while. “Unfortunately this simple lifesaving practice has become part of a political debate that says: If you're for Trump, you don't wear a mask. If you're against Trump, you do,” Alexander said Tuesday during a hearing focused on COVID-19. “That is why I have suggested the president should occasionally wear a mask even though there are not many occasions when it is necessary for him to do so. The president has millions of admirers. They would follow his lead. It would help end this political debate. The stakes are too high for it to continue.” Read more here. What we’re reading Adam Silver: On track but coronavirus spread may stop NBA (ESPN) Workers filed more than 4,000 complaints about protective gear. Some still died. (Kaiser Health News) As virus roars back, so do signs of a new round of layoffs (Associated Press) In the Covid-19 death of a hospital food worker, a microcosm of the pandemic (Stat News) Pandemic unleashes a spike in overdose deaths (Politico) State by state Virginia prepares to enter Phase 3, as D.C. worries and cases spike elsewhere (Washington Post) For the first time since start of coronavirus pandemic, Massachusetts reports no new coronavirus deaths, 114 new cases (Masslive) July 4 will be a do-or-die moment for California as coronavirus rages (Los Angeles Times) Los Angeles County closes beaches for July 4 weekend, citing coronavirus risk (CBS News) The Hill op-eds Flattening the malaria and COVID-19 curves Government health care restrictions are costing lives | 
