The latest coronavirus surge is raging across the American heartland, most acutely in the Midwest and Mountain West.
This harrowing third surge, which led to a U.S. single-day record of more than 85,000 new cases Friday, is happening less than two weeks from Election Day, which will mark the end of a campaign dominated by the pandemic and President Trump’s much-criticized response to it.
As of Friday evening, 15 states have added more cases in the past week than in any other seven-day stretch of the pandemic: Wisconsin, a battleground in the presidential election, Colorado, Kentucky, Illinois, Wyoming, Idaho, Utah, South Dakota, Montana, Arkansas, Alaska, Tennessee, Ohio, Indiana and North Dakota. And four states have added more deaths this week than in previous weeks: Wisconsin, Kentucky, South Dakota and Oklahoma.
North Dakota leads the nation in coronavirus cases per capita. Illinois is averaging more than 4,100 new cases per day, up 85 percent from the average two weeks ago. And Pennsylvania, another battleground state, on Friday reported a record of 2,258 cases.
The virus will be front of mind for voters in several key states: in Ohio, where more people are hospitalized than at any other time during the pandemic, and especially Wisconsin, home to seven of the country’s 10 metro areas with the highest numbers of recent cases. On Friday, the Wisconsin Supreme Court blocked Gov. Tony Evers’ emergency order restricting the size of indoor gatherings to 25 percent capacity on Friday.
Experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount, especially in rural areas where medical facilities could be quickly overwhelmed.
Citing a rise in hospitalizations across the state, the Colorado Department of Public Health and Environment announced a strengthening of coronavirus restrictions in certain counties, capping gatherings at 10 people from no more than two separate households. For the third straight day, Colorado announced a new single-day cases record on Friday.
Overnight, nearly 2,500 people were hospitalized in Illinois, the state’s top public health official, Dr. Ngozi Ezike, said in a news conference Friday afternoon. The mayor of Chicago, Lori E. Lightfoot, announced a curfew on nonessential businesses beginning at 10 p.m. on Friday.
In the latest presidential debate on Thursday night, President Trump asserted that the virus was “going away” as he defended his management of the pandemic. Former Vice President Joseph R. Biden Jr., the Democratic nominee, attacked Mr. Trump’s handling, calling for much more aggressive federal action for the “dark winter” ahead.
President Trump and many supporters blame restrictions on business activity, often imposed by Democratic governors and mayors, for prolonging the economic crisis initially caused by the virus. But the experience of states like Iowa, which recently set a record for patients hospitalized with Covid-19, shows the economy is far from back to normal even in Republican-led states that have imposed few business restrictions.
Iowa was one of only a handful of states that never imposed a full stay-at-home order. Restaurants, movie theaters, hair salons and bars were allowed to reopen starting in May, earlier than in most states. Many businesses worry they won’t be able to make it through the winter without more help from Congress. Others have already failed.
Defying the guidance of infectious disease experts, who say that universal masking and social distancing are essential to limiting the virus’s spread, has eroded support for both Mr. Trump and Gov. Kim Reynolds in Iowa, especially among voters over 65, normally a solid Republican constituency, according to public and private polls. Mr. Trump and Senator Joni Ernst — whose seat could play a decisive role in determining control of the Senate — are both in tight races in a state that the president easily won four years ago.
Dr. Anthony S. Fauci, the nation’s leading expert on infectious diseases, again stressed the importance of wearing masks, socially distancing, avoiding crowds and regular hand washing Friday evening in an appearance on CNN.
“It’s not going to spontaneously turn around unless we do something about it,” he said, adding “I plead with the American public to please take these things seriously.”
The United States is in the midst of one of the most severe surges of the coronavirus to date, with more new cases reported across the country on Friday than on any other single day since the pandemic began.
Since the start of October, the rise in cases has been steady and inexorable, with no plateau in sight. By Friday night, more than 85,000 new cases had been reported across the country, breaking a single-day record set on July 16 by more than 9,000 cases.
By that measure, Friday was the worst day of the pandemic, and health experts warned of a further surge as cold weather sets in.
For many, the soaring numbers brought back ragged memories of what it was like in mid-July, when the virus was raging through the Sun Belt.
Raymond Embry saw the worst of it up close. His small Arizona medical clinic had been giving about five coronavirus tests a day. That grew to dozens a day, and then came the surge on July 16, with 4,192 people lined up for tests to find out if they had the coronavirus.
That day, arguably the worst of the pandemic in the United States to that point, set records nationwide. By the end of that 24-hour period, a staggering 75,687 new cases had been reported around the country, and Arizona led the nation in deaths per capita.
On the Texas-Mexico border, mid-July was a nightmare. Johnny Salinas Jr., the owner of Salinas Funeral Home, was handling six to seven funerals a day, a number he would usually see over a week before the pandemic. Some of those included family members and relatives of employees.
But in some other parts of the country that day, the virus felt far away.
On July 16, towns in North Dakota were holding their annual summer festivals. People cheered the rodeos and danced together, maskless, in the streets.
Deaths from the coronavirus in Germany surpassed 10,000 on Saturday, a disconcerting milestone in a country that has been widely admired for its ability to manage the pandemic. The number of new infections in a 24-hour period also reached a record level — 14,714 — although the country’s public health authority said that some of those cases should have been factored in earlier in the week but had not been because of technical issues.
Either way, Germany appears to be losing its grip on controlling the virus, which the public health authority, the Robert Koch Institute, said was spreading largely among young adults in private homes and parties. Infections in nursing homes and hospitals have also been increasing since last month, as have the number of coronavirus patients requiring hospitalization.
Local health authorities, who are responsible for the contact tracing of infected people, are increasingly overwhelmed, despite help from hundreds of soldiers who have been dispatched to communities across the country. In its banking capital, Frankfurt, a city of about 750,000, the number of new cases has quadrupled since the beginning of this month, and health officials there conceded that their ability to stop chains of infection had collapsed.
“It is no longer possible to trace each case,” the head of Frankfurt’s office of public health, René Gottschalk, told ZDF public television on Friday.
Late-stage coronavirus vaccine trials run by AstraZeneca and Johnson & Johnson have resumed in the United States after the companies said Friday that serious illnesses in a few volunteers appeared not to be related to the vaccines.
Federal health regulators gave AstraZeneca the green light after a six-week pause, concluding there was no evidence the experimental vaccine had directly caused neurological side effects reported in two participants. The AstraZeneca news was first reported by The Wall Street Journal.
Johnson & Johnson said that its trial, which had been on pause for 11 days, would restart after a company investigation determined that a “serious medical event” in one study volunteer had “no clear cause.” To maintain the integrity of the trial, the company said, it did not check whether the volunteer received the vaccine or the placebo.
Dr. Luciana Borio, a former acting chief scientist at the Food and Drug Administration, welcomed the announcements, citing the urgent need for multiple vaccines to remain in the race for a product that could protect the global population from the coronavirus, which has already killed more than a million people worldwide.
“The demand for safe and effective Covid vaccines exceeds any single manufacturer’s production capacity,” Dr. Borio said. “We really need several in the field.”
An F.D.A. spokesperson declined to comment on Friday afternoon.
AstraZeneca and Johnson & Johnson are two of the four companies now in late-stage clinical trials in the U.S. for experimental coronavirus vaccines. Both companies are using adenoviruses, which typically cause harmless colds. The adenovirus is engineered so that it can chauffeur a coronavirus gene into human cells.
Their two high-profile competitors, Moderna and Pfizer, also in advanced trials, are instead using a technology based on genetic material known as mRNA. Delivered into human cells, the mRNA prompts the production of coronavirus proteins, triggering an immune response.
AstraZeneca moved swiftly into clinical trials, enrolling thousands of volunteers for its vaccine trials around the world in countries including Brazil, India, South Africa and Britain. A large, late-stage trial kicked off in the United States at the end of August. But all the trials were halted days later, on Sept. 6. A volunteer who had received the vaccine in the United Kingdom reportedly experienced symptoms of transverse myelitis, or inflammation of the spinal cord, triggering a global pause to the company’s efforts.
The incident sparked some concern among experts, who noted that a similar adverse neurological event, reported months ago, had occurred in another vaccinated volunteer. While this earlier event prompted its own pause in AstraZeneca’s trials, an independent safety board ultimately determined it was unrelated to the vaccine, allowing studies to resume.
Following the second AstraZeneca halt in September, trials abroad rapidly resumed in most countries. But the American hiatus persisted, with few details released as to why.
According to two vaccine experts familiar with the situation who were not authorized to discuss it publicly, the F.D.A. did not directly tie the vaccine to the two neurological illnesses, although it could not be ruled out. The agency has advised the company to alert study volunteers about related symptoms like weakness and numbness that might point to a milder case of transverse myelitis, the experts said.
Johnson & Johnson launched their Phase 3 trial on 60,000 volunteers in September. On October 12, the company announced its own trial pause, citing concerns that an illness had happened in one of its volunteers as well. The company has kept mostly quiet about the details of the incident.
“There are many possible factors that could have caused the event,” the company said. “Based on the information gathered to date and the input of independent experts, the Company has found no evidence that the vaccine candidate caused the event.”
Adverse events are not uncommon in large-scale vaccine trials. In some cases, they are caused by a vaccine. But investigations usually reveal that they’re coincidental — a simple matter of chance.
Before the pauses, both companies had indicated they would likely submit their vaccines for emergency authorization from the Food and Drug Administration within a few month’s time — perhaps even by year’s end. It remains unclear how much these plans have now been thrown into flux in the wake of trial delays. Results from AstraZeneca’s late-stage trials are still expected later this year, according to the statement. Johnson & Johnson did not provide an updated estimate in their statement.
With early voting underway and the election days away, many U.S. cities and states have imposed safety measures to protect voters and poll workers from exposure to the coronavirus.
But polling places could still become “mass gathering events,” the Centers for Disease Control and Prevention warned in an advisory released on Friday, adding that measures to prevent the spread of Covid-19 could be improved.
The C.D.C. based its latest advice on a survey of 522 poll workers in Delaware’s statewide primary in September. That survey did not indicate whether any cases of Covid-19 were linked to the voting centers.
Guidelines issued by the agency in June recommended various ways to minimize crowds at polling locations, including absentee voting, extended voting hours and the use of protective gear by poll workers assisting voters with coronavirus symptoms.
The C.D.C. also recommended putting up physical barriers between voting machines, spacing the machines apart from one another, indicating 6-foot distances with signs or floor markings for those waiting in line to vote and allowing curbside voting for people who are ill, among other measures.
The advisory published on Friday said that “a substantial proportion” of poll workers in the Delaware study saw incorrect mask use by voters, and said that “further messaging on proper mask use, including at polling locations, might be needed to strengthen the effectiveness of masks during upcoming elections.”
“Ensuring that ill voters can vote while maintaining poll worker and voter safety will be essential to minimizing transmission without restricting voting rights,” the advisory added.
But in Alabama, where curbside voting had been allowed, the state’s attorney general has ordered that it be stopped. On Wednesday, the U.S. Supreme Court upheld the ban.