(NEXSTAR/AP) – Dr. Deborah Birx, the coordinator of the White House coronavirus task force is sounding the alarm about the ongoing spike in COVID cases across the country.

Birx and Dr. Anthony Fauci became household names during White House coronavirus task force briefings in the early days of the pandemic, but the two have been increasingly out of step with President Donald Trump as he has characterized the nation as “rounding the turn” on the virus despite evidence of a third spike in cases.

“We are entering the most concerning and most deadly phase of this pandemic,” Birx wrote in a memo distributed to top administration officials, according to the Associated Press. She added that the nation was not implementing “balanced” measures needed to slow the spread of the virus.

The Republican president and health officials have appeared further apart since White House chief of staff Mark Meadows declared in late October that “we’re not going to control the pandemic.”

Since then, Health and Human Services Assistant Secretary Adm. Brett Giroir has done a round of interviews warning that the country’s situation is “tenuous” but that Americans can indeed control the virus by practicing what he calls the “3W’s” — watching your distance from others, wearing a mask and frequently washing your hands.

Earlier this week while touring states Birx lamented in Bismarck, North Dakota, that she hadn’t seen such disdain for mask-wearing elsewhere. “We find that deeply unfortunate because you don’t know who’s infected and you don’t know if you’re infected yourself,” she told reporters. The state’s positive test rate was 11%, above the level indicating widespread transmission.

But Trump continued to ridicule masks and mask-wearing in the final days of the campaign. At a reelection rally Wednesday in Bullhead City, Arizona, the president painted a sardonic word picture of left-coast Californians trying to eat through their masks.

“How about California … where you are supposed to eat with the mask (and) can’t take it off?” Trump said. “You see people and, boy, you know when you have spaghetti and meat sauce … you walk out it looks like you got into a fight.”

That’s not actually what the California governor’s office recently recommended to restaurant goers. The advice was to keep the mask on when not eating, or “between bites.” An illustration showed a diner masked while reading the menu and, later, while wiping her hands with a napkin after eating.

It might all be considered political theater if the nation’s situation weren’t so serious.

“We are in a third wave,” said Marta Wosinska of the Duke-Margolis Center for Health Policy. “We are seeing pretty dramatic increases in the number of people hospitalized and an uptick in deaths.”

The White House insists there’s no conflict between Trump and the health advisers who back in the spring shared the briefing room podium with the president on many an occasion.

The Associated Press contributed to this report.