Covid-19 hospitalizations in the United States hit an all-time high of 61,964 on Tuesday, and new daily cases passed 139,000 for the first time, as the raging pandemic continued to shatter record after record and strain medical facilities.
The number of people hospitalized with the coronavirus, tallied by the Covid Tracking Project, has more than doubled since September, and now exceeds the peak reached early in the pandemic, when 59,940 hospitalized patients were reported on April 15. A second peak in the summer fell just short of matching that record.
Those spikes in April and July lasted only a few days and quickly subsided, but as winter approaches experts do not expect that this time.
The United States, which surpassed 10 million known cases on Sunday, is averaging more than 111,000 new cases a day, a record, according to a New York Times database.
More than 139,800 new cases were announced in the United States on Tuesday, the highest total of the pandemic.
The country has surpassed 100,000 cases every day for a week, pushing the seven-day average to more than 123,000 per day. Four states set single-day case records; 34 states and Guam added more cases in the last week than in any other seven-day stretch. More than 1,440 new deaths were reported on Tuesday, pushing the seven-day average to more than 1,000 new deaths a day for the first time since August 19.
While the number of patients continues to climb, a shortage of nurses and other medical personnel is limiting the ability to add more hospital beds to care for them.
The critical staff shortage, especially in Western states that struggle to attract doctors and other medical workers even in the best of times, is causing growing alarm, and driving some places to take extraordinary measures.
El Paso, a border city of 680,000, now has more people hospitalized with Covid-19 than most states — 1,076 as of Tuesday — and is more than doubling its supply of mobile morgues, to 10 from four.
The University Medical Center, a teaching hospital in El Paso, set up tents to care for patients in a parking lot. A downtown convention center became a field hospital, and the state began airlifting dozens of intensive care patients to other cities to free up more space.
Gov. Douglas J. Burgum of North Dakota, which has the worst infection and death rates per person in the country, announced on Monday that health care workers who have tested positive but have no symptoms could continue to work in hospitals and nursing homes under certain restrictions, including that they treat only Covid-19 patients.
The Centers for Disease Control and Prevention’s guidelines allow the use of asymptomatic personnel during severe staff shortages. Mr. Burgum said his state was about two or three weeks away from facing “severe constraints” in hospital capacity.
In Wisconsin, now among the hardest-hit states, a major health care provider, Aurora Health Care, announced it would pause testing sites in Sinai, Green Bay and Kenosha and focus on bedside care, a spokeswoman for the health care system said. Hospitalizations in the greater Milwaukee area have increased fivefold in the past two months.
When cases spiked in New York in April and in the South over the summer, health care professionals flew in from elsewhere to help. But now, officials describe a kind of national gridlock.
“Everywhere is either hard hit or is watching their Covid numbers go up, and are expecting to get a lot of flu patients,” said Nancy Foster, a vice president of the American Hospital Association. “The ability of health care professionals to pick up and leave their hometowns is very limited.”
Breaking from its tentative recommendations on mask use thus far, the Centers for Disease Control and Prevention said on Tuesday that using masks benefits wearers, which is a step beyond its previous declaration that said wearing masks would only protect those around them.
“Experimental and epidemiological data support community masking to reduce the spread” of the virus, the C.D.C. said in a document that details scientific evidence supporting mask use. “Individual benefit increases with increasing community mask use,” it said.
The unequivocal statements are a departure from the agency’s previous language, which suggested that “the latest science may convince” Americans to wear masks and that mask use could prevent an infected person from spreading the virus to others. “The main protection individuals gain from masking occurs when others in their communities also wear face coverings,” it said.
The agency also offered an economic argument, saying that increasing the proportion of people who wear masks by 15 percent could prevent the need for lockdowns and cut associated losses of up to $1 trillion, or about 5 percent of gross domestic product.
The new document listed several studies that “have confirmed the benefit of universal masking,” as well as some observational studies that have given evidence of its usefulness, including an example of two masked hair stylists who had been experiencing symptoms but did not transmit the virus to any of their 67 masked clients who were later contacted. The document also referred to a study of 124 Beijing households in which mask use significantly cut transmission of the virus, and an outbreak aboard the U.S.S. Theodore Roosevelt in which face coverings appeared to have reduced risk of infection by 70 percent.
Experts said they were thrilled to see the change in the C.D.C.’s stance, and particularly the emphasis on face coverings that protect wearers.
“That matters for public-health messaging, because we don’t have people yet who are completely convinced about the benefits of masking until they see the C.D.C. say that it also protects you and your family,” said Dr. Monica Gandhi, an infectious-disease expert at the University of California, San Francisco.
“I would encourage every American to adhere to masking guidelines now that we hear more clearly today that this will protect you and others,” Dr. Gandhi said. “We cannot afford more lockdowns, but we can do our part to stop Covid-19 transmission and disease.”
Two months ago, India looked like a coronavirus disaster zone.
Reported infections neared 100,000 a day, deaths were shooting up, and India seemed ready to surpass the United States in total recorded cases.
Today, India’s situation looks much different. Reported infections, deaths and the share of people testing positive have all fallen significantly. By contrast, infections in Europe and the United States are surging.
But doubts persist about the reasons for India’s drop, and some researchers say that cases are falling off at least in part from a change in testing. The experts generally agree that the number of infections has far outstripped efforts to track them in India, like elsewhere, and that infections in the country could still get considerably worse.
There has also been a shift in collective thinking, and experts worry that India has begun to lower its guard.
The overall mood seems to be, “Let’s move on.”
Mobility data show that Indians have returned to shopping areas and public spaces. Many are not wearing masks. A large chunk of the population seems resigned to the threat of infection.
In many places, said Naresh Trehan, a cardiologist and the head of the Medanta hospital chain, based near New Delhi, “People are partying like there is no tomorrow. So if you do things like that, you are bound to suffer.”
Many doctors here believe it’s just a matter of time before cases start shooting up again. Other countries, including the United States, France and Germany, thought the worst virus days were behind them, only to hit new highs.
The Institute for Health Metrics and Evaluation at the University of Washington projects that India’s cases will soon increase again and exceed one million daily infections by year’s end, assuming that the country does not widely embrace wearing masks.
“India could light up like a Christmas tree in the next three or four months,” said Michael Osterholm, an epidemiologist at the University of Minnesota. “We welcome, obviously, the decrease in cases, but realizing just as every other country that as soon as you let off the brake, then it comes.”
BRUSSELS — In a bid to coordinate a patchwork of Covid-19 measures across the European Union and centralize responses to the pandemic, the bloc’s executive arm on Wednesday proposed a “European Health Union.”
The proposal by the European Commission, which would need to be approved by the European Parliament and member countries, would create an E.U.-wide plan to prepare for future health crises, as well as coordinate Covid-19 testing across the bloc.
The commission also wants to reinforce Europe’s health agencies — the European Center for Disease Prevention and Control, and the European Medicines Agency — and set up a health task force, which could be deployed quickly within the bloc and to third countries.
The aim is to strengthen the ability of the agencies to manage issues, like medicine and medical device supplies, and issue recommendations on different Covid-19 measures.
“In times of crisis, citizens rightfully expect the E.U. to take a more active role,” the bloc’s health commissioner, Stella Kyriakides, said at a news conference on Wednesday. “The European Health Union is all about preparing for and facing up to common health threats together, as a union. We need to do this in order to meet the expectations of our citizens.”
Asked whether national governments were ready to endorse the proposal, Ms. Kyriakides said she was “optimistic” that they will see the plan as “the step in the right direction.”
The commission’s effort comes a day after it announced a deal with the drugmaker Pfizer and BioNTech, a German company, which will allow member countries to order up to 300 million doses of their Covid-19 vaccine.
On Tuesday, the two companies announced preliminary results of a trial showing that their vaccine was more than 90 percent effective in preventing the disease among trial volunteers who had no evidence of prior coronavirus infection. However, the vaccine will not be available for several months.
As President Trump pushes to overturn the results of the election while the pandemic rages on, his only public statements about the coronavirus in the last few days have been to make clear his pique that good news about a vaccine had not come until after Election Day.
Meanwhile, the Strategic National Stockpile, the U.S. emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear.
The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.
Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care.
In the absence of leadership, local officials feel as if they are struggling alone. New weekly cases among nursing home residents jumped fourfold from the end of May to late October, and deaths have more than doubled in 20 states, according to R. Tamara Konetzka and Rebecca J. Gorges, researchers at the University of Chicago who analyzed data from the Centers for Disease Control and Prevention.
Even many large hospital chains, which say they have adequate supplies of medical gear, continue to operate in crisis mode. That often means requiring employees to repeatedly reuse respirator masks that are meant to be discarded after each use.
Two critical unemployment programs are set to expire at the end of the year, potentially leaving millions of Americans vulnerable to eviction and hunger and threatening to short-circuit an economic recovery that has already lost momentum, writes The New York Times’ Ben Casselman.
Here’s a breakdown of what’s at stake:
As many as 13 million people are receiving payments under the programs, which Congress created last spring to expand and extend the regular unemployment system during the pandemic.
Leaders of both major parties have expressed support for renewing the programs in some form, but Congress has been unable to reach a deal to do so. It remains unclear how the results of Tuesday’s election will affect prospects for an agreement.
The programs are some of the last vestiges of the trillions of dollars in aid that included direct checks to most U.S. households, $600 a week in supplemental unemployment benefits and hundreds of billions of dollars in support for small businesses.
Much of that assistance expired over the summer, however. Economic gains have slowed significantly since then, and studies have found that millions of Americans fell into poverty as aid dried up.
The year-end benefits cliff could be even more damaging. Many families have depleted any savings they built when the $600 supplement was available. A partial federal eviction moratorium is scheduled to expire at the end of the year, although it could be extended. And benefits checks won’t just shrink, as they did over the summer — they will disappear.
“The safety net still has kind of held up until now, and I think we have been maybe lulled into a sense of complacency,” said Andrew Stettner, an expert on unemployment benefits at the Century Foundation, a progressive policy research group.
As New York City faces the prospect of a second wave of coronavirus infections, Staten Island finds itself at the leading edge of the pandemic’s resurgence. The borough’s rate of positive test results is the highest in the city.
On Wednesday, Mayor Bill de Blasio said that the seven-day average positivity rate citywide was 2.52 percent.
“This is our LAST chance to stop a second wave,” he said on Twitter. “We can do it, but we have to act NOW.”
Two Staten Island ZIP codes have now risen above 5 percent, prompting the mayor to target the borough for a “Day of Action” on Tuesday, sending a flood of volunteers to raise awareness about the problem and to combat growing fatigue with the limitations that have become a daily part of life for millions of New Yorkers.
But Staten Island has long diverged from the rest of the city both culturally and politically, and some borough residents bristle at restrictions in a way that can at times more closely resemble the backlash in Republican strongholds in other parts of the nation — places that are now grappling with their own rise in cases.
Many here take coronavirus precautions seriously, pulling masks over their faces as they emerge from their cars. But some say they’ve seen other Staten Islanders begin to let down their guard. Whether the borough can beat back this latest surge is a question that could help determine whether the city at large can keep the pandemic at bay.
The uptick in Staten Island is happening in an area of New York where Republican leaders have fought restrictions by Democrats who control the city. Residents have strong social ties to New Jersey, and the borough is home to many police officers and firefighters. Staten Island is a solitary stronghold in the city for President Trump, who has downplayed the importance of masks and the seriousness of the virus.
As the pandemic swept up the Nile this spring, doctors lacked protective equipment, often making do with a single mask for a 24-hour shift. Testing kits were in short supply. Egypt had one of the highest fatality rates in the Arab world.
Six years earlier, President Abdel Fattah el-Sisi of Egypt had vowed to put health care reform “at the heart” of his agenda.
It didn’t work out like that.
Egypt’s public health system was straining badly, a doctor, Ibrahim Bediwy, 27, warned in a message posted online in May. “Any doctor in the current situation is not safe,” he said. “And neither is his family.”
Days after Dr. Bediwy’s post, Mr. el-Sisi’s security officials burst into his parents’ home and whisked him away. He now faces a raft of terrorism-related charges.
For almost every nation on earth — including the richest —not only has the coronavirus proved an extraordinary, often humbling challenge, it has brought a political reckoning for their leaders. It lifted the fortunes of some, while endangering the futures of others.
In Egypt, the pandemic offered Mr. el-Sisi a chance to showcase the sweeping health care reforms he promised in 2014, at the start of his presidency. Instead, it exposed chronic weaknesses.
In the early months of the crisis, overstretched hospitals struggled badly. Angry doctors went on strike, and those who dared criticize the government’s efforts were thrown in jail.
At the same time, Mr. el-Sisi continued to cut subsidies to the poor while splurging on arms deals for warships and fighter jets totaling at least $12 billion.
The coronavirus response was “typical of Egypt under Sisi,” said Nadim Houry, executive director of the Arab Reform Initiative. “On the surface, things seem to be under control. But underneath, the story is not so good.”
Singapore and Hong Kong said Wednesday that a travel bubble between the two Asian financial centers will begin this month, allowing travelers to bypass quarantine.
The arrangement, set to begin on Nov. 22, would allow one designated “bubble” flight into each city every day, each carrying a maximum of 200 passengers. Travelers must test negative for the virus and fly only on the designated flights.
Singapore’s transport minister, Ong Ye Kung, said in a video Wednesday that the bubble is “as close as it gets” to travel before the coronavirus pandemic. “This is only possible because both Singapore and Hong Kong have successfully controlled the spread of Covid-19,” he said.
Travelers from Singapore would be the first allowed to enter Hong Kong since the semiautonomous Chinese territory barred all nonresidents from outside China in March. Singapore requires most travelers to serve a mandatory quarantine period upon arrival.
Edward Yau, Hong Kong’s secretary of commerce, said in a statement Wednesday that he hoped the travel arrangement would bring relief to Hong Kong’s economy. “We hope that aviation, tourism, hotel, retail and catering businesses can benefit from it,” he said.
Cathay Pacific, Hong Kong’s flagship carrier, has eliminated 8,500 jobs, saying it had to “fundamentally restructure” as the coronavirus pandemic pummeled the aviation industry.
Hong Kong Express, a budget carrier, began offering this month a “flight to nowhere,” an hourlong tour of the city’s airspace. In Singapore, travel-starved customers have paid hundreds of dollars to eat first-class and business-class meals on grounded Singapore Airlines planes.
In January, Dr. Ugur Sahin read an article in the medical journal The Lancet that left him convinced that the coronavirus, at the time spreading quickly in parts of China, would explode into a full-blown pandemic.
So Dr. Sahin and scientists at BioNTech, the start-up he founded with his wife, Dr. Özlem Türeci, went to work on what they called Project Lightspeed, using so-called messenger RNA technology to rapidly develop a vaccine.
On Monday, BioNTech and Pfizer announced that a vaccine for the coronavirus developed by Dr. Sahin and his team was more than 90 percent effective in preventing the disease among trial volunteers who had no evidence of having previously been infected.
“It could be the beginning of the end of the Covid era,” Dr. Sahin said in an interview on Tuesday.
Dr. Sahin, 55, was born in Iskenderun, Turkey but grew up in Cologne, Germany where his parents worked at a Ford factory. He met his wife, Dr. Türeci, early in his career. She had early hopes of becoming a nun but ultimately wound up studying medicine.
Dr. Türeci, now 53 and the chief medical officer of BioNTech, was born in Germany, the daughter of a Turkish physician who immigrated from Istanbul.
On the day they were married, Dr. Sahin and Dr. Türeci returned to the lab after the ceremony.
Dr. Sahin said he and Dr. Türeci learned about the vaccine’s efficacy data on Sunday night and marked the moment by brewing Turkish tea at home. “We celebrated, of course,” he said. “It was a relief.”
James Goodrich and his husband, Jason Kramer, both 44, moved to Talent, Ore., almost two years ago to work in the costume department of the Oregon Shakespeare Festival.
Together for 17 years and married for six, they lost their jobs in April when the coronavirus pandemic shuttered theaters and live performances.
The loss was like a terrible breakup, Jason said. Uncertain about the future, the couple tried to cling to normalcy by making a daily schedule — Jason, who likes to go food shopping, was the only person who left the house.
“The pandemic made us more resilient,” Jason said. “We realized we had each other and needed to rely on ourselves, which was really kind of daunting.”
The couple were relying on savings and a small side business when, five months later, the Almeda wildfire destroyed their home and much of their town. They fled with their passports, marriage license, a few personal items and their dog.
“If Covid hadn’t happened and we had this fire, we would have a safe place to go, and there wouldn’t be as many complications,” Jason said. “But Covid has complicated it. We can’t interact with my parents. We can’t hug or be near people as much. Covid is making it difficult to move on.”
Now, life is a game of trial and error. Surviving a pandemic and a wildfire has made them more honest with each other, and more forgiving of mistakes.
“I may forget something at the store but, honestly, our house is burned down,” Jason said. “There are bigger fish to fry.”
BERLIN — More than 300,000 school-aged children in Germany are currently quarantined at home because of the coronavirus, according to an estimate by the German teacher’s federation. The news, first reported by the tabloid Bild, comes as some states are considering extending winter breaks to slow infections at schools.
“Our politicians are relying on the health authorities and not the school system itself to protect pupils from infections,” said Heinz-Peter Meidinger, the president of the German Teachers’ Association.
Mr. Meidinger estimates that between 2.5 percent and 3 percent of all students across the country are quarantining either because they are infected with or have been exposed to the virus. Germany’s second nationwide lockdown, which began early this month, does not include schools and day-care centers, which can be shut down individually by health authorities if they are hit by an outbreak.
In its second week of the lockdown, Germany has shown a marked reduction in its reproduction number, meaning that while the number of new of infections reported daily remains high (on Tuesday health authorities registered 18,487 new cases) the daily increase rate appears to have leveled off.
According to a new poll, nearly half of adult respondents — 48 percent — favor using masks in schools at all times. Currently many schools allow children to remove their masks once they are seated.
In North Rhine-Westphalia, where about 50,000 of the state’s 1.9 million school-aged children are quarantined at home, the governor is considering extending the Christmas break to lower the number of transmissions occurring in schools.