The day was still young when Dr. Robert Redfield, the head the Centers for Disease Control and Preventions, took the virtual stage at a business group gathering and offered the starkest of warnings about the months of pandemic ahead.
“I actually believe they’re going to be the most difficult time in the public health history of this nation,” Dr. Redfield declared to the Chamber of Commerce Foundation on Wednesday morning.
As the day unfolded, the numbers did nothing to undercut him.
First, Americans learned in the afternoon that the number of people in the hospital for Covid-19 was more than 100,000. That was nearly double the high point in spring, when the pandemic hit its first peak, according to the Covid Tracking Project.
Then, not long after evening fell, the U.S. recorded its greatest daily death toll ever: 2,760, with no sign of a letup. That surpassed the record set in April, when the pandemic hit its first peak in the country. And with hospitals filling, the days ahead seemed all too clear.
“If you tell me the hospitalizations are up this week, I’ll tell you that several weeks down the road, the deaths will be up,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston.
Dr. Redfield told the Chamber of Commerce Foundation that the winter might prove devastating, and that perhaps by February, 450,000 Americans might be dead. (The number now is about 273,000.)
But the C.D.C. head seeded his caution with a grain of hope. Americans, he said, could reduce their losses through simple measures like wearing a mask.
“It’s not a fait accompli,” he said. “We’re not defenseless. The truth is that mitigation works. But it’s not going to work if half of us do what we need to do. Probably not even if three-quarters do.”
For all the similarities to the spring pandemic peak, there are some profound differences.
In April, the virus and the deaths were concentrated in New York and New England. Today, the pandemic’s toll is being felt across the country.
Still more sobering: The April peak represented the worst moment of spring. It was followed by a decline in deaths as lockdowns were imposed and many Americans altered their behavior.
And as staggering as it is, the death toll reported Wednesday appears likely only to worsen, experts say, as the delayed effects of Thanksgiving travel are felt. And many Americans are now weighing how to celebrate Christmas and New Year’s.
“This is a much worse situation,” said Dr. Ashish Jha, dean of Brown University’s School of Public Health. “Summer is not going to bail us out. Things are not shut down.”
There are other differences from the spring, some more hopeful.
Though coronavirus cases have exploded recently, with new infections topping one million a week, a far smaller proportion of people who get the virus these days are dying from it. National data from the Centers for Disease Control and Prevention shows that the share of cases resulting in death dropped from 6.7 percent in April to 1.9 percent in September.
But over all, deaths in the United States are still climbing.
“It’s terrible, because it was avoidable,” said Dr. Leora Horwitz, an associate professor of population health and medicine at the N.Y.U. Grossman School of Medicine. “We are a world outlier in this regard.”
As hospitals fill with virus patients, the biggest need has been finding enough staff to tend to the critically ill. Demand for travel nurses has increased by more than 40 percent in the last month, according to Aya Healthcare, an agency based in California that dispatches them to hospitals. At least 25,000 nurses work in travel nursing, taking up temporary contracts for higher fees and moving from city to city, and hospitals have depended on them for decades.
Laura Liffiton, 32, one of those travel nurses, found herself racing along behind the pandemic as the coronavirus cut a devastating path around the country.
She arrived in New York City in April, on one of the worst days of the pandemic, for a stint as a nurse in the overrun intensive-care unit of a crowded hospital. After her contract there ended, she flew in July to another hot spot with an urgent need for nurses: a hospital in Arizona where four of her patients died of the coronavirus on her first day. In October, Ms. Liffiton traveled on, to Green Bay, Wis., just as the virus was surging uncontrollably throughout the Midwest.
“When the pandemic began, I thought, ‘I’m going to go help, I can do some good, I can make some good money,’” she said. But on the first day of treating coronavirus patients, Ms. Liffiton remembered, “I was like Dorothy landing in Oz. I was totally unprepared for the reality.”
As the coronavirus has spiked across the country, leaving a record 100,226 Americans hospitalized on Wednesday, travel nurses, have become more urgently needed than ever.
Three former presidents — Barack Obama, George W. Bush and Bill Clinton — have said they would be willing to get a vaccine for Covid-19 publicly to help ensure public confidence in its safety, once a vaccine is approved for use in the United States.
“I promise you that when it’s been made for people who are less at risk, I will be taking it,” Mr. Obama said during an interview with SiriusXM’s Joe Madison, set to air Thursday. “I may end up taking it on TV or having it filmed, just so that people know that I trust this science, and what I don’t trust is getting Covid.”
During the interview, Mr. Obama said he understood why some members of minority groups might be skeptical of being vaccinated, pointing to the history of medical abuse and the mistrust it has engendered among Black people. Among the abuses was the 40-year-long Tuskegee study in which officials from the U.S. Public Health Service allowed Black men infected with syphilis to go untreated.
Mr. Obama also discussed the disproportionate number of coronavirus cases and deaths among Black, Hispanic and Native American people. Black and Latino residents are about three times as likely to be infected with the coronavirus and about twice as likely to die from it.
It could take until May or June, according to federal officials, for a vaccine to become more widely available to the general public beyond those who are most at-risk and certain priority groups such as health care workers.
President Bush’s chief of staff, Freddy Ford, told CNN on Thursday that the former president had reached out to public health officials to see how he could help promote the vaccine.
“First, the vaccines need to be deemed safe and administered to the priority populations,” Mr. Ford told the news outlet. “Then, President Bush will get in line for his, and will gladly do so on camera.”
President Clinton’s press secretary, Angel Urena, told CNN that the former president would also be willing to take the vaccine publicly as soon as it was available to him.
“And he will do it in a public setting if it will help urge all Americans to do the same,” he said.
Nearly a year into the pandemic, some 192 million tests for the coronavirus have been processed in the United States, and millions more will be needed in the months ahead. Behind these staggering figures are thousands of scientists who have been working nonstop to identify infections.
Across the nation, testing teams are grappling with burnout, repetitive-stress injuries and an overwhelming sense of doom. As supply chains sputter and laboratories rush to keep pace with demand, experts warn that the most severe shortage is not one that can be solved by a wider production line or a more efficient machine. It is a dearth of human power: the dwindling ranks in a field that much of the public does not know even exists.
“There’s signs everywhere that say, ‘Heroes work here,’” said Elizabeth Stoeppler, a senior medical technologist in the molecular microbiology lab at the University of North Carolina’s School of Medicine. “But nobody sees us. We’re just in the basement, or in the back.”
As tests inundate labs across the nation, testing teams are grappling with a surge unlike anything they’ve seen before.
Joanne Bartkus, the former director of the Minnesota Department of Public Health Laboratory, said her team went from receiving less than a dozen coronavirus testing samples on a daily basis in March to about 1,000 daily specimens. (During the H1N1 flu pandemic in 2009, the laboratory tested only about 6,000 specimens.)
The intricacies of the method called polymerase chain reaction, or P.C.R., which has been heralded as the golden standard in coronavirus diagnostics, has presented one unique challenge. But others are more straightforward: Technologists often have to repair instruments that have been running almost nonstop during the pandemic, a frequency they are not designed for.
The pressure of processing hundreds of tests as well as working 10-plus-hour shifts has led to burnout among technologists and health issues. Some technologists leave their jobs altogether, leaving vacancies scientists are scrambling to fill.
Because the number of tests seems unlikely to decline anytime soon.
Nearly a half-million South Korean high school seniors hunkered down on Thursday to take an annual university entrance exam they had been preparing for since kindergarten — a nine-hour marathon of tests that could decide their futures.
But this year, the government had to ensure the exam did not become a super-spreader event for the coronavirus.
For days, health officials in full protective gear had repeatedly disinfected 31,000 classrooms where the exam was to take place.
All students had to get their temperature taken before entering the classrooms. They sat at desks separated by plastic dividers and wore masks throughout the test.
Government-run health clinics stayed overnight to test students and screen anyone infected with the virus at the last minute. Those with a fever or sore throat were escorted to separate rooms to take their exams. At least one student showed up in full protective gear for fear of catching the coronavirus.
“I came early because I feared that I might be caught in a traffic jam,” another student, Kim Mun-jeong, told the cable channel JTBC. “I also wanted to check into the test-taking room sooner than other students to get myself familiarized with it and gain composure.”
In this education-obsessed country, it’s hard to overestimate the importance of the College Scholastic Ability Tests, or suneung, in the life of a South Korean student.
Most universities select their students based largely on the test scores of the single standardized year-end exam. Diplomas from a few top universities like Seoul National can make a huge difference when applying for jobs and promotions. Many students who fail to enter the universities they covet take the tests again and again in the following years, often living and studying in institutes with militarylike discipline.
Exam day is also a day when the country collectively wrings its hands and much of life is put on pause.
All banks, businesses and government offices delayed opening their doors by an hour to lessen road traffic. All planes were grounded and all military guns silenced for half an hour for fear they might interrupt students focused on an English listening-comprehension test. In the Jogyesa Buddhist temple in Central Seoul, parents lit candles and burned incense as they prayed for the success of their children taking the exam.
The pandemic has added new twists and an extra layer of anxiety and suspense to the grueling test. South Korea is grappling with a third wave of coronavirus infections, with health officials reporting some of the highest daily caseloads the country has seen. In the past week, the country has reported 438 to 581 new cases per day, including 540 on Thursday.
Drive through a leaf-strewn forest and past a charming street market in Epping, about 20 miles northeast of London, and a jarring sight appears: black London taxis, parked bumper-to-bumper by the hundreds in a muddy field, surrounded by beehives and a barn for raising squab pigeons.
It’s a camera-ready monument to the economic devastation wrought by the pandemic. The cabs were returned by their drivers to a rental company because of the collapse in business after Britain went into lockdown last March. As the number of idled taxis piled up, the company ran out of room in its garage and cut a deal with a local farmer to store about 200 of them alongside his bees and pigeons.
“I call it the field of broken dreams,” said Steve McNamara, general secretary of the Licensed Taxi Drivers’ Association, which represents about half of the British capital’s more than 21,500 licensed cabbies. “It’s awful, and it’s getting worse.”
On Wednesday, England emerged from its second lockdown, but severe restrictions remain in effect, and it’s anyone’s guess when central London’s deserted streets will once again fill with office workers, theatergoers and tourists.
As of now, barely a fifth of London’s taxis are currently operating, Mr. McNamara said, and the drivers still on the road are averaging just a quarter of their pre-pandemic fares.
Of 546 N.B.A. players recently screened for the coronavirus, 48 tested positive, the league announced Wednesday, a day after training camps opened for the 2020-21 season.
The league said in a statement that the testing began last week as players started returning to their teams’ cities. The statement did not say which players had tested positive.
“Anyone who has returned a confirmed positive test during this initial phase of testing in their team’s market is isolated until they are cleared for leaving isolation under the rules established by the N.B.A. and the Players Association in accordance with C.D.C. guidance,” the N.B.A. said in its statement.
For the coming season, the league is departing from the so-called bubble environment it established to finish the interrupted 2019-20 season, which was halted for four and a half months before resuming with the players and vital team personnel living together in an isolation zone at Walt Disney World near Orlando, Fla. No player tested positive there after clearing quarantine.
Now, most teams will compete at their usual arenas, except for the Toronto Raptors, who will play in Tampa, Fla., because of travel restrictions between the United States and Canada. Most of the arenas will be devoid of fans, although some may have limited attendance, like the State Farm Arena, home of the Atlanta Hawks.
The regular season is slated to begin Dec. 22 and will last 72 games, 10 fewer than in a typical N.B.A. season.
Britain gave emergency authorization on Wednesday to Pfizer’s coronavirus vaccine, leaping ahead of the United States to become the first Western country to allow mass inoculations against a disease that has killed more than 1.4 million people worldwide.
The decision kicked off a vaccination campaign with little precedent in modern medicine, encompassing not only ultracold dry ice and trays of glass vials but also a crusade against anti-vaccine misinformation.
Britain beating the United States to authorization — on a vaccine codeveloped by the American pharmaceutical giant Pfizer, no less — may intensify pressure on U.S. regulators, who are already under fire from the White House for not moving faster to get doses to people. And it has stirred up a global debate about how to weigh the desperate need for a vaccine with the imperative of assuring people that it is safe.
“Help is on its way with this vaccine — and we can now say that with certainty, rather than with all the caveats,” the British health secretary, Matt Hancock, said on Wednesday, as the government exulted in the authorization.
While the go-ahead bodes well for Britain, it will have no effect on the distribution of the hundreds of millions of doses that other wealthy countries have procured in prepaid contracts.
It also offers little relief to poorer countries that could not afford to buy supplies in advance and may struggle to pay for both the vaccines and the exceptional demands of distributing them.
The Pfizer vaccine, developed with BioNTech, a smaller German firm, must be transported at South Pole-like temperatures, a requirement that could dictate who will be vaccinated first in Britain: Nursing-home residents were supposed to be the top priority under an advisory committee’s plans, but efforts to limit transportation of the vaccine and ensure it remains cold may mean that National Health Service staff will receive the shots first.
The government said on Wednesday that 800,000 doses would be available by next week for health workers to begin administering. For Britain, which has suffered one of Europe’s highest per capita death tolls from the virus, the decision by its drug regulator testified to a vaccination strategy that has been the most aggressive in the West.