Governors and public health officials across the United States are pleading with Americans to change their behavior and prepare for a long winter as the country shatters record after record on coronavirus cases and hospitalizations.
Both records fell yet again Friday, as more than 181,100 new cases were reported nationwide. It was only eight days earlier that the U.S. reported its first 100,000-case day. Now the seven-day average of new daily cases is more than 140,000.
Sixteen states also set single-day case records on Friday, and 30 states added more cases in the last week than in any other seven-day period. On Saturday, officials in West Virginia announced 1,153 new cases, and, in Maryland, the number rose past 2,050, both single-day records.
Gov. Andrew M. Cuomo of New York tweeted: “One in every 378 Americans tested positive for COVID over the past week. Wear a mask.” Mr. Cuomo’s math is on target: In a population of 330 million, 894,819 people, or 1 in 378, tested positive since last Saturday.
One in every 378 Americans tested positive for COVID over the past week.
Wear a mask.
— Andrew Cuomo (@NYGovCuomo) November 14, 2020
In a reversal, Gov. Doug Burgum of North Dakota, which has critically understaffed hospitals and the highest rates of new cases and deaths per person in the nation, announced several measures late Friday, including a mask mandate, a limit on indoor dining of 50 percent capacity or 150 people and a suspension of high school winter sports and extracurricular activities until Dec. 14.
In the spring, North Dakota was one of a handful of states that never entered a lockdown. More recently, Mr. Burgum had for weeks resisted any new orders, emphasizing personal responsibility instead of requirements such as a mask mandate.
But North Dakota’s situation has rapidly deteriorated: Over the past week, it has averaged 1,334 cases per day, an increase of 54 percent from the average two weeks earlier, and deaths are climbing fast. Hospitals are so overwhelmed that on Monday, Mr. Burgum angered the state nurses’ union by announcing that medical workers who test positive could stay on the job to treat Covid-19 patients as long as the workers show no symptoms.
In New Mexico on Friday, Gov. Michelle Lujan Grisham announced the nation’s most sweeping statewide measure of the fall season, issuing a two-week “stay at home” order to begin Monday. She asked people to shelter in place except for essential trips and said nonessential businesses and nonprofits must cease in-person activities.
Gov. Kate Brown of Oregon issued orders Friday to place the state in a partial lockdown for two weeks, shuttering gyms, halting restaurant dining and mandating that social gatherings have no more than six people. Ms. Brown, along with the governors of California and Washington, also urged residents to avoid all nonessential interstate travel in the days ahead.
Nearly half of all states have measures in place for visitors, but the measures themselves vary from mandatory testing to quarantine requirements. On Thursday, California surpassed one million cases, becoming the second state, after Texas, to do so.
The latest wave of cases is washing over nearly every part of the United States, unlike the spring, when it was concentrated in the New York metropolitan area. Case numbers are trending upward in 49 states, and no states are seeing declines. More than 30 states, from Alaska to New Hampshire, have set records in recent days.
More than 1,380 new deaths were also reported on Friday, pushing the 7-day average to more than 1,090 new deaths a day. And hospitalizations for Covid-19 also set a national record on Friday for the fourth-straight day, reaching 68,516, according to the Covid Tracking Project — a figure that has more than doubled in just five weeks.
The outlook is especially dire in the Great Lakes region. Pennsylvania, Indiana and Minnesota all exceeded their previous single-day records on Thursday by more than 1,000 cases. Gov. Mike DeWine of Ohio warned that hospitalizations had soared to record levels. Wisconsin surpassed 300,000 known cases this week, an increase of more than 130,000 in just a month.
And in New York City, an early hot spot now facing a possible second wave, the mayor warned on Friday that public schools could close as early as Monday if the seven-day average positivity rate surpasses 3 percent. Private residential gatherings must be limited to 10 people beginning at 10 p.m.
Dr. Anthony S. Fauci, the nation’s top infectious disease expert, appeared on “CBS This Morning” on Friday to repeat his pleas to Americans to take the virus seriously.
“If we do the things that are simple public health measures, that soaring will level and start to come down,” he said. “You add that to the help of a vaccine, we can turn this around. It is not futile.”
A state-owned long-term nursing care facility for veterans near Lexington, Ky., is in the grip of a lethal outbreak of the coronavirus.
Eighty-six veterans have tested positive for the virus at the Thomson-Hood Veterans Center since October, and 24 have died, according to Gov. Andy Beshear. Forty-eight of the veterans have recovered, five are in the hospital, and nine are being treated at the center.
Among the staff, 63 have tested positive. Fifty-two of them have recovered, and 11 cases are still active, Mr. Beshear said in a news conference on Friday. He said that the outbreak, the center’s first, was the result of community spread and that it began when three veterans and seven staff members tested positive last month. The U.S. Department of Veterans Affairs provided medical staff to assist at the center.
The governor pleaded for Kentuckians to do what they could to limit the virus’s spread. “This is the toughest spot we’ve been in thus far,” Mr. Beshear said. “You must do your part and folks, this is now to the point where you need to be wearing your mask simply to protect yourself. It will also help others around you, but if you are not wearing a mask, you are putting yourself at personal risk of this virus.”
Over the past week, the state has logged an average of 2,272 cases per day, an increase of 37 percent from the average two weeks earlier. Since the start of the pandemic, Kentucky has had 135,855 coronavirus cases and 1,729 deaths, according to a New York Times database.
The spread of the virus within Thomson-Hood, in Wilmore, Ky., is the latest example of the vulnerabilities at veterans’ homes around the country. Eighty one have died of the virus at a veterans center in Paramus, N.J and two former leaders at the Holyoke Soldiers’ Home in Holyoke, Mass. were indicted on charges of criminal neglect in connection to a coronavirus outbreak that contributed to the death of at least 76 residents.
“We are still battling,” a post from Monday on Thomson-Hood’s Facebook page said. “Keep praying for our incredible, warrior staff and our precious veterans.”
More than 1,000 Americans are dying of the coronavirus every day on average, a 50 percent increase in the last month. Iowa, Minnesota, New Mexico, Tennessee and Wisconsin have recorded more deaths over the last seven days than in any other week of the pandemic. Twice this past week, the country has suffered more than 1,400 deaths reported in a single day.
“It’s getting bad and it’s potentially going to get a lot worse,” said Jennifer Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. “The months ahead are looking quite horrifying.”
More than 244,000 people have died from the coronavirus in the United States, more than any other country, and experts say the pace of new deaths is likely to accelerate in the coming weeks.
In towns and cities in Wisconsin and New Mexico, medical examiners are stocking extra body bags, parking mobile morgue units — the size of trucks — outside their doors and ensuring that refrigerated morgue trucks are cooled and ready to be used if needed. And hospitals are filling with patients, threatening the limits of medical systems in some regions.
Deaths lag several weeks behind infections, so the toll being recorded now reflects transmission that happened several weeks ago, before the country began logging more than 140,000 new cases per day and hospitalizations reached their highest levels of the pandemic. On Friday, public health officials reported more than 181,000 new cases across the country, more than ever before.
The rising case numbers — and the threat of mounting deaths — have led some experts to call for a coordinated national shutdown for four to six weeks, but with no announcements from the White House for new measures to respond to the soaring outbreak, most of the country is open for business, even as a few governors began calling for new restrictions on Friday.
President Trump and his motorcade drove by hundreds of supporters who showed up in Washington on Saturday for demonstrations protesting the outcome of the 2020 election, which Mr. Trump has refused to concede.
The president was on his way to his private golf club in Sterling, Va., and was greeted, according to a pool report, by applause and cheers from a crowd in which many were unmasked. People who watched him go by carried signs reading “Best prez ever” and “Stop the steal.” Some people climbed building structures by Freedom Plaza as the motorcade passed to get a better view.
Election results in the last two states were announced on Friday, with President-elect Joseph R. Biden Jr. winning Georgia to finish with a total of 306 electoral votes — the same number that Mr. Trump won in 2016 and called a landslide — and Mr. Trump winning North Carolina, for a total of 232 electoral votes
Demonstrations of the Trump faithful planned for Saturday in Washington include a “Million MAGA March,” a “Stop the Steal” rally and a “Women for Trump” event, and at least several thousand people turned out.
A 53-year-old truck driver who declined to give his name because he feared losing his job for attending drove from Pennsylvania for the occasion.
Though many in the crowd were not wearing masks, he put one on as the crowd sang the Star Spangled Banner, acknowledging concerns that he might expose himself to the coronavirus and infect his 81-year-old mother.
“I’m hoping maybe I don’t catch it but you can’t stop everything,” he said.
On Friday — in his first public remarks since the election was called — a White House briefing on the Trump administration’s efforts to distribute a coronavirus vaccine, the president came close to acknowledging Mr. Biden’s win before catching himself.
“This administration will not be going to a lockdown,” Mr. Trump said in the Rose Garden, adding that “hopefully the — whatever happens in the future, who knows which administration it will be. I guess time will tell. But I can tell you this administration will not go to a lockdown. There won’t be a necessity.”
On Friday, Mr. Biden urged the distracted president to turn his attention to the rapidly worsening pandemic and take stronger action. In a blistering statement, Mr. Biden said that the recent surge, which is killing more than 1,000 Americans and hospitalizing almost 70,000 every day, required a “robust and immediate federal response, which has been woefully lacking.”
“I am the president-elect, but I will not be president until next year,” Mr. Biden said. “The crisis does not respect dates on the calendar, it is accelerating right now.”
President-elect Joseph R. Biden Jr.’s first economic test is coming months before Inauguration Day, as a slowing recovery and accelerating coronavirus infections give new urgency to talks on government aid to struggling households and businesses.
With a short window for action in the lame-duck congressional session, Mr. Biden must decide whether to push Democratic leaders to cut a quick deal on a package much smaller than they say is needed or to hold out hope for a larger one after he takes office.
A continued standoff over aid could set the stage for sluggish growth that persists long into Mr. Biden’s presidency. Republican and Democratic leaders remain far apart on the size and contents of a rescue package, though both sides say lawmakers should act quickly.
The shifting dynamics of both the pandemic and the recovery are complicating the debate. Even as it has slowed, the economy has proved more resilient than many experts had expected, leading Republicans, in particular, to resist a big new dose of federal aid. But the recent surge in hospitalizations and deaths has increased the risk that the economy could slow further.
Last spring, economists were nearly unanimous in urging Congress to provide as much money as possible, as quickly as it could. Now, many conservative economists say a much smaller follow-up package would suffice. Even as progressives argue for trillions of dollars in aid, a growing number of liberal economists are urging Democrats to compromise and accept a smaller package to get money flowing quickly.
But others with ties to Mr. Biden’s team see the economic and political trade-offs differently. William E. Spriggs, a Labor Department official under former President Barack Obama, agreed that it was vital for Congress to act quickly. But he urged Democrats not to accept too small a deal.
“You will get people saying it didn’t work, so we don’t need to do it again,” said Mr. Spriggs, whom prominent Democrats have pushed for a role in the Biden administration. “You make it harder to go to the well again.”
New York’s mayor, Bill de Blasio, announced on Saturday morning that the city’s seven-day positivity rate for coronavirus tests remained below 3 percent, the threshold that would trigger the closure of all in-person classes as the city confronts a surge in coronavirus cases. About 300,000 children of the 1.1 million in New York City’s public school system have returned to classrooms so far.
The positivity rate remained at 2.47 percent Saturday, lower than days earlier, Mr. de Blasio said on Twitter, but he warned that the decision to shut down the school system, the nation’s largest, was not off the table yet. “That could change,” he tweeted. “We MUST fight back a second wave to keep our schools open.” It is still possible that the city could reach the 3 percent threshold within the next few days.
Here are this morning’s #COVID19 indicators:
• 97 patients admitted to the hospital
• 926 new cases
• The test positivity 7-day average is 2.47%
We’re still below 3%, but that could change. We MUST fight back a second wave to keep our schools open.
— Mayor Bill de Blasio (@NYCMayor) November 14, 2020
Officials had warned that the positivity rate could surpass 3 percent this week, and many had anticipated that school closures could happen as soon as Monday.
Signs that the pandemic is making a feared resurgence in what was once the epicenter of a global pandemic have become evident. New Yorkers have been standing in long lines for hours for tests, some seeking to determine if they could return to work, and some fearing they may have gotten infected during the election or during the street celebrations after Joe Biden was declared the winner of the highly contested presidential race.
Others were hoping for a negative test in hopes of visiting out-of-state relatives over the Thanksgiving holiday. Mr. de Blasio reported 926 new cases for the preceding 24 hours and added that 97 people had been admitted to area hospitals.
New York City may choose to close its classrooms, where transmission of the virus in schools has been strikingly low, before the halt of indoor dining, which falls under Gov. Andrew M. Cuomo, not the mayor.
During a conference call with reporters on Saturday, Mr. Cuomo said that Mayor de Blasio should focus on the positivity rate of individual schools instead of making that determination based on citywide rates. He suggested that an individual school should close its doors only after 3 percent of its staff and student body had tested positive for the virus to avoid a citywide disruption of in-person classes. He added that thousands of students rely on schools for free breakfast and lunch, and that the economy depends on keeping them open.
“If you close the schools, you make it more difficult for parents to go to work, because now they have to worry about who’s going to take care of their children,” Mr. Cuomo said.
Just two small hospitals serve mostly rural Elkhart County in northern Indiana, and earlier this week one of them instructed the local ambulance services not to bring any more patients.
With coronavirus cases hitting daily records, Elkhart General Hospital had run out of room.
The hospital’s capacity is 144 beds and more than 200 patients had been admitted, said Dr. Michelle Bache, the hospital’s vice president for medical affairs. On Tuesday, more than 90 were Covid-19 patients, and there were over 20 people with various medical issues in the emergency room needing beds.
“The patients were building up in the waiting room and causing an unsafe situation,” said Dr. Bache, adding that it was only the second time in her 22 years at the hospital that ambulances had been diverted.
Administrators went hunting for more rooms. They reopened 12 beds in a wing that had been shuttered for five or six years, stopped elective surgeries and moved nurses from other departments to staff the beds.
That, and releasing five coronavirus patients, who no longer needed hospitalization, allowed the hospital to start taking ambulances again. It did not really provide a sense of relief, however. Across Indiana, 2,548 Covid-19 patients are hospitalized and infections are rising, with a 39 percent increase in hospitalizations in the state over the past two weeks.
The need for yet more beds is inevitable. Elkhart County hit another record on Thursday with 411 infections out of a population of roughly 200,000, said Dr. Bache. “There still seems to be some people who think that Covid is not real, and the patients we have are not real, so that is frustrating,” she said. “These patients are sick enough to need oxygen.”
Hospital administrators calculated how many more patients they could admit if they put two in each room. They surveyed the hospital auditorium to assess how many beds would fit. They thought about a tent, but temperatures were already dipping below freezing.
The numbers are sapping the medical system of its elasticity. Typically, Memorial Hospital in South Bend, just 15 miles east, takes patients that Elkhart General cannot handle. But Memorial said it could not take any now. Hospitals in Indianapolis, three hours south, have some capacity, but transferring even a few patients dramatically lowers the availability of ambulances, Dr. Bache said.
Elkhart General is not alone in facing this dilemma.
In Mississippi on Thursday, Dr. Thomas Dobbs, the state health officer, said that the main hospitals in Jackson, the capital, had run out of available critical care beds and very few were available elsewhere.
One hospital could not find a transfer bed in Mississippi, so it looked in cities like Birmingham and Mobile in neighboring Alabama, but they were also full, Dr. Dobbs told a news briefing. The closest critical care bed they could find was in Pensacola, Fla., more than 200 miles away.
Chancellor Sebastian Kurz of Austria said on Saturday that the country will go into a full lockdown after an existing partial shutdown failed to stem rising infections.
“If we do not react massively, there is a great risk that the numbers will continue to rise or remain at a high level and overstretch the health system,” Mr. Kurz said during a news conference announcing the measures.
Starting on Tuesday and going until at least Dec. 6, schools and most stores will close and people will be required to work from home unless their physical presence at a job site is critical. People will only be able leave their homes for essential reasons, such as grocery shopping.
“My urgent request: Do not meet anybody,” said Mr. Kurz. “Every social contact is one too many.”
The new measures represent the kind of emergency lockdown Mr. Kurz had hoped to avoid. Similar restrictions in the spring led to a drop in new infections, but they also significantly damaged the national economy.
The recent, lighter shutdown, which went into effect on Nov. 3, allowed stores, schools and other services to stay open, but shuttered cultural sites, bars and restaurants.
On Friday, Austria recorded 9,586 cases in a single day, a record, and about nine times more than during the country’s peak in March, according to health ministry figures.
In other news from around the world:
Tuscany and Campania joined four other Italian regions in locking down on Saturday. The others were sealed off earlier this month. Residents will be able to leave their homes for essentials and travel outside their own municipalities for work and health reasons only. On Saturday, Italy registered 37,255 new cases and 544 deaths.
Hong Kong is making Covid-19 tests mandatory for people in high-risk groups as the Chinese territory works to prevent what it said is a potential fourth wave of infections in the cooler months. Those who ignore orders face possible jail sentences.
Those subject to the compulsory tests include people who show symptoms, residents linked to clusters, workers in high-risk occupations and travelers who are completing their mandatory 14-day quarantine upon arriving, Hong Kong’s health officials said Saturday. Those who refuse to comply could face fines of up to $3,220 and six months’ imprisonment.
“The fourth wave of outbreak could be triggered at any moment,” a spokesman with the Food and Health Bureau said Saturday, warning of “fatigue in the community” as people become less vigilant about wearing masks at social gatherings.
In September, Hong Kong rolled out free and voluntary tests for its 7.5 million residents, but less than a quarter of its population took them. Some activists voiced concern that the citywide tests, which were launched with the help of Beijing, could be used to collect people’s DNA. Authorities forcefully denied the charges.
The city will also limit the number of people at each table in restaurants to four, after briefly raising the cap to six people. And at bars and nightclubs, no more than two people may be seated together. Saunas and ball pits were also deemed risky and will remain closed, the government said.
Hong Kong recorded eight new cases on Saturday, five of which were imported.
With the prospect that a coronavirus vaccine will become available for emergency use as soon as next month, states and cities are warning that distributing the shots to an anxious public could be hindered by inadequate technology, severe funding shortfalls and a lack of trained personnel.
While the Trump administration has showered billions of dollars on the companies developing the vaccines, it has left the logistics of inoculating and tracking as many as 25 million people by year’s end — and many tens of millions more next year — largely to local governments without providing enough money, officials in several localities and public health experts involved in the preparations said in interviews.
Public health departments, already strained by a pandemic that has overrun hospitals and drained budgets, are racing to expand online systems to track and share information about who has been vaccinated; to recruit and train hundreds of thousands of doctors, nurses and pharmacists to give people the shot and collect data about everyone who gets it; to find safe locations for mass vaccination events; and to convince the public of the importance of getting immunized.
The federal Centers for Disease Control and Prevention have sent $200 million to the states for the effort, with another $140 million promised in December, but state and local officials said that was billions of dollars short of what would be needed to carry out their complex plans.
“We absolutely do not have enough to pull this off successfully,” said Dr. Thomas E. Dobbs III, the state health officer of Mississippi. “This is going to be a phenomenal logistical feat, to vaccinate everybody in the country. We absolutely have zero margin for failure. We really have to get this right.”
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Last Sunday, the United States reported its 10 millionth case of the coronavirus, with the last million added in the preceding 10 days. Covid-19 hospitalizations hit a new high this week, and new daily cases passed 165,000 for the first time on Friday. Throughout the pandemic, the science and health reporter Donald G. McNeil Jr. has been at the forefront of The New York Times’s coverage and was recently awarded the 2020 John Chancellor Award for Excellence in Journalism by the Columbia Journalism School. In this edited interview, he talked about the new wave of infections.
There’s a lot of optimism around Pfizer’s announcement on Monday, which suggested its mRNA-based vaccine could be more than 90 percent effective. What should we make of this? Is it too soon to rejoice?
No, I’d say a little rejoicing is in order. The F.D.A. has said it would accept a vaccine that was only 50 percent effective, which is worse than some year’s flu shots, so everyone’s expectations were lowered. This is pretty great. Plus, we were already pretty sure that mRNA vaccines would be harmless. With this type of vaccine, you’re injecting just a short stretch of the virus’s genome packed into a tiny ball of fat with a mild electric charge. In contrast, some vaccines use a whole virus that is killed or weakened and is more likely to cause bad reactions.
Pfizer actually said its vaccine is at least 90 percent effective. We need to be cautious: That was its news release, rather than the actual data, which scientists will want to examine. But I’ve read previous news releases from Big Pharma companies and compared them to the data issued later, and they’ve been honest.
Some scientists are worried that the virus in animals, like the mink, could mutate and be more dangerous to humans. Does this have any effect on the outlook for a vaccine?
Probably no effect, at least for now. Pfizer said its vaccine works against all the strains circulating in humans. The worrying mutation in one mink strain is mostly in the minks. There’s no immediate worry that it will become a dominant strain in humans.
Lockdowns have renewed around much of the world and have faced some fierce backlash in places like Italy. What’s your view on the efficiency of lockdowns, and what’s the appropriate balance to strike for economic sustainability, mental and emotional well being, and health in terms of the virus?
We need to stop thinking of lockdowns as if they are an end in themselves. A really harsh lockdown — in which people are literally ordered to stay home — pauses transmission long enough for you to launch real tools: rapid accurate testing, rapid contact tracing, isolation of infected people away from their families, and so on. China did that. New Zealand did that. But we never had any of that here. Our “national lockdown” in the spring was a joke.
China refused to reopen cities until they had zero cases for 14 days. We never dropped below an average of 20,000 cases a day. We can’t do contact tracing because a) many Americans won’t cooperate and b) outside of lockdown, every case has about 50 contacts — 20,000 times 50 is one million new contacts to trace every day. Who can do that? It’s impossible. So we’re basically stuck with masks and not eating or meeting indoors until the vaccines arrive. If people don’t do that, their hospitals get overwhelmed. When that happens, a virus that kills less than 1 percent of its victims suddenly kills 2 or 3 or 4 or 5 percent because people can’t get ventilators, can’t get ambulances, can’t even get oxygen. “Flattening the curve” is all about slowing things down so your hospitals don’t collapse.
Some companies have offered perks, like free lunch, to get workers to return to the office. Other companies, including The New York Times, have extended home working until summer 2021. When would you personally feel comfortable returning to the office?
When I’m vaccinated and everyone around me is.
The holiday season is just around the corner. What advice do you have for families eager to celebrate with their loved ones?
Do it by Zoom. Don’t let Junior come home and kill Grandma. Think of this like World War II — our soldiers didn’t get to fly home to eat turkey. My father was at Normandy. My mother was with the Red Cross in occupied Austria. They missed the holidays. Life went on. There were happier years later.
The authorities in Greece announced on Saturday the closure of all schools as the country faces a spike in coronavirus infections and deaths.
Although Greece was relatively successful in containing the first phase of the pandemic, in the spring, the second wave has been more taxing. Greek health authorities announced 3,038 new infections on Friday, a large number of them in the north, where hospitals are under particular pressure, with deaths and intubations increasing sharply in recent days.
Greece has added a daily average of 2,489 new cases over the past seven days, pushing its total caseload since the start of the pandemic to 69,675. Deaths are rising rapidly, with an average of more than 40 a day over the last week.
High schools had already closed as part of the country’s second lockdown, which was introduced earlier this month, and they will continue to operate by remote learning. The new restrictions mean that kindergartens and primary schools will also close, until at least the end of the month.
Announcing the new measures, Greece’s education minister, Niki Kerameus, said that the authorities understood the “upheaval” being created for parents but that health experts had said the move was necessary. Last month, Ms. Kerameus announced via a tweet that she and her husband had tested positive for the virus and would enter isolation.
A nationwide public curfew is now also in effect from 9 p.m. until 5 a.m., with exceptions made for people who need to go out for work, to visit a doctor or to walk a pet.
The curfew was announced a few days after Greece’s second nationwide lockdown began, which closed most shops and reinstated a system enforced during the spring lockdown that required people to send a text message to the government citing their reason for leaving their house.