Officials in the United States have reported more than 11 million total cases of coronavirus as of Sunday, as the country’s outbreaks lead to agonizing new levels of hospitalizations. Cases passed 10 million just a week ago, and more than 1 in 400 Americans have tested positive since.
The latest virus surge began accelerating across much of the country in mid-October. It took just over two weeks for the nation to go from eight million cases to nine million on Oct. 30; from nine to 10 million took only 10 days.
The country logged more than 159,100 new cases on Saturday, the third highest total of the pandemic, raising the new seven-day average to more than 145,000, with upward trends in 48 states and an 80 percent increase in new cases from the average two weeks ago. Hospitalizations are nearly 69,000, just below the record of 69,455 set on Saturday.
Ten states set single-day case records on Saturday; 29 states added more cases in the last week than in any other seven-day period, according to a New York Times database. At least two of the states that broke daily records on Saturday — Maryland and New Jersey — had broken them again by late Sunday afternoon.
Deaths nationwide remain at lower levels than in spring’s peak, but they are rising rapidly and approaching 250,000. More than 1,200 new deaths were reported on Saturday, pushing the seven-day average to more than 1,120 a day, a 38 percent increase from the average two weeks ago. Four states set new death records on Saturday: Montana, Oklahoma, Wyoming and South Dakota.
Dr. Michael Osterholm, an adviser to President-elect Biden, said the country was “in a very dangerous period,” calling it the most dangerous public health crisis since the 1918 influenza pandemic, which killed an estimated 50 million worldwide, including some 675,000 Americans. “My worst fear is we will see what we saw happening in other countries, where people were dying on the streets,” he said on the NBC program “Meet the Press.” “The health care system is breaking, literally breaking.”
Adm. Brett Giroir, the assistant secretary of health and human services, called the situation “critical” on the ABC program “This Week.”
The pandemic continues to take a disproportionate toll on Americans of color, who have been hospitalized at rates roughly four times higher than non-Hispanic whites since the start of the epidemic.
Hispanic or Latino people have been hospitalized at the highest rate, 4.2 times the rate of whites, with non-Hispanic American Indian or Alaska Native people hospitalized at 4.1 times the rate of whites and African-Americans at 3.9 times the rate of whites, according to figures from the Centers for Disease Control and Prevention. The figures were tabulated through the week ending Nov. 7.
The higher hospitalization rates have been linked to higher positivity rates, as nonwhite Americans are more likely to be essential workers with jobs in the food service industry or home health care, which cannot be carried out remotely and require interacting with the public. These jobs often don’t provide health insurance or paid time off, benefits that enable workers to stay home when sick.
Many people in these communities are also more likely to live in multigenerational households in densely populated communities, where infections spread quickly and easily.
In a speech on Sunday criticizing President Trump’s vaccine distribution plans, Gov. Andrew M. Cuomo of New York said that the pandemic had revealed “the systemic discrimination in this nation.”
“That is the sad reality,” Mr. Cuomo said at on Sunday at Riverside Church in Manhattan. “And we must have the courage to face it and to admit it because you will never solve a problem that you are unwilling to admit.”
Michigan and Washington State announced strict new restrictions on Sunday, joining a growing list of states that have reimposed tough measures as the virus rages across the country.
Gov. Gretchen Whitmer of Michigan announced that the state will suspend all in-person learning for college and high school students and indoor dining for three weeks. Other indoor gathering places, like casinos and movie theaters, must also close as part of the order, which will take effect Wednesday. All organized sports, excluding professional and college, are suspended.
“This is the worst public health emergency our nation has faced in over a century and our response has got to reflect the same level of urgency,” Ms. Whitmer said.
Michigan’s coronavirus cases have skyrocketed this month, and hospitalizations have more than doubled over the past two weeks.
In Washington State, Gov. Jay Inslee said he was ordering fitness facilities and restaurants to stop serving customers indoors, shutting down museums and limiting retail stores to 25 percent of capacity indoors.
The governor prohibited all indoor social gatherings with people beyond one household. He limited wedding and funeral ceremonies to 30 people or fewer, and barred wedding and funeral receptions entirely. The new rules begin Monday night and are set to last through Dec. 14.
Governor Inslee was among the first elected leaders in the nation to order lockdowns in the spring, after an outbreak around Seattle led to some of the first U.S. coronavirus deaths. He said on Sunday in a news conference that the situation was more dangerous now than it was back in March.
“Inaction here is not an option,” Mr. Inslee said. “We have to take bold and decisive action.”
The goal, Mr. Inslee said, was to keep as many people alive as possible until a vaccine is available. Left unchecked, the virus would overrun the state’s health care systems, he warned.
Washington has been reporting an average of more than 1,700 new cases a day lately, more than double the pace of a month ago.
In a reversal, the governor of North Dakota, Doug Burgum, 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. The state has critically understaffed hospitals and the highest rates of new cases and deaths per person in the nation.
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.
On Sunday, Dr. Scott W. Atlas, a coronavirus adviser for President Trump, responded to the news of Michigan’s tighter restrictions in a tweet, writing, “The only way this stops is if people rise up. You get what you accept.”
Dr. Atlas, a radiologist, is not an epidemiologist or an infectious disease expert. He has made contrarian arguments, like the science of mask wearing is uncertain.
As some governors bring back coronavirus restrictions similar to those imposed in the early days of the pandemic, workers in those states say they are bracing for unemployment again — and, this time, many fear, they will get no extra aid from the federal government.
Virus cases have spiked across the country, including in Oregon and New Mexico. Those states will return to strict rules in the coming week, their Democratic governors have announced, limiting restaurants to serving takeout and requiring gyms to shut down again for two weeks. New Mexico also directed nonessential businesses to keep employees home.
More states and localities may turn to such restrictions as the nation’s outbreaks grow. On Sunday, Adm. Brett Giroir, the assistant secretary of health and human services, acknowledged on the ABC program “This Week,” that “limiting bars and restaurants” would be crucial to limiting the virus’s spread.
In the states with new restrictions, workers worry about the impact. One server at a restaurant in Eugene, Ore., said she was putting off a move into her own apartment from her family’s home because she feared she will lose her paychecks. A film crew worker concerned that work will shrink in New Mexico said she will buy even fewer groceries.
The federal government is, in most cases, no longer providing extra money on top of state unemployment benefits, and congressional Democrats and Republicans remain in a standoff over another stimulus bill. The federal government had provided $600 weekly supplemental payments in the spring and summer; when the program expired, it was replaced with a $300 weekly payment, but that ended in September. In just the first week of November, more than 700,000 people filed new claims for state unemployment benefits.
Lauren Anderson, 25, another server at a restaurant in northwest Oregon, said the new restrictions will mean losing hundreds of dollars over the next two weeks, money she said she cannot fully recoup through unemployment insurance.
Even though the restaurant at which she works, The Uptown Café in Warrenton, Ore., plans to remain open for takeout, more than half of her income comes from tips, which are few and far between when people take their burritos or burgers to go.
“If this shutdown extends to a month, two months, three months, and we don’t get assistance, I’m not going to be able to pay my rent,” she said.
Ms. Anderson said she supports the governor’s new restrictions, in part because she lives with her younger brother, who is 23 and has Stage Four cancer, but she said that any new limits need to be coupled with more government aid.
In Albuquerque, the new restrictions mean Anna Dukes, 17, a high school senior who lives with a friend and works at Charley’s Philly Steaks, a chain restaurant, may not be able to buy a graduation gown. The deadline to buy one, she said, is only weeks away. She is more focused on using her money for gas and food, and already plans to forgo the usual money she sends to help support her younger sister.
She worked at a chicken wings chain during the state’s first lockdown and never expected that the state’s rising virus cases and hospitalizations would force another. “We’re kind of getting left on a limb right now,” she said. “We don’t really know what to do.”
Seven months after he battled a serious case of Covid-19, the British prime minister, Boris Johnson, announced Sunday that he was quarantining after coming into contact with a lawmaker later found to be infected.
Mr. Johnson’s office said in a statement that he felt fine and was showing no symptoms.
Experts say it’s still too early to know how long immunity to the coronavirus lasts, but reinfection with the virus is thought to be very rare for at least many months after the first illness.
The prime minister decided to go into isolation after the National Health Service’s test-and-trace program contacted him and said he had been exposed to the coronavirus. On Thursday, Mr. Johnson spent about half an hour with a member of Parliament who tested positive after feeling ill.
Other than isolating himself, Mr. Johnson is conducting business as usual, officials said. “He will carry on working from Downing Street, including on leading the government’s response to the coronavirus pandemic,” his office’s statement said.
The prime minister had a close call with the virus in April, when he was hospitalized and spent three days in intensive care.
Mr. Johnson has been accused repeatedly of taking a lackadaisical approach to the pandemic, but when he emerged from the hospital he appeared chastened.
In an emotional five-minute video, Mr. Johnson thanked the country’s National Health Service, declaring it had “saved my life, no question.”
Over three months in the summer, the portion of people in Britain with detectable antibodies to the coronavirus fell by about 27 percent. Experts say it’s normal for levels of antibodies to drop after the body clears an infection. However, when needed, immune cells already carry a memory of the virus and can churn out fresh antibodies.
The nation’s top infectious disease expert, Dr. Anthony S. Fauci, made it clear on Sunday that President Trump’s coronavirus task force has not been allowed to communicate with President-elect Biden’s transition team, a step that he said was critically important to curbing the pandemic.
Responding to a question from Jake Tapper, the host of the CNN program “State of the Union,” about President Trump’s refusal to allow a normal transition to the incoming administration, Dr. Fauci said a smooth “handing over of the information” was in the interest of protecting public health.
“It’s almost like passing a baton in a race, you don’t want to stop,” Dr. Fauci said, adding later, “Of course it would be better if we could start working with them.”
When Mr. Tapper asked how he thought history would remember the U.S. government’s response to the pandemic, Dr. Fauci replied, “Obviously it’s not going to be a good report, because of the extent of suffering that we’ve had.”
He added, however, that the answer was complex, and that many variables were involved in the failure, including the nation’s “flair of independence” and the fact that many Americans simply “don’t want to be told what to do.”
Asked when President Trump had last attended a meeting of the White House coronavirus task force, Dr. Fauci said it had been “several months.”
Dr. Fauci praised Mr. Biden’s choice of Ron Klain, who led the Obama administration’s response to the Ebola pandemic, to be chief of his White House staff, saying Mr. Klain had been “absolutely terrific” during his tenure as “Ebola czar” in 2014 and 2015.
Dr. Fauci also expressed cautious optimism that Pfizer’s vaccine candidate would continue to prove effective and that it, and perhaps other vaccines as well, would be rolled out successfully with a high degree of acceptance. But he warned that life would not return to normal until the second or third quarter of next year, and that Americans would have to continue adhering to public health measures, like wearing masks and avoiding large gatherings, even after vaccination begins.
“It’s not like a light switch,” he said. “We’re not going to turn it on and off, going from where we are back to normal.”
The news that hundreds of thousands of parents and educators had been awaiting arrived at 9:45 on Sunday morning, in a tweet from Mayor Bill de Blasio: New York City’s test positivity rate remained below 3 percent.
The city’s school system, which must close if the positivity rate hits a 3 percent seven-day average, would remain open another day. New Yorkers breathed a sigh of relief, for now.
New York City, one of the few big cities to return children to school buildings, has chosen a relatively conservative threshold for closure.
But it was also clear that parents’ and teachers’ focus on that number would not let up. The fixation points to both the profound anxiety surrounding the fate of the school system — the nation’s largest — and the extraordinary challenge of operating schools in a pandemic that is again on the upswing.
Adding to parents’ concerns is the fact that Sunday is the deadline for families to decide if they want any in-person classes for their children — most likely the last chance to opt in for the entire school year.
The mayor’s messaging has been consistent: The 3 percent threshold is sacrosanct, meaning it is likely that schools will soon close temporarily.
As of Sunday morning, the city’s average positivity rate stood at 2.57 percent, and the expectation is that the rate will only increase.
On Friday, school administrators weren’t taking any chances. Teachers filled bags with books and papers in anticipation of teaching from home for weeks or longer. Some students cleaned out their desks.
Parents questioned whether the 3 percent metric was in fact the correct one, or just a relic from the earlier days of the pandemic, when scientists knew less about how the virus would spread in schools.
On Saturday, Mr. Cuomo suggested that New York City should reconsider its plans.
In recent days, Mr. Cuomo has suggested that the mayor re-evaluate his calculus, based upon scientists’ current understanding of virus transmission. Still, the governor has left most decisions about school reopening to individual districts, and the mayor doesn’t want to move the goal posts for safety now, officials said — particularly after the uproar in September, when he repeatedly pushed back the school reopening date.
Thousands of medical practices are closing in the United States, as doctors and nurses opt for early retirement or job changes after struggling with the stresses of the coronavirus pandemic.
In a survey of 3,500 doctors this summer by the Physicians Foundation, a nonprofit group, about 8 percent of the respondents reported closing their offices in recent months, which the foundation estimated could equal some 16,000 practices. Another 4 percent said they planned to shutter within the coming year.
Some doctors and nurses worry about their own health because of age or a medical condition that puts them at high risk. Others stopped practicing during the worst of the outbreaks and don’t have the energy to start again. Some simply need a break from the toll that the pandemic has taken among their peers and patients.
Another analysis, from the Larry A. Green Center with the Primary Care Collaborative, a nonprofit group, found similar patterns. Nearly a fifth of primary care clinicians surveyed in September said someone in their practice plans to retire early or has already retired because of Covid-19, and 15 percent said someone has left or plans to leave the practice.
The clinicians also painted a grim picture of their lives, as the pandemic enters a newly robust phase with record case counts in the United States. About half already said their mental exhaustion was at an all-time high. Many worried about keeping their practice doors open: about 7 percent said they were not sure they could remain open past December without financial help.
Mexico has exceeded a total of one million coronavirus cases, the 11th country to do so, as it struggles to tame one of the world’s worst outbreaks.
The country is also approaching 100,000 deaths, recording 98,259 as of Sunday morning, according to a New York Times database, the world’s fourth-highest toll after the United States, Brazil and India. Experts say the true number is probably much higher, partly because sick people who are afraid to go to the hospital die at home without being tested. Along with Argentina, Peru and other Latin American countries, Mexico has among the highest coronavirus deaths per capita.
President Andrés Manuel López Obrador has been criticized over his pandemic response, with six former health ministers proposing a new national strategy last month that would include targeted lockdowns, nationwide testing and the mandatory use of face masks. Hugo López-Gatell, the deputy health minister, has defended government actions as sufficient, saying the benefits of masks are exaggerated.
The center of the country’s outbreak is in the capital, Mexico City, where Mayor Claudia Sheinbaum has been reluctant to criticize Mr. López Obrador, her political ally. Ms. Sheinbaum, who tested positive for the virus last month, said on Friday that all bars and restaurants in the city would have to close for two weeks starting Monday.
In May, The Times found that the Mexican government was not reporting hundreds, possibly thousands, of deaths from the coronavirus in Mexico City, according to officials and confidential data.
In other news from around the world:
President Hassan Rouhani of Iran called on Sunday for a widespread mobilization of the nation and the government to fight the coronavirus, after state media reported that the health authorities had logged a record 12,543 new cases in a day, putting the country’s total above 762,000. The health ministry reported 459 new deaths, bringing the total to 41,493. The government said on Saturday that nonessential businesses and services would be shut in Tehran and in about 100 other cities, and that cars would not be allowed to drive in or out of those cities, according to Reuters.
Authorities in the impoverished Gaza Strip announced more than 400 new infections on Sunday, the highest single-day total since the first cases of community transmission were discovered in the territory in late August. The authorities ordered almost all shops to start closing down at 5 p.m. A nightly curfew beginning at 8 p.m. is already in place. As of Sunday morning, 10,532 people in Gaza — whose population is relatively young — have been infected and 48 have died, according to the Health Ministry.
India will fly doctors in to the region around New Delhi, will double the number of tests it carries out and will ensure that people wear masks, in an effort to contain the spread of coronavirus in the capital, officials said on Sunday, according to Reuters. “Delhi has witnessed a huge surge in daily active cases which is likely to worsen over next few weeks,” the health minister, Harsh Vardhan, said in a tweet.
Catholic protesters around France held demonstrations on Sunday, demanding that the authorities allow religious services to continue, The Associated Press reported. With almost two million confirmed coronavirus cases in the country, the authorities paused religious services for the month of November, as part of a partial nationwide lockdown.
Health care workers in some hard-hit states have taken to social media to issue urgent pleas for new restrictions to slow the spread of the virus and for the public to take precautions more seriously.
In Nebraska, Dr. Dan Johnson, a critical care anesthesiologist with Nebraska Medicine, a major health network in the region, posted on Facebook about the crisis last week, saying that current measures were not enough to stop the high rate of transmission.
The state has seen new virus cases reach an average of 2,033 cases per day, an increase of 99 percent from two weeks earlier. In the state, masks are required at indoor businesses where close contact is maintained, and indoor gathering limits are set at 25 percent of capacity. Retail stores, restaurants and bars are still open, as are houses of worship.
“This means that individual citizens and families must take matters into our own hands. Strict adherence to social distancing is essential,” Dr. Johnson wrote. “If things get completely out of control, every family in Nebraska will be affected either by a death or by serious illness.”
On Twitter, Dr. Angela Hewlett, an epidemiologist at the University of Nebraska Medical Center, specifically called on the governor to increase “directed health measures,” noting that the number of hospitalizations in the state was “skyrocketing.”
“Our community and our hospitals are suffering,” she said. “We are not an unlimited resource.”
In another appeal on Facebook, Dr. John McCarley, a doctor in Chattanooga, Tenn., noted that local hospitals were filling up. He posted: “I’m not saying we need a lockdown but I am asking everyone to get back to a May 2020 mind-set and routinely wear the mask when indoors around others besides your household.”
On the ABC program “This Week,” Adm. Brett Giroir, the assistant secretary of health and human services, called masks “critically important.” “They’re highly protective against you spreading it to someone else and we also know that it provides you protection from getting it from someone else,” he said.
Chief executives of six hospital systems in northeastern Ohio jointly ran a full-page advertisement in The Cleveland Plain Dealer on Sunday, pleading with the public to “remain on guard” with virus precautions during the holiday season. “We must make sacrifices today — by limiting indoor gatherings — in the hope of better tomorrows,” the hospital executives wrote.
In Amarillo, Texas, an internal medicine doctor said that hospitals in the city were trying to find ways to add additional I.C.U. space, and pleaded with the public to wear a mask and socially distance. “An ounce of prevention is better than a pound of cure,” Dr. Whit Walker wrote on Facebook. “I see some people inside in a public store without a mask. If you give this virus to me I might give the virus to 5 or 20 other people. One or five of those might die from the virus. Even though you feel well, you can carry this virus. Even if you had the infection in the past, you might get this same virus again. This is real. This is deadly.”
In North Dakota, a state with critically understaffed hospitals and the nation’s highest rates of new cases and deaths per person, doctors have for weeks been asking the government to implement stricter restrictions — in particular a mask mandate.
On Friday, Gov. Doug Burgum finally obliged by announcing several measures, 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. The state reported 2,270 new infections on Saturday, 19 deaths and 425 hospitalizations.
And in Missouri — which announced 7,164 new cases on Saturday, the state’s third single-day record in a row, along with 11 deaths and more than 2,400 hospitalizations — health care workers asked government officials to enact more restrictions in response to their dire words of caution with a statement released Thursday by the Missouri Hospital Association.
“We urge Gov. Mike Parson to continue to promote the message that Missourians’ help and compliance is necessary to help prevent catastrophic increases in hospital admissions,” the statement said.
About 200 of the nearly 8,000 people on N.F.L. teams or affiliated with them had been infected with the coronavirus when the season recently reached its halfway point, and league officials have said there is no evidence of players transmitting the virus on the field despite the close contact in games. The officials added that the league’s contact tracing indicated there had been little transmission inside team facilities, where social distancing guidelines are in place.
Instead, the officials said, the 218 infections have largely been traced to places the employees were together outside the facilities, either in restaurants or shared car rides, or when they came into contact with people outside the N.F.L., like nannies.
Between Aug. 1, four days after the start of training camps, and Nov. 7, a total of 78 players and 140 staff members tested positive, the league officials said. Only one player is known to have been hospitalized, and most players have had mild symptoms and returned after their mandatory isolation.
But as the number of infections in the United States has soared again, so have cases in the N.F.L., forcing players — including star quarterbacks like the Pittsburgh Steelers’ Ben Roethlisberger and the Detroit Lions’ Matthew Stafford — to stay away from team facilities because they had been in close contact with co-workers who tested positive. Five coaches on the Miami Dolphins skipped the team’s trip to Arizona last weekend. Four offensive linemen on the Las Vegas Raiders had to quarantine for five days after coming into contact with right tackle Trent Brown, who tested positive for the virus.
“All of us are aware there has been an uptick in cases that we’ve seen in the N.F.L. last week,” said Dr. Allen Sills, the league’s chief medical officer. “It’s not a surprise, and it’s something we’ve been preparing for,” he added.
Commissioner Roger Goodell continues to say that the league expects to complete a full slate of games and play the Super Bowl, as scheduled, on Feb. 7 in Tampa, Fla. The league is also making contingencies for an incomplete regular season. On Tuesday, the 32 team owners approved a plan that would permit one more team from each conference to reach the playoffs if some clubs are unable to complete their 16-game schedule.
In other sports news on Sunday:
Syracuse University’s men’s basketball coach Jim Boeheim announced on Twitter Sunday evening that he had tested positive for the coronavirus and that he had not been experiencing any symptoms. “Thank you for the well wishes,” Mr. Boeheim — who will turn 76 on Tuesday — wrote. “I look forward to getting back on the court with my team.” The Syracuse athletic director, John Wildhack, said the basketball team would pause all activities after another member of the program had also tested positive soon after Mr. Boeheim announced his virus result, according to The Post-Standard. The team is scheduled to open the season on Nov. 27.
Paul Gazelka, the leader of the razor-thin Republican majority in the Minnesota State Senate, announced on Sunday that he tested positive for the coronavirus last week.
“I have been in quarantine since experiencing symptoms last Monday, and will remain in quarantine as long as my doctor advises me to,” Mr. Gazelka said in a statement, adding, “I am not experiencing major issues or symptoms and I expect, like 99 percent of people, I will make a full recovery.”
Depending on the outcome of one uncalled race, the 2020 election may have left the Republicans with just a single Senate seat more than the Democrats, who are known in Minnesota as the Democratic-Farmer-Labor Party. The Democrats control the State House.
The virus has been surging through the fall in Minnesota, especially since the last week in October. The state averaged more than 5,800 new cases a day over the past week, ten times as many as in mid-September, according to a New York Times database, and deaths have soared as well.
New restrictions imposed by Gov. Tim Walz, a Democrat, took effect in the state on Friday, with a 10 p.m. curfew for indoor dining and limits on household gatherings. State Republicans swiftly criticized the new measures.
Mr. Gazelka and his wife were traveling in Florida when he tested positive. Rachel Aplikowski, Mr. Gazelka’s communications director, said he had no symptoms or known exposure at the time he boarded his flight. His wife has tested negative, and they are both staying in Florida while he remains in isolation, Ms. Aplikowski said.
She confirmed that two other Republican state senators in Minnesota — David Senjem and Paul Anderson — also have the virus, and are in isolation and recovering at home.
Governor Walz took Republicans in the State Senate to task on Sunday for letting their own members know about positive cases in their ranks, but not promptly informing Democratic colleagues. “Covid-19 doesn’t operate along party lines, and neither can we,” he wrote on Twitter.