More than 132,700 new cases were announced across the United States on Friday. The country also reported more than 1,000 deaths for the fourth straight day.
As the eyes of a tired nation remained transfixed on the results of the presidential election, the United States set a daily record for new cases for the third straight day, with more than 132,700 new cases on Friday. And it reported more than 1,000 deaths for the fourth straight day, the first such stretch since August.
The United States first reported a record of over 107,000 cases in a single day on Wednesday. On Thursday, it was over 121,000 new cases, another record, according to a New York Times database.
The country recorded more than 1,220 deaths on Friday. It was the first time over 1,000 deaths had been recorded for four consecutive days since Aug. 25-28.
At least 17 states reported single day records for new cases on Friday. And four states reported record deaths: Kansas, Nebraska, South Dakota and Utah.
In 27 states, there have been more cases announced in the past week than in any other seven-day stretch since the pandemic began. More than 54,800 people were hospitalized with the virus on Friday, according to the Covid Tracking Project.
Driven by surges in the United States and Europe, new daily cases have surpassed 605,000 globally for the first time and a harrowing 50 million total cases appears to be close on the horizon.
Across the continent, hospitals and health care systems are stretched thin, prompting fresh lockdowns and restrictions.
Portugal declared a new state of emergency on Friday. Romania, which passed 10,000 daily cases for the first time, announced that it would close schools and implement an overnight curfew. Poland reported a record 445 virus deaths on Friday and admitted the first patient to its new field hospital at a stadium in Warsaw.
As of Saturday morning, at least 1,242,600 people with Covid-19 worldwide had died since the start of the pandemic. Both new infections and deaths have risen more than 30 percent in the past 14 days.
The number of confirmed cases lags behind the true number of infections, though it is guesswork to say by how much. Countries around the world have worked to increase their testing capacity, but the new surges are straining even that in some places.
Germany, which had been lauded for its testing capacity early on, is tightening the rules governing who gets a test paid for by the public health insurers. Under new rules those with flulike symptoms are only eligible if they also belong to a high-risk group, or can prove contact to someone either infected or at high risk of becoming infected.
“Test, test test — but target,” read a government announcement released on Friday. In the first week of November, the country’s labs were able to handle nearly 1.6 million tests a day, but as the new cases rise and with more people becoming sick with seasonal flu, the system is under stress.
There have been 9,487,080 coronavirus cases in the United States, and 233,729 people have died (Johns Hopkins). Around 3,743,527 people have recovered, and the United States has conducted 150,969,797 tests. Worldwide, there have been 48,107,322 confirmed cases of coronavirus, with 1,225,881 deaths. At least 31,917,411 people have recovered from the virus.
U.S. Reports More Than 100,000 New Cases on Wednesday, Following Second-Highest Daily Covid-19 Cases on Election Day; Hospitalizations Increase; Covid-19 Becomes Third Leading Cause of Death in Arkansas.
The U.S. recorded more than 91,000 new cases of Covid-19 on Election Day, Nov. 3, and more than 100,000 new cases on Wednesday, Nov. 4 (CNN, Johns Hopkins, NYT). Six states – Idaho, Maine, Minnesota, New Mexico, Ohio and Pennsylvania – reported single-day highs on Tuesday. And five states — Maine, Minnesota, Indiana, Nebraska and Colorado — set single-day case records on Wednesday. The seven-day average for daily new cases now tops 90,000, the highest since the pandemic began and more than twice as high as the average during the low point in early September.
More than 50,000 people were hospitalized with the virus during voting on Tuesday. In the Midwest in particular, hospitalizations are rising steeply. Some Midwest hospitals are under strain as they work to provide care for large numbers of Covid-19 patients.
In Arkansas on Tuesday, Governor Asa Hutchinson announced that Covid-19 has become the third leading cause of death in the state, after cancer and heart attacks. “It is a deadly virus that takes people’s lives,” the governor said. “We want to make sure everybody understands the seriousness of it.” Bo Ryall, president and CEO of the Arkansas Hospital Association, asked residents to “please adhere to safety measures again” to help mitigate the strain on hospitals.
“This is not about lockdowns. … It’s about an aggressive balanced approach that is not being implemented,” says internal White House report that challenges many of Trump’s pronouncements.
A top White House coronavirus adviser sounded alarms Monday about a new and deadly phase in the health crisis, pleading with top administration officials for “much more aggressive action,” even as President Trump continues to assure rallygoers that the nation is “rounding the turn” on the pandemic.
“We are entering the most concerning and most deadly phase of this pandemic … leading to increasing mortality,” said the Nov. 2 report from Deborah Birx, coordinator of the White House coronavirus task force. “This is not about lockdowns — it hasn’t been about lockdowns since March or April. It’s about an aggressive balanced approach that is not being implemented.”
Birx’s internal report, shared with top White House and agency officials, contradicts Trump on numerous points: While the president holds large campaign events with hundreds of attendees, most without masks, she explicitly warns against them. While the president blames rising cases on more testing, she says testing is “flat or declining” in many areas where cases are rising. And while Trump says the country is “rounding the turn,” Birx notes that the country is entering its most dangerous period yet and will see more than 100,000 new cases a day this week.
Through a spokesperson, Birx did not respond to a request for comment.
Other health experts, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, have warned of record surges in cases and hospitalizations as the United States records more than 9 million cases and 230,000 deaths.
“We’re in for a whole lot of hurt,” Faucitold The Washington Post late Friday, predicting a long and potentially deadly winter unless there’s an “abrupt change” — prompting Trump to suggest that he planned to fire the scientist after the election.
But Birx’s daily missives go further, revealing how much the administration’s internal reports are in direct conflict with Trump’s public pronouncements that downplay the seriousness of the threat and erroneously suggest that few people are dying. They also speak to the increasing desperation of health officials to spotlight the risks of a pandemic that is forecast to take thousands more lives as the weather worsens unless people change their behaviors. Some officials are also concerned about recouping their reputations in a post-Trump era.
The increasingly dire tone of Birx’s reports has gotten little traction, according to an administration official who works with her and spoke on the condition of anonymity to share sensitive information. “She feels like she’s being ignored,” the official said.
Birx’s message “has been urgent for weeks,” said another administration official, “as has the plea for the administration to ask the American people to use masks, avoid gatherings and socially distance, basically since it became apparent that we were heading into a third surge.”
The report hits hard on the worsening situation: “Cases are rapidly rising in nearly 30 percent of all USA counties, the highest number of county hotspots we have seen with this pandemic,” it said. “Half of the United States is in the red or orange zone for cases despite flat or declining testing.”
Sounding a similar theme to past reports, it calls for “much more aggressive action from messaging, to testing, to surging personnel around the country before the crisis point.”
What is “essential at this time point,” the report said, is “consistent messaging about uniform use of masks, physical distancing and hand washing with profound limitation on indoor gatherings especially with family and friends.”
It adds: “This is about empowerment Americans with the knowledge and data for decision-making to prevent community spread and save lives.”
The president appears unpersuaded by such messages, convinced by new medical adviser Scott Atlas, a neuroradiologist with no infectious-disease experience, that allowing healthy people to return to daily activities without restrictions will hasten herd immunity and bolster the economy, say some advisers who spoke on the condition of anonymity because they were not authorized to speak publicly.
Trump plans to hold a large indoor gathering for 300 to 400 guests at the White House on Tuesday to watch the election returns, only a few weeks after a White House event to announce his Supreme Court nominee Amy Coney Barrett became a superspreader event.
White House communications director Alyssa Farah disputed the report’s suggestion that the administration’s response has been inadequate to the crisis. She said the White House has “significantly increased” the U.S. national stockpile to ensure the country has sufficient personal protective equipment; bought 150 million coronavirus tests and distributed them to the most vulnerable populations, including nursing homes, assisted-living facilities and Native American tribal areas; and sent special teams to states and nursing homes with the most cases.
In addition, she said, the administration continues to work to “safely rush therapeutics” to the sick and develop vaccines. “We are working around-the-clock to safely treat the virus and ultimately defeat it,” Farah said.
Birx’s report goes to pains to dispute Trump’s false claims that coronavirus cases are increasing only because of increases in testing. Monday’s report notes that although testing is flat, a rising number of tests are positive, suggesting “community spread is much worse than is evident by current [measurements].”
An earlier, Oct. 17 report sounded the same theme: It cited increasing daily hospital admissions, rising fatalities and emergency room visits, and bluntly stated, “this is not due to increased testing but broad and ever-increasing community spread.”
That report added these words highlighted in bold: “There is an absolute necessity of the Administration to use this moment to ask the American people to wear masks, physical distance and avoid gatherings in both public and private spaces.” On that day, Trump held two large rallies, according to his public schedule, one in Michigan and one in Wisconsin.
Birx’s report goes to pains to dispute Trump’s false claims that coronavirus cases are increasing only because of increases in testing. Monday’s report notes that although testing is flat, a rising number of tests are positive, suggesting “community spread is much worse than is evident by current [measurements].”
An earlier, Oct. 17 report sounded the same theme: It cited increasing daily hospital admissions, rising fatalities and emergency room visits, and bluntly stated, “this is not due to increased testing but broad and ever-increasing community spread.”
That report added these words highlighted in bold: “There is an absolute necessity of the Administration to use this moment to ask the American people to wear masks, physical distance and avoid gatherings in both public and private spaces.” On that day, Trump held two large rallies, according to his public schedule, one in Michigan and one in Wisconsin.
Officials describe Birx as frustrated with Atlas’s growing influence. She has challenged his views in task force meetings, suggesting that reopening society without any restrictions would lead to thousands of deaths.
In recent weeks, Birx has crisscrossed the country, traveling to dozens of virus hot spots, where she has urged state and local officials to mandate masks, close bars and restaurants and encourage distancing.
Birx is said to be close to Vice President Pence, but he’s been on the road campaigning in recent weeks, taking his attention away from the coronavirus, according to a senior administration official who spoke on the condition of anonymity to share internal discussions.
Unlike Fauci, a highly regarded civil servant who Trump has criticized as a “Democrat,” Birx was chosen by the administration to helm the response and has been lavishly praised in the past by Trump.
Fauci said in his interview Friday that he and Birx lost the president’s ear as Trump worried increasingly about a sputtering economy and his reelection prospects.
“They needed to have a medical message that was essentially consistent with what they were saying, and one of the ways to say: ‘The outbreak is over. [Mitigation strategies are] really irrelevant because it doesn’t make any difference. All you need to do is prevent people from dying and protect people in places like the nursing homes,’ ” Fauci said.
Last Friday, the CDC reported 99,750 new cases, a record high from the day before.
The United States reported its highest number of new COVID-19 cases in a single day on Friday as cases across the country have been rising since mid-September, according to the Centers for Disease Control and Prevention’s COVID-19 data tracker.
Last Friday, the CDC reported 99,750 new cases, a record high from the day before when there were 90,155 new cases.
The overall national percentage of positive COVID-19 tests increased from 6.6% from the week ending on Oct. 17 to 7.1% for the week ending on Oct. 24, according to the CDC’s weekly surveillance summary.
WHAT’S THE IMPACT
With the spike in cases, the U.S. now has 9,182,628 total COVID-19 cases, with 565,607 of these coming in the last week.
Hospitalization rates have also increased since September,according to the CDC’s weekly COVID-19 summary. In the most recent report, the COVID-19-related hospitalization rate was about 200 hospitalizations per 100,000 population.
States that are being hardest hit with the most cases in the last week are Illinois (44,570), Texas (42,480), Wisconsin (32,506), California (28,505) and Florida (28,149).
While hospitals in surge areas of Texas, South and North Dakota, Utah and Wisconsin are reportedly overwhelmed, The New York Times reported that the death rate for seriously ill COVID-19 patients has declined. At one New York hospital system, the report said, where 30% of coronavirus patients died in March, the death rate dropped to 3% by the end of June.
Racial minorities continue to be harder hit by the pandemic; the hospitalization rate for Hispanic or Latino people was approximately 4.4 times that of non-Hispanic whites. The rate was 4.3 times higher for non-Hispanic American Indian or Alaska Native and 4.2 times higher for non-Hispanic Black individuals compared with non-Hispanic whites.
COVID-19 deaths in the U.S. have remained fairly consistent at 700 to 800 deaths per week since the beginning of September. The current death toll sits at 230,383, according to the CDC.
THE LARGER TREND
Congress has been unable to agree on legislation for more relief funding that might help hospitals, as the Coronavirus Aid, Relief and Economic Security Act did.
The recent surge in cases marks the country’s third and highest peak. Meanwhile, as other countries began locking down after their own increases in COVID-19 cases, President Trump criticized the preventative measures as “draconian.”
This is only the beginning of a new wave of COVID-19 cases, according to public health officials. Dr. Anthony Fauci, the nation’s leading infectious disease expert, told The Washington Post, “We’re in for a whole lot of hurt,” as the winter months come closer. Former FDA Commissioner Dr. Scott Gottlieb warned on CBS News’ “Face the Nation” that Thanksgiving is going to be the point where the country will begin to see “exponential growth in a lot of states,” with December likely being the hardest hit month.
With what hospitals and health systems learned from the first wave of COVID-19, ensuring their medical supply chains are intact and their telehealth offerings remain easy to use will be critical. Other strategies from the CDC include creating a written and structured COVID-19 plan that includes communication, triage and visitor protocols.
New outbreaks used to be traced back to crowded factories and rowdy bars. But now, the virus is so widespread not even health officials are able to keep up.
When the coronavirus first erupted in Sioux Falls, S.D., in the spring, Mayor Paul TenHaken arrived at work each morning with a clear mission: Stop the outbreak at the pork plant. Hundreds of employees, chopping meat shoulder to shoulder, had gotten sick in what was then the largest virus cluster in the United States.
That outbreak was extinguished months ago, and these days, when he heads into City Hall, the situation is far more nebulous. The virus has spread all over town.
“You can swing a cat and hit someone who has got it,” said Mr. TenHaken, who had to reschedule his own meetings to Zoom this past week after his assistant tested positive for the virus.
Gone are the days when Americans could easily understand the virus by tracking rising case numbers back to discrete sources — the crowded factory, the troubled nursing home, the rowdy bar. Now, there are so many cases, in so many places, that many people are coming to a frightening conclusion: They have no idea where the virus is spreading.
“It’s just kind of everywhere,” said Crystal Watson, a senior scholar at the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, who estimated that tracing coronavirus cases becomes difficult once the virus spreads to more than 10 cases per 100,000 people.
The election. And its impact on you.
In some of the hardest-hit spots in the United States, the virus is spreading at 10 to 20 times that rate, and even health officials have all but given up trying to figure out who is giving the virus to whom.
There have been periods earlier in the pandemic when infections spread beyond large, well-understood clusters in prisons, business meetings and dinner parties, tearing through communities in ways that were nearly impossible to keep track of. But for the most part, that experience was isolated to hard-hit places like New York City in the spring and portions of the Sun Belt in the summer.
This time, the diffuse, chaotic spread is happening in many places at once. Infections are rising in 41 states, the country is recording an average of more than 79,000 new cases each day, and more Americans say they feel left to do their own lonely detective work.
“I was so careful,” said Denny Taylor, 45, who said he had taken exacting precautions — wearing a mask, getting groceries delivered — before he became the first in his family and among his co-workers to test positive for the virus. Lying in a hospital bed in Omaha this past week, he said he still had no idea where he caught it.
Uncovering the path of transmission from person to person, known as contact tracing, is seen as a key tool for containing the spread of the coronavirus. Within a day or two of testing positive, residents in many communities can expect to get a phone call from a trained contact tracer, who conducts a detailed interview before beginning the painstaking process of tracking down each new person who may have been exposed.
“We were pretty successful and we were very proud of how the case numbers went down,” said Dr. Sehyo Yune, who supervised a team of contact tracers in Massachusetts this spring. It was one of several strategies that helped tamp down earlier outbreaks in places like Massachusetts, New York and Washington, D.C.
But as cases skyrocket again in many states, many health officials have conceded that interviewing patients and dutifully calling each contact will not be enough to slow the outbreak. “Contact tracing is not going to save us,” said Dr. Ogechika Alozie, chief medical officer at Del Sol Medical Center in El Paso, where hospitalizations in the county have soared by more than 400 percent and officials issued a new order for residents to stay at home.
The problem, of course, is that failing to fully track the virus makes it much harder to get a sense of where the virus is flourishing, and how to get ahead of new outbreaks. But once an area spins out of control, trying to trace back each chain of transmission can feel like scooping cupfuls of water from a flood.
In some places, overwhelmed health officials have abandoned any pretense of keeping up.
In North Dakota, state officials announced they could no longer have one-on-one conversations with everyone who may have been exposed. Aside from situations involving schools and health care facilities, people who test positive were advised to notify their own contacts, leaving residents largely on their own to follow the trail of the outbreak.
In Philadelphia, where cases recently spiked to more than 300 per day, city officials acknowledged that they now must leave some cases untracked. Most people, they said, are catching the virus through family and friends.
“We weren’t supposed to get to this point,” said Dr. Arnold S. Monto, a professor of epidemiology at the University of Michigan, who said the process of tracking cases and notifying people who may have been exposed is a gold standard of disease prevention but impractical after a certain level of infection.
“If you have five clusters going on at the same time,” he said, “it’s hard to say where it came from.”
When a first major outbreak hit Grand Forks, N.D., in April, the problem was clear: More than 150 employees of a wind turbine blade factory were infected. The factory shut its doors for several weeks, and public health officials tested and contact traced each case.
For the rest of the summer, Grand Forks, a college town of 56,000 on the border with Minnesota, saw almost no new infections. An uptick in August was quickly tied to students at the University of North Dakota and largely contained.
Now, though, any sense of control has vanished. Active cases of Covid-19 have quadrupled since the beginning of October to 912 in Grand Forks County, and about half the people contacted by the health department say they are not sure how they became infected.
“People are realizing that you can get it anywhere,” said Kailee Leingang, a 21-year-old nursing student who also works as a state contact tracer in Grand Forks. Even Ms. Leingang has fallen ill, along with several of her colleagues. She traces her case to her parents, who first started showing symptoms. Beyond that, the trail goes cold.
“They have no idea,” she said of where her parents came in contact with the virus.
Ms. Leingang, isolating at her home with her cat, feels sicker by the day. Dishes have piled up in the sink — she is too weak to stand long enough to wash them. But she is still working, calling at least 50 people a day to notify them that their tests came back positive, though her job is no longer to track who else they may have infected. “With the high number of cases right now,” she said, “our team can’t afford to have somebody not work.”
In earlier, quieter periods of the pandemic, the virus spread with some degree of certainty. In all but the hardest-hit cities, people could ask a common question — “Where did you get it?” — and often find tangible answers.
A popular college bar in East Lansing, Mich., Harper’s Restaurant and Brewpub, became a hot spot this summerafter dozens of people piled into the bar, drinking, dancing and crowding close together. At least 192 people — 146 people at the bar and 46 people with ties to those at the bar — were infected. Afterward, Gov. Gretchen Whitmer shut down indoor dining in bars in parts of the state.
In Ingham County, which includes much of East Lansing, it is far harder to tell where the virus is spreading now. Of the county’s 4,700 reported cases over the course of the pandemic, more than 2,700 have come since the beginning of September.
Much of the new spread may be tied to students at Michigan State University, where students are living off campus and taking classes online. But every day, employers and residents call the Health Department to report random cases that defy easy explanation.
“It’s just a hodgepodge,” said Linda Vail, the Ingham County health officer.
Heidi Stevens is among the newly infected who considers her case a mystery. As a columnist at The Chicago Tribune, Ms. Stevens works from home. Her children attend school online. She wears a mask when she goes for a run, and she has not had a haircut since January.
So when she got a precautionary test a few weeks ago, with the hopes of inviting friends over to have cake for her daughter’s 15th birthday, Ms. Stevens was shocked to learn she was positive.
“I would drive myself crazy if I tried to really nail it down,” said Ms. Stevens, 46, who was hospitalized for three days and still wakes up with headaches. Did she pick up an infected apple at the grocery store and somehow touch her eye? Should she have been wearing a face shield, in addition to her mask? The possibilities feel endless.
Over the past week, as coronavirus cases have spiked and COVID hospitalizations have grown to alarming levels, we’ve been keeping a close pulse on the situation at our member health systems in markets across the country.
Here’s what we can report: admissions are rising on a curve that looks increasingly vertical.
The ICU is less of a problem than inpatient beds, and while no one wants to cancel non-emergent procedures again, having just worked through the backlog of cases that were postponed in late spring and early summer, discussions about reallocating capacityare starting again. Some are considering shifting more surgeries to ambulatory centers, others are planning to dedicate more space to COVID-positive cases in an attempt to segregate the “hot zone”, and still others are exploring home-based care for certain medical admissions. Fortunately, the supply of PPE feels sufficient for the time being, as does testing capacity.
The number one concern among everyone we’ve talked to: staffing. Because of the high level of community spread, many are now losing nurses and other key staff to COVID isolation, with one system reporting that 35 percent of its critical care nurses at a key hospital had tested positive or were in quarantine after exposure. Staff are burned out, exhausted from the past eight months, and turnover rates are spiking. Because the third wave is so widespread, it’s become harder to find nurses from other markets who can temporarily relocate to help with a surge of cases. And the rates being charged for “agency” nurses—stopgap staff hired on a temporary basis—are going through the roof.
The staffing issue may prove to be the biggest crisis of the third wave of COVID, given how difficult it is to solve; there’s no Defense Production Act or National Guard supply chain for nurses. At best, hospitals will find themselves cobbling together a solution by cross-training staff, paying extra for temporary workers, and asking their already-overtaxed workforce to weather yet another storm. We’re eager to hear any creative approaches to solving the staffing challenge as winter approaches, and we’ve dedicated a senior member of our team to tracking the workforce crisis. Let us know what you’re seeing.
The United States reported a record high of more than 90,000 new coronavirus infections on Friday, and today’s count is on pace to go even higher. The country has now exceeded 9 million cases since the outbreak began, with the last 1 million added in just the last two weeks.
As evidence, Trump Jr. cited a misleading graph on his Instagram page – apparently compiled from incomplete and already outdated federal data – which was used as evidence to suggest that the “death rate” has been falling dramatically in the last two weeks. In fact, daily deaths are slightly rising after a long plateau, and the situation is expected to worsen in November as the virus takes its toll on the newly infected. “I realize I am naive,” Ashish K. Jha, the dean of the Brown University School of Public Health, tweeted in response to the interview. “But I’m still shocked by the casualness by which our political and media leaders and their families dismiss the daily deaths of nearly a thousand Americans.”
Hundreds of thousands of Americans will have coronavirus infections on Election Day, and options are dwindling for those who intend to vote. “Some will be required to get doctor’s notes or enlist family members to help,” our Investigations desk reported. “Others, in isolation, will need to have a witness present while they vote. Planned accommodations — such as officials hand-delivering ballots — may prove inadequate or could be strained beyond limits.”
Nearly half a million people in the United States have contracted the novel coronavirus in the last seven days, according to a Reuters tally, as cases and hospitalizations set fresh records in hot spots in the Midwest.
More than 5,600 people died from the virus nationwide in the last week, with hospitalizations shooting up 13%, a Reuters analysis showed.
Illinois, which has emerged as a hot spot in recent weeks, reported over 31,000 new cases in the last seven days, more new infections than any other state except Texas.
To try and contain the surge, Illinois Governor J.B. Pritzker imposed fresh rounds of restrictions in six of 11 regions.
Indoor dining in bars and restaurants will be suspended by Wednesday and gatherings will be limited to 25 people under a state formula that triggers ‘mitigation’ when the positivity rate tops 8% for at least two days in a row. The affected areas include some Chicago suburbs.
Other states have walked back reopening plans to curb the spread of the virus as cooler weather sets in across most of the nation.
Idaho Governor Brad Little on Monday announced indoor gatherings of more than 50 people would be prohibited, and outdoor gatherings are to be capped at 25% capacity.
Health experts believe the virus is surging because of private social gatherings, colder temperatures driving people inside, and fatigue with COVID-19 precautions.
Beyond the Midwest, the Texas city of El Paso is also facing a surge in cases that is overwhelming local hospitals, with officials setting up an alternate care facility to help relieve medical centers.
“We are seeing all sorts of patients. The narrative historically has been the above-65, those with multiple co-morbidities. But we’re seeing 20-year-olds. We’re seeing 30-year-olds, 40-year-olds,” Dr. Ogechika Alozie, an infectious disease specialist in El Paso, told Reuters. “There’s that exhaustion, but again, we buckle up and we take care of the patients.”
U.S. President Donald Trump, facing a tough re-election battle on Nov. 3, lashed out again at reports that the coronavirus is surging, and reiterated his false claim that the country is “rounding the turn” in its battle with the virus that has killed more than 225,800 people.
Pennsylvania, a hotly contested ‘battleground’ state in next week’s election, on Tuesday reported a fresh record in new coronavirus cases, according to the state’s health department.
The number of people hospitalized with the coronavirus has climbed significantly from a month ago, straining cities that have fewer resources to weather the surges.
The patient who died on Tuesday morning at Aurora St. Luke’s Medical Center was rolled out of her room under a white sheet. One nurse, fighting back tears, stood silently in the hall as the outline of the body passed by — one more death in an eight-month-old pandemic that has no end in sight.
“Those moments, they hit the soul,” said Jodie Gord, a nurse manager who oversees a team of about 120 people at the hospital in Milwaukee.
Aurora St. Luke’s is far from alone in coming under strain. Hospitals around the United States are reeling from the rampaging spread of the coronavirus, many of them in parts of the country that initially had been spared the worst.
Approaching the eve of the election, President Trump has downplayed the steep rise in cases, attributing much of it to increased testing. But the number of people hospitalized for the virus tells a different story, climbing an estimated 46 percent from a month ago and raising fears about the capacity of regional health care systems to respond to overwhelming demand.
The exploding case numbers point to a volatile new phase in the pandemic, coming after earlier waves hit large cities such as New York, then Sun Belt states like Florida and Arizona. While some of those places have begun to bring the virus under control, the surge of hospitalizations is crippling some cities with fewer resources.
In El Paso, where the number of people hospitalized with Covid-19 has more than tripled over the past three weeks, doctors at University Medical Center have started airlifting some patients to hospitals as far away as San Antonio while treating others in a field hospital in a nearby parking lot. Across the border in Mexico, the mayor of Ciudad Juárez, himself hospitalized after testing positive for the virus for the second time, is urging a temporary ban on U.S. citizens crossing into his city.
“We have never seen this in El Paso,” said Dr. Joel Hendryx, chief medical officer at University Medical Center, one of the largest hospitals along the border. Citing the need for field hospitals, Dr. Hendryx drew a sharp contrast to the city’s earlier surge in July, when mitigation measures drove case numbers down.
Dr. Hendryx’s hospital had 195 inpatient coronavirus cases as of Tuesday compared with about 30 a month ago. In addition to the parking lot tents, officials in El Paso are converting the downtown convention center into a 50-bed hospital. Hundreds of health workers from other parts of Texas are deploying to El Paso, including an ambulance strike team with paramedics from the Houston area.
The situation is also becoming critical in states such as Idaho, Missouri, New Mexico and Utah, with frontline workers exhausted and hospitals struggling to find replacements for those testing positive each day.
At St. Luke’s Magic Valley Medical Center in Twin Falls, Idaho, where more than one-third of patients have Covid-19, administrators are sending children to a hospital in Boise, two hours away. The influx of patients from rural areas with little health infrastructure is similarly straining hospitals in Wisconsin, where cases have increased 53 percent from two weeks ago.
Across the country, case numbers have risen to fearsome new levels in recent days, with the seven-day average for new cases exceeding 70,000 for the first time in the pandemic. Twenty-six states are at or near record numbers for new infections. More than 500,000 cases have been announced in the past week. And exactly zero states are seeing sustained declines in case numbers.
On a per capita basis, smaller cities and rural counties in the Upper Midwest and Mountain West are struggling most acutely. North Dakota, South Dakota, Wisconsin and Montana lead the country in new infections per capita. Of the 12 metro areas with the highest rates of new cases over the past two weeks, 10 are in North Dakota or Wisconsin.
But the dismal trend lines are not confined to those regions. North Carolina, New Mexico, Pennsylvania, Rhode Island and West Virginia have recently set seven-day records for new cases. And more big cities are starting to spiral, with alarming trends emerging in Chicago, Milwaukee and Newark.
And while the escalating case numbers had not been accompanied by a steep rise in deaths, that trend is starting to change. About 800 deaths are now being recorded across the country each day, far fewer than in the spring but up slightly from earlier this month.
Cities and towns nationwide are rushing to impose new restrictions. In Idaho, Gov. Brad Little backtracked on reopening but stopped short of a statewide mask mandate. Mr. Little limited indoor gatherings to 50 people, required masks at long-term care facilities and placed new restrictions on how bars and restaurants could serve their customers.
In Newark, all nonessential businesses will have to close at 8 p.m. beginning on Tuesday. Mayor Lori Lightfoot of Chicago imposed a curfew under which nonessential businesses must shut down from 10 p.m. to 6 a.m., and bars without a food license are no longer allowed to serve customers indoors.
In Fargo, N.D., Mayor Tim Mahoney used his emergency powers to pass the first mask mandate in the state. The mayors of Nixa and Ozark in Missouri imposed mask mandates after appeals by nearby hospitals overwhelmed by coronavirus hospitalizations.
On one of the I.C.U. floors at Aurora St. Luke’s in Milwaukee, the mood was somber on Tuesday morning as doctors and nurses made their rounds. Twenty of the 24 beds were filled, and many of the patients were on ventilators.
But the staff put on a brave face. They gave thumbs-up to patients from the hallways, walked into rooms to greet others and assisted one woman as she ate her breakfast.
Before noon, an older woman was transferred to the I.C.U. from the Covid-19 floor. Within 30 minutes of her arrival, loud beeping sent staff members running to her room, frantically grabbing personal protection gear.
The patient’s oxygen levels had plummeted to dangerously low levels, and she was going into cardiac arrest. A nurse practitioner called the patient’s family, making it clear there was a possibility she would not make it.
A staff member performed compressions on the woman in hopes of keeping her alive. After several minutes, her condition stabilized — for the moment.
She was the second patient who needed such care in just three hours. When the nurses and doctors stepped away for a breath, the woman lay on the bed, now intubated, eyes glazed over and her face pale. It was hard to see any clear signs of breathing.
Some staff members patted each other on the back. Others took deep breaths. A health care worker walked out of the patient’s room, holding a small plastic bag in her hand. Inside was jewelry to give to the family, said Ms. Gord, the nurse manager, in case the woman died.
Staff members still seemed in shock over the death of the other patient from that morning. She had become dear to the I.C.U. team, said Ms. Gord, who stood quietly and with obvious emotion as the stretcher slipped past. “Bless her soul,” she murmured. “Sweet little lady.”
Staff members said they were fighting constant exhaustion. “What’s going to happen when we cannot take care of these patients?” said Dr. Pedro Salinas, a critical care specialist, who worries about how much longer the staff can endure. “They are emotionally and mentally exhausted.”
The prospect of ending up in an overcrowded hospital ward is making some who are sick with the virus hesitant to check in. At the hospital in El Paso, staff members said some Covid-19 patients were arriving in the emergency room so debilitated that they required intubation almost immediately.
Sandra Garcia, 31, an El Paso resident who tested positive for the coronavirus last week, said she had been grappling with fatigue, shortness of breath and a loss of taste and smell, but had refrained from seeking care in the city’s crowded hospitals.
In the meantime, she is caring for a 13-year-old who also has Covid-19 and 5-year-old twins, who are all studying online from home. Ms. Garcia said she questioned why Dee Margo, El Paso’s mayor, had failed to order a shutdown of the city to curb the spike in cases.
“He’s just trying to get re-elected and it’s disgusting,” Ms. Garcia said.
Last week, Mr. Margo announced new restrictions such as closing parks to league and tournament play, but he said an order for a full city shutdown would need to come from the governor of Texas.
Dr. German Hernandez, a nephrologist who has been caring for patients at several hospitals in El Paso, said the situation was so acute that patients on oxygen were being kept in rooms in the trauma area of University Medical Center. He said that could be devastating in the event of a disaster such as the August 2019 mass shooting at a Walmart in the city that left 23 people dead.
“God forbid we have another Aug. 3 shooting because we can’t handle it right now,” Dr. Hernandez said. “We have no buffer.”
The fall Covid-19 surge keeps growing, with 29 states setting new records this month for the most new daily cases since the pandemic began, according to data from Johns Hopkins University.
And it’s not just due to more testing. The average number of daily new cases this past week is up 21% compared to the previous week, according to JHU. But testing has increased only 6.63% over the same time frame, according to the Covid Tracking Project. “We’re rising quickly. If we just go back about six, seven weeks ago to Labor Day, we were at about 35,000 cases a day,” said Dr. Ashish Jha, dean of Brown University School of Public Health.”
At least 73,240 new US cases and 985 deaths were reported Tuesday, according to JHU. “I would not be surprised if we end up getting to 100,000” new cases a day, Jha said. The surge is hitting all regions of the country. As of Wednesday, 40 states were trending in the wrong direction, with at least 10% more new cases this past week compared to the previous week, according to JHU. Missouri is the only state with at least 10% fewer cases, and the remaining nine states are relatively steady.
Without changes, ‘half a million people will be dead’
This month, 11 states reported their highest single day of new deaths since the pandemic began.
And because a vaccine probably won’t be available to most Americans until the middle of next year, personal responsibility will be key to saving American lives.“If we continue our current behavior, by the time we start to go down the other side of the curve, a half a million people will be dead,”said CNN medical analyst Dr. Jonathan Reiner, a professor of medicine at George Washington University.Under the current conditions, the daily US death toll is projected to reach 2,000 by January 1, according to the University of Washington’s Institute for Health Metrics and Evaluation.In the past nine months, more than 8.7million people in the US have been infected with coronavirus, and more than 226,000 have died.
Imminent threats to hospital capacity
Even after setting up a field hospital at the state fairgrounds, Wisconsin is facing a dire predicament with hospital capacity. “There is no way to sugarcoat it. We are facing an urgent crisis, and there is an imminent risk to you and your family,” Gov. Tony Evers said.
In Ohio, admissions to intensive care units have doubled since the beginning of this month, Gov. Mike DeWine said. Colorado is also worried about hospital capacity as the number of daily new cases skyrocketed this month. “If these trends continue, it would exceed May hospitalization numbers,” Gov. Jared Polis said. “And the modeling suggests that if we don’t change what we’re doing, it’ll exceed all of the existing hospital capacity by the end of the year. This thing moves quick, and we need to change the way we live.”The city and county of Denver has reduced the maximum allowed occupancy of restaurants, retailers and some other businesses from 50% to 25%, according to a statement Tuesday.”Why we’re doing this is to send a clarion call to everyone that we have a responsibility to once again put our hands on this boulder and begin to push it back up the hill,” Denver Mayor Michael Hancock said.
HENRY KOTULA 