The US hit a record number of coronavirus hospitalizations on Tuesday and surpassed 1 million new confirmed cases in just the first 10 days of November, as a nationwide surge of infections that shows no signs of slowing.
The country recorded a seventh consecutive day of more than 100,000 new cases, and one of the public health advisers recruited to president-elect Joe Biden’s transition team warned that those case numbers could double in the coming weeks under the leadership of Donald Trump.
Monday saw the US surpass 10m total cases – the highest number in the world, by far – and reach a death toll of 238,256. There were 111,433 new cases on Monday and 590 new deaths, according to data compiled by Johns Hopkins University.
Hospitalisations have risen to nearly 62,000 nationwide, according to the Covid Tracking Project, which saw the biggest single-day increase since 10 July. It found South Dakota had the highest hospitalisation rates in the US and said Illinois had reported more than 10,000 cases for four days straight.
In California, cases are at their highest levels in months. On Tuesday, the state announced several counties would revert back to more restrictive reopening rules as a result.
Biden has already warned the US is “facing a very dark winter” and that even with Pfizer’s announcement that it has a vaccine it believes is 90% effective, 200,000 more lives could be lost in the US in the next few months.
Alex Azar, secretary of health and human services, said on Tuesday the federal government will have enough of the vaccine by the end of December “to have vaccinated our most vulnerable citizens”. By the end of January, he told NBC, there will be enough for all healthcare workers and first responders, with March or early April targeted for a general vaccination programme.
Experts say cases could rise exponentially in the coming weeks. Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota and a member of Biden’s Covid-19 advisory board, told CNN daily cases could soon double.
“We are watching cases increase substantially in this country far beyond, I think, what most people ever thought could happen,” he said, adding: “It will not surprise me if in the next weeks we see over 200,000 new cases a day.”
On Tuesday, Donald Trump tweeted purported quotes from a Fox Business journalist and his former White House doctor turned congressman-elect, Ronny Jackson, crediting the president with the possible arrival of a vaccine. He also retweeted a post describing Biden as an “ambulance chaser”.
Pfizer senior vice-president Kathrin Jansen told the New York Times the company did not participate in the government’s Operation Warp Speed or take any of its money.
The Food and Drug Administration said it had issued an emergency use authorisation for Eli Lilly’s monoclonal antibody therapy, called bamlanivimab, to treat mild to moderate cases in adults and children over 12.
On Tuesday, Osterholm told CBS a “perfect storm” was forming and that hospitals were “about to be overrun”.
“We’re going to see by far the darkest days of this pandemic between now and next spring when the vaccine becomes available,” he told CBS.
Top US infectious disease expert Anthony Fauci told MSNBC he expects the FDA will probably put in for an emergency use authorisation of the Pfizer vaccine in the next week to week and a half. Providing it goes through, he said, doses should be available for highest-priority people in December.
Asked if he would take the vaccine if it was approved by the FDA, he said he would.
“I’m going to look at the data, but I trust Pfizer. I trust the FDA,” Fauci said. “These are colleagues of mine for decades, the career scientists. If they look at this data, and they say this data is solid, let’s go ahead and approve it, I promise you, I will take the vaccine, and I will recommend that my family take the vaccine.”
He also reiterated the importance of wearing a mask, saying: “You protect others. Their mask protects you, and your mask also protects you.”
Public health officials believe the federal government has not done enough to encourage Americans to take a vaccine or prepare them for what to expect.
“This needed to happen ‘yesterday’,” Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health, told USA Today. “It’s like watching a train wreck happen.”
Across the US, states are struggling. In El Paso, Texas, officials have six mobile morgues and have requested four more, CNN reported. The state was approaching 1m infections. In Ohio the chief medical officer, Dr Bruce Vanderhoff, warned of an “unprecedented spike” in hospital use and a growing demand on staff.
“If we don’t control the spread of this virus, we won’t be able to care for those who are acutely ill without postponing important, but less urgent, care,” he said. “We anticipate that this kind of shift could happen in a matter of weeks if trends don’t change.”
In Utah, the governor Gary Herbert, warned of a “dire situation” in hospitals, declared a state of emergency, issued a mask mandate and restricted social gatherings.
“This is a sacrifice for all of us,” he said. “But as we slow the spread it will make all the difference for our overworked healthcare workers, who desperately need our help.”
Meanwhile, 28 employees of the election board in one of Missouri’s largest counties, Jackson, have tested positive for the coronavirus in recent weeks, and a director, Tammy Brown, a Republican, believes they got infected from voters.
Agencies contributed reporting