The United States passed 11 million total coronavirus cases on Sunday, and its caseload has now soared past 12 million. New daily cases are approaching 200,000: on Friday, the country recorded more than 198,500, a record.
As the nation reconsiders the usual winter holiday travel and cozy indoor gatherings, new cases are being reported at an unrelenting clip. The seven-day average has exceeded 100,000 cases a day every day for the last two weeks, according to a New York Times database.
The country’s death toll at the virus stood at 254,320 as of midday Saturday. And a Times analysis shows that the United States has deaths are higher than normal in all 50 states, as the pandemic brings unusual patterns of death.
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; going from nine to 10 million took only 10 days. From 10 million to 11 million took just under seven days.
Despite near-daily records for both new cases and hospitalizations, there remains bipartisan reluctance toward issuing the sort of sweeping stay-at-home orders seen in the earliest days of the pandemic. In their place, officials are instituting 10 p.m. curfews, closing schools and announcing long-resisted mask mandates.
In Illinois, residents received what once might have been considered an apocalyptic warning on their phones Friday evening: “Effective today, all of Illinois enters Tier 3 Mitigation. Work from home when possible, avoid unnecessary travel, and celebrate the holidays virtually with extended family.” The state has averaged more than 12,000 cases per day for the past week and some regions of the state are down to just a few dozen I.C.U. beds.
Still, the citizenry’s resolve is wearing thin.
And as families weigh whether to gather for Thanksgiving, creeping back into headlines are the hours-long lines for tests, the overwhelmed hospital systems and the demand for additional refrigerated morgue trucks.
The Centers for Disease Control and Prevention has urged Americans to avoid travel for Thanksgiving and to celebrate only with members of their immediate households. It remains unclear if many families across the United States will alter their holiday plans, despite pleas from government officials and public health experts.
“It will not be long before we can embrace one another, eat together and let this year become a distant memory,” Dr. Elisabeth Poorman, an internal medicine physician, wrote for NPR. “I beg of you, don’t let this Thanksgiving be your last.”
The records are falling at a time of great political tension. President Trump has refused to concede his loss while largely ceding the fight against the virus to state and local governments who continue to go their own way, and President-elect Joseph R. Biden Jr. argues in vain for a start of the transition, warning that failing to do so will cost lives.
Dr. Deborah L. Birx, the Trump administration’s coronavirus response coordinator, has been issuing dire assessments, urging Americans to “increase their vigilance” as they await the approval of a vaccine.
She implored Americans on Thursday to practice social distancing and to wear masks.
The national rhetoric is slowing shifting. Gov. Kim Reynolds of Iowa, a Republican, announced a statewide mask mandate this week after months of insisting it was an unenforceable “feel-good measure.” Iowa has the sixth-highest rate of new cases in the nation.
“If Iowans don’t buy into this, we lose,” Ms. Reynolds said, warning that the hospital system could collapse. “The cost in human life will be high.”
As the United States continues breaking record after record — over 198,000 new cases in a single day on Friday, more than 82,000 people hospitalized — some states and cities are hoping nightly curfews will help stop the coronavirus from leaping from person to person at bars, parties and other nocturnal events.
California is the latest to issue an overnight curfew, a measure more often imposed to calm public unrest than for the sake of public health.
Gov. Gavin Newsom of California, a Democrat, issued the order for most of the state’s counties on Thursday, requiring that, beginning Saturday, people not leave their homes from 10 p.m. to 5 a.m. except for essential reasons, and that restaurants close for dining then as well. Gov. Mike DeWine of Ohio, a Republican, issued a similar curfew that went into effect on Thursday.
In New York, Gov. Andrew M. Cuomo, a Democrat, ordered that bars and restaurants in the state close at 10 p.m. Some local governments have also imposed curfews, such as in Pueblo, Colo., and Miami-Dade County, Fla. Chicago also ordered that restaurants and bars close at 10 p.m.
The measures also show how widely the response to the virus can vary by state. None of the states where the virus is spreading at the fastest rates — South Dakota, North Dakota, Wyoming, Iowa and Nebraska — have issued curfews, even as governors of some of those states have begun to require face masks indoors for the first time.
The changes come as the virus has, in the past week, killed more than 1,900 people and infected more than 168,000 new people each day, on average as of Friday.
Public health officials have repeatedly warned that the virus can spread more easily at late-night gatherings as people shout, sing, get closer to one another or, perhaps, flout the rules as they drink. In June, health officials in Ada County, Idaho, which includes Boise, determined that half of the area’s newly infected were people who had likely gotten the virus from bars and nightclubs.
“The rules for when bars are open are supposed to be that you can come down with your group and you don’t interact with others,” said Mayor Nick Gradisar of Pueblo, Colo., a city of about 112,000 people where a curfew has been extended to Nov. 27. But people sometimes don’t follow those rules after they have been drinking, he added. “That’s how this virus spreads.”
Public health experts also caution that it can take several weeks for measures like mask mandates, restaurant closings and restrictions on gatherings to influence people’s behavior and start to flatten the epidemic curve. The effect may be delayed because the incubation period for the disease is up to 14 days, so some proportion of the public is already infected.
A spokesman for Mr. DeWine said he believed Ohio’s three-week curfew “can make a dent” in the state’s rising cases while letting bars and restaurants continue to make money by serving people earlier in the evening.
Dr. Mark Ghaly, the secretary of California Health and Human Services, said that the state’s curfew was targeted to stop the most harmful behaviors.
“We’ve seen in the past that Covid goes from zero to 60 miles per hour very quickly,” he said at a news conference on Thursday. “We know that those who are out, who might be engaging in higher-risk behaviors, that those infections can quickly spread to other settings.”
The drug maker Pfizer said on Friday that it had submitted an application to the Food and Drug Administration to authorize its coronavirus vaccine for emergency use, setting in motion an accelerated regulatory process that could allow some Americans to get a vaccine by the middle of December.
Regulators at the F.D.A. plan to take about three weeks to review Pfizer’s vaccine before an outside panel of experts meets to review the application the second week of December. That meeting has been scheduled for Dec. 10.
The agency typically, though not always, follows the advice of its advisory committees. If committee members reach a consensus about the effectiveness of Pfizer’s vaccine, the company could receive emergency clearance by mid-December.
Another front-runner, Moderna, is also on the verge of submitting its vaccine for review, and the outside panel could review the company’s vaccine soon after Pfizer’s. Both use a synthetic version of coronavirus genetic material, called mRNA, to program a person’s cells to churn out many copies of a fragment of the virus, teaching the immune system how to build a protective response.
You might assume that means that these vaccines will protect 95 out of 100 people who get them. But exactly how the vaccines perform out in the real world will depend on a lot of factors we just don’t have answers to yet.
Here are some things to consider about the vaccines’ actual effectiveness.
What’s the difference between efficacy and effectiveness?
Efficacy is a measurement made during a clinical trial, while effectiveness describes how well it works in real life. If previous vaccines are any guide, effectiveness may prove somewhat lower than the impressive efficacy found in clinical trials.
That’s because the people who join clinical trials are not a perfect reflection of the population at large. Out in the real world, people may have a host of chronic health problems that could interfere with a vaccine’s protection, for example.
What exactly are these vaccines effective at doing?
The clinical trials run by Pfizer and other companies were specifically designed to see whether vaccines protect people from getting sick from Covid-19. So only volunteers who developed symptoms like a fever or cough were tested for the coronavirus. But it’s possible that some people who got vaccinated in the trials got infected without developing symptoms. If those cases exist, none of them are reflected in the 95 percent efficacy rate, and the real rate would actually be lower.
Will these vaccines put a dent in the epidemic?
Even a vaccine with extremely high efficacy in clinical trials will have a small impact if only a few people end up getting it. A. David Paltiel, a professor at the Yale School of Public Health, modeled different vaccines based on their efficacy rates, and also how quickly and widely they can be distributed.
“Infrastructure is going to contribute at least as much, if not more, than the vaccine itself to the success of the program,” he said.
President-elect Joseph R. Biden Jr. and Vice President-elect Kamala Harris met on Friday with House Speaker Nancy Pelosi and Senator Chuck Schumer, Democrat of New York and the minority leader, the first in-person gathering of the Democratic leaders since the election.
In a one-minute photo opportunity with reporters, Mr. Biden and Vice President-elect Kamala Harris were seated in a conference room at a large table with Ms. Pelosi and Mr. Schumer. All were masked and sat several feet from one another.
“In my Oval Office, me casa, you casa,” Mr. Biden joked, drawing chuckles from the others. “I hope we’re going to spend a lot of time together.”
Ms. Pelosi gave Mr. Biden a white orchid to celebrate his 78th birthday, according to an aide.
In a joint statement afterward, the four Democrats said the meeting was focused on the need “to pass a bipartisan emergency aid package in the lame duck session,” one that included money to fight the coronavirus and provide financial relief to the unemployed, businesses, and state and local governments.
Mr. Biden also discussed his agenda for the first 100 days of his presidency, according to the statement, including his plans to contain the coronavirus and restore the economy, based on “the American people’s mandate for action.”
Jen Psaki, a transition spokeswoman, told reporters earlier in the day that the four leaders were “going to be working in lock step and they are in lock step agreement that there needs to be emergency assistance and aid during the lame duck session to help families, to help small businesses.”
“There’s no more room for delay,” she added.
The meeting came as the nation continues to be led by a president who refuses to concede the election and is using lawsuits, divisive language and pressure tactics to try to overturn the results.
Mr. Biden, Democrats and a small number of Republicans have been urging the president to focus on fighting the surging pandemic and bolstering economic recovery.
In recent days, Mr. Biden has spoken repeatedly about the urgent need for Congress to agree on a new stimulus spending package, saying that Senate Republicans should drop their opposition to a measure passed by House Democrats last month. He has made no public suggestion that Democrats should change their position or offer new compromise legislation.
Beyond his meeting with Ms. Pelosi and Mr. Schumer on Friday, Mr. Biden was speaking with “elected officials from both sides of the aisle” about the issue, Ms. Psaki said, but did not offer more specifics.
Donald Trump Jr., the president’s son, tested positive for the coronavirus at the beginning of the week and has been isolating since Monday, a spokesman for Mr. Trump said on Friday.
He added that Mr. Trump has shown no symptoms and is following virus protocols.
Mr. Trump is the latest person close to the president who has tested positive for Covid-19. Barron Trump, the president’s youngest son, tested positive last month. Melania Trump, the first lady, also tested positive in October. In July, Mr. Trump’s girlfriend, Kimberly Guilfoyle, had tested positive for the virus.
President Trump tested positive for the virus in October and was hospitalized as his symptoms worsened. The president underwent a series of invasive therapies typically reserved for people seriously sick with Covid-19.
Donald Trump Jr.’s announcement comes hours after Rudolph W. Giuliani’s son, Andrew Giuliani, a special assistant to the president, announced on Twitter that he had tested positive. This week, two Republican senators, Rick Scott of Florida and Chuck Grassley of Iowa, also said they had the virus.
After an exposure to the virus, symptoms can take up to 14 days to appear, if they ever appear at all. In that time, the virus can still spread from person to person.
According to guidelines from the Centers for Disease Control and Prevention, Mr. Trump should isolate for at least 10 days following his positive test. The spokesman did not indicate which test Mr. Trump had taken.
In recent months, Mr. Trump has questioned the seriousness of the coronavirus pandemic, saying in a Fox News interview that since deaths from the virus had dropped to “almost nothing” the outbreak had come under control. That day deaths in the United States topped 1,000.
Mr. Trump’s diagnosis, reported earlier by Bloomberg, comes as the virus is surging across the nation. As of Thursday, at least 1,962 new coronavirus deaths and 187,428 new cases were reported in the United States.
Two of China’s largest port cities, Shanghai and Tianjin, have announced locally transmitted coronavirus infections, renewing worries about whether the country can continue to keep out the virus after coming close to eradicating it over the summer.
Tianjin said on Friday that it had discovered four cases, all in its port area. Shanghai said on Saturday that an airport cargo security officer and his wife, a nurse, had both been infected. The Shanghai cases come less than two weeks after an air cargo worker at the same oceanfront airport, Pudong International, tested positive.
Chinese cities respond to even a single case with extensive coronavirus testing programs. Within hours of the two new cases in Shanghai, local authorities said they had tested six family members of the couple and 80 other close contacts, all of whom were negative. Another 8,120 people in the area were also tested, with more than half of these tests already processed and all negative, officials added.
In Tianjin, the residential community with four new cases was completely sealed off by the authorities. Other neighborhoods nearby, which have people who had been in contact with residents of the sealed-off community, were put under mandatory testing programs, with schools and public places closed and travel restricted.
The Chinese government has repeatedly warned that the virus could re-enter the country on food or other shipments of chilled or frozen goods. Tianjin and Shanghai officials have emphasized that their recent cases were concentrated in areas that handle such goods.
The U.S. Centers for Disease Control and Prevention has said that the virus is primarily airborne. Experts generally say that while it can be transmitted through frozen food and contaminated surfaces, the likelihood is exceedingly low.
National and municipal officials in China have been quick this autumn to blame foreign countries for virus outbreaks on their soil. In addition to extra testing of imported food, the government has made it difficult for Chinese nationals to return from overseas and banned the entry of foreign visitors and many longtime foreign residents.
Amy Chang Chien contributed research.
Canada is awash in grim coronavirus news.
The far northern Canadian territory of Nunavut lost its status as the last place in Canada to be free of Covid-19. Toronto is rolling back its reopening and imposing the longest and strictest closures the province has seen since the first wave of the pandemic. And the federal government said on Friday that unless Canadians reduce contact with one another and provinces apply more restrictions, the country is on a path to 60,000 new cases a day by the end of the year, about 5.5 times the current rate.
Only Atlantic Canada, which is isolated from the rest of the country and the world by travel restrictions, has escaped the trend.
Some physicians and scientists are saying that to address the crisis, Canada should aim to not just contain the spread of the virus but outright eliminate new infections. It’s an idea known on social media as #COVIDzero, and it is gaining momentum around the world.
The big question is how aggressive countries need to become. Australia provides one example.
Two of my colleagues in Australia, Yan Zhuang and Damien Cave, looked at Melbourne’s 111-day hibernation. It eliminated cases in the city of five million, but the measures went well beyond anything Canada has seen and included strict curfews and severe travel restrictions.
My colleagues portrayed “a dizzying and lonely experience that many in Melbourne described as an emotional roller coaster with effects on the economy, education and mental health that will linger.”
I spoke with Dr. Irfan Dhalla, an associate professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation about Covid-zero, an idea he raised in a Globe and Mail op-ed in May.
He told me thathe did not propose copying Australia’s severe lockdown and that he supported keeping Canada’s schools open. Instead, he said, “We should look at Covid-zero as a rallying cry for a better approach.”
Dr. Dhalla said that several Asian countries, particularly Korea, could serve as templates, but that “the most compelling example” is the four provinces of Atlantic Canada. Their chief distinction: deciding to form a travel bubble. Most outsiders who enter must quarantine.
New York Times data showed on Friday that Newfoundland and Nova Scotia had an average of just 0.3 cases per 100,000 people over the previous week, New Brunswick stood at 0.7, and Prince Edward Island had no cases at all.
This year, as they prepare to let turkeys brine and pie crusts thaw, people across the country are waiting for something extra: a coronavirus test they hope can clear them to mingle with loved ones.
Because a positive test filters out people who should definitely not be out with others, many people consider a negative coronavirus test to be a ticket to freely socialize without precautions. But scientists and doctors say this is dangerously misguided.
The main reason is that a test gives information about the level of the virus at the time of the test. A person could be infected but not have enough virus for it to register yet. Or, a person may become infected in the hours or days after taking a test. Also, the tests do not have 100 percent accuracy.
“If you require all of your guests to email you a negative test result before your Thanksgiving dinner, it will definitely decrease the risk of an outbreak — but not completely,” said Dr. KJ Seung, chief of strategy and policy for the Covid response at Partners in Health. Yet this is a common misperception contact tracers hear when talking to people, he said.
Laboratory tests that rely on a technique called polymerase chain reaction, or P.C.R., can detect the virus when it’s present even at very low levels. But it might take a couple of days to return results, leaving time for someone to be exposed.
Antigen tests are faster, less expensive and more convenient — they can deliver results in a matter of minutes — but are also more prone to missing the virus when it’s scarce. And that could give someone a false sense of security en route to Thanksgiving dinner, said Paige Larkin, a clinical microbiologist at NorthShore University HealthSystem in Chicago, where she specializes in infectious disease diagnostics.
“A negative result is a snapshot in time,” Dr. Larkin said. “It’s telling you that, at that exact second you are tested, the virus was not detected. It does not mean you’re not infected.”
In summary, as Dr. Esther Choo, an emergency medicine physician and a professor at Oregon Health and Science University, put it: “Testing negative basically changes nothing about behavior. It still means wear a mask, distance, avoid indoors if you can.”
The family of one epidemiologist plans to celebrate Thanksgiving in a garage, with tables 10 feet apart and the doors rolled up. Another epidemiologist’s family is forgoing a traditional meal for an outdoor hot cider toast with neighbors. A third is dining in an outdoor tent, with a heater, humidifier and air purifier running.
And, according to an informal survey of 635 epidemiologists by The New York Times, the large majority are not celebrating with people outside their household. Public health experts from a range of backgrounds answered our questionnaire. Not all of them study Covid-19, but all have professional training about how to think about disease spread and risk.
Seventy-nine percent said they were having Thanksgiving dinner with members of their household or not at all. Just 21 percent said they would be dining with people outside their household — and in most cases, they described going to great lengths to do so in a safe way. Their answers were similar for the other winter holidays, like Christmas and Hanukkah.
About 8,000 epidemiologists were invited to participate in our survey, which was circulated by email to the membership of the Society for Epidemiologic Research and to individual scientists.
The holiday season is arriving as the coronavirus spreads with renewed strength across the United States, with cases up 67 percent and deaths up 63 percent in the last 14 days. On Thursday, officials at the Centers for Disease Control and Prevention urged Americans to avoid travel and celebrate the holiday only with members of their household. Epidemiologists are making these same personal decisions, with added expertise.
This is an excerpt of Farhad Manjoo’s latest column for Times Opinion.
After all that has happened this year, the idea of skipping Thanksgiving has brought me low. I am blessed not to have lost anyone close to me to the coronavirus. For my family, the pandemic’s most crushing hardship has been its enforced isolation, especially the cruel way it has cleaved us apart at generational seams, separating my kids from their grandparents.
If 2020 has taught me anything, it is to resist taking the future for granted and to impose an actuarial frankness on all of our planning. Sure, we could skip Thanksgiving this year — but how many future Thanksgivings will we all have together, anyway?
To find some empirical foothold in a debate mired in uncertainty, I decided to investigate my own potential lethality to the older people in my life. Among other things, I contact-traced myself — an exercise that ended up being nearly as vulgar as it sounds. I went to all of my regular close contacts, then I went to all of their contacts, and so on, asking everyone about their potential exposure to the virus.
What I found floored me.
I thought my bubble was pretty small, but it turned out to be far larger than I’d guessed. My only close contacts each week are my wife and kids. My kids, on the other hand, are in a learning pod with seven other children, and my daughter attends a weekly gymnastics class.
I emailed the parents of my kids’ friends and classmates, as well as their teachers, and asked how large each family’s bubble was. Already, my network was up to almost 40 people.
Turns out a few of the families in our learning pod have children in day care or preschool. And one classmate’s mother is a doctor who comes into contact with about 10 patients each week.
Once I had counted everyone, I realized that visiting my parents for Thanksgiving would be like asking them to sit down to dinner with more than 100 people.
With coronavirus cases in New York surging and health officials pleading with people to wear masks, social distance and stay home ahead of the holiday season, one group of Democratic power brokers in New York did not seem to get the message.
Photos published by the New York Daily News on Thursday show some city leaders at a birthday party for the leader of an influential trade organization, sipping drinks at a private residence in Brooklyn, speaking while standing close to one another and rubbing shoulders, with few masks in sight. The crowd appeared to exceed Gov. Andrew M. Cuomo’s limit of 10 people for gatherings in homes,
According to an official familiar with the gathering, the party, for Carlo Scissura, president of the New York Building Congress, was held on Nov. 14 — a day when the city reported 1,800 coronavirus cases, and shortly before Mayor Bill de Blasio closed schools. It prompted cries of hypocrisy, calls for resignations and, eventually, a round of apologies.
“This is a particularly trying time and there were shortcomings that I regret,” Mr. Scissura said in a statement. “I greatly appreciate the gesture of my friends to throw me a surprise party, but we all must follow strict protocols so we can get past this pandemic.”
At the party, guests were given masks, each person’s temperature was taken and the event was primarily held outside, according to someone who attended the party. But the photos show Frank Seddio, the former chairman of the Brooklyn Democratic Party, chatting closely with Ingrid Lewis-Martin, the deputy Brooklyn borough president, whose boss has just announced his intention to run for mayor. Neither wore masks.
“I apologize for my lapse in compliance with Covid-19 precautions,” Ms. Lewis-Martin said in a statement. “As a public figure in Brooklyn, I know it is my responsibility to lead by example.”
Mr. Seddio gave The Daily News two estimates from that night; he put the party’s attendance at roughly a dozen, and, oddly, the number of times he passed gas at four. He did not respond to a request for comment.
Those We’ve Lost
Nelly Kaplan, whose witty, satire-tinged French films about female empowerment and revenge made her a distinctive voice in a male-dominated era, died on Nov. 12 in Geneva. She was 89.
The Société des Réalisateurs de Films, the French filmmakers’ association, announced her death on its website. French news agencies, quoting a relative, said the cause was Covid-19.
Ms. Kaplan, who was born in Argentina, arrived in Paris in her early 20s and became both a filmmaking and a romantic partner of Abel Gance, the French director known for the innovative silent movie “Napoleon” (1927). In 1969 she drew acclaim with her first feature, “A Very Curious Girl.” (The French title was “La Fiancée du Pirate,” or “The Pirate’s Fiancée.”)
It starred Bernadette Lafont, an actress already well known from the New Wave films of Claude Chabrol and others, as Marie, a young servant who is preyed upon by men in her village until she turns the tables on them by charging for sexual favors and tape-recording the encounters, ultimately exposing the townspeople’s hypocrisy.
That film was the centerpiece of “Wild Things: The Ferocious Films of Nelly Kaplan,” a retrospective at the Quad Cinema in Manhattan in 2019 that helped fuel a new appreciation of her work and her characters.
“While very much of its time, ‘A Very Curious Girl’ remains amazingly fresh after 50 years,” the film critic J. Hoberman wrote in The Times then. “Marie’s triumph is not just a victory for her sex and class but, given the explicitly xenophobic nature of the smug patriarchal order that she upends, a win for outsiders and outcasts of all varieties.”
Ms. Kaplan made only a few feature films after that, and none achieved the level of acclaim that her debut did.