The United States reported its 10 millionth coronavirus case on Sunday, with the latest million added in just 10 days, as most of the country struggled to contain outbreaks in the third and most widespread wave of infection since the pandemic began.
Case reports have soared in the last week, shattering records. The seven-day average of new cases now exceeds 100,000 per day, far more than any other country. The United States accounts for about one-fifth of all reported coronavirus cases in the world, a total that is nearing 50 million. In Europe, which accounts for as much or more of the global number, many countries have imposed national or regional restrictions far more encompassing than the limits in force in patches of the United States.
The American surge comes at the approach of a holiday season when many people will be weighing whether to travel and attend indoor gatherings with friends and relatives — situations where the risk of virus transmission is high, public health experts say.
The Centers for Disease Control and Prevention recommends that people take into account how fast the virus is spreading in each community as they weigh the risks of traveling or of hosting out-of-town guests. As of Saturday, transmission rates in 44 states and Puerto Rico were high — above 15 new cases a day for every 100,000 people — and rising, according to a New York Times database.
The Great Lakes, Great Plains and Mountain West states are where the virus has been spreading the fastest recently. North Dakota, South Dakota and Wisconsin have led the country for weeks in the number of new cases relative to their population, and Iowa has recently shot up to match Wisconsin. Daily new case reports in Minnesota have doubled since Halloween, prompting the state health department to warn residents last week that even small gatherings pose risks of transmission.
When the country reached the million-case mark in late April, the virus was more concentrated geographically — the New York area and the West Coast were the main hot spots — but outbreaks were surfacing elsewhere in vulnerable settings like nursing homes, prisons and meat packing plants. Shutdowns intended to rein in the virus had thrown more than 26 million Americans out of work, and many governors were impatient to ease restrictions despite warnings from public health experts that it was too soon.
Six weeks after reaching a million cases, the nation passed the two million case mark. It took four weeks to add the third million, and less than three weeks each to add the fourth and fifth, as states in the Sunbelt struggled following early reopenings. By the end of August, the pace had slowed slightly, and the nation was taking three weeks or more to pass each million-case milestone.
That changed in mid-October, when the virus began surging again across much of the country. The ninth million followed the eighth by just over two weeks, and now the 10th has taken just 10 days.
Covid-19 deaths are also on the rise, though not yet as steeply as case reports. As of Sunday afternoon, more than 237,000 people had died from the virus in the U.S., and the seven-day average of deaths per day was over 900 for the first time since August. The Centers for Disease Control and Prevention predicts that the toll could reach 256,000 by Nov. 21.
Gov. Andrew Cuomo of New York said he thinks that Joseph R. Biden Jr.’s election will cause governors and other leaders to “take a different tone.”
“I think the political pressure of denying Covid is gone,” he said Sunday on the ABC program “This Week.” “I think you’ll see scientists speak with an unmuzzled voice now,” the governor said.
As coronavirus outbreaks rage in the United States at harrowing new levels, President-elect Joseph R. Biden Jr. said in a victory speech Saturday evening that he would announce a Covid-19 task force on Monday.
Mr. Biden, who made criticism of President Trump’s handling of the pandemic a centerpiece of his campaign, left no doubt that the virus was his first priority.
“Our work begins with getting Covid under control,” he said.
Mr. Biden is expected to name three co-chairs of the 12-member panel: Vivek Murthy, a former surgeon general, who has been a key Biden adviser for months and is expected to take a major public role; David Kessler, a former commissioner of the Food and Drug Administration; and Dr. Marcella Nunez-Smith, a Yale University professor.
The announcement of the task force would be part of a weeklong focus that Mr. Biden intends to place on health care and the pandemic, as he begins the process of building his administration, a person close to the transition said.
During the campaign, Mr. Biden repeatedly assailed Mr. Trump’s handling of the pandemic, his refusal to wear a mask and his downplaying of the threat from the virus, which has spread across the country.
“I will spare no effort, none, or any commitment to turn around this pandemic,” Mr. Biden said Saturday.
But Mr. Trump, who has largely shuttered the White House Coronavirus Task Force and has repeatedly told voters that the country was “rounding the corner,” is not due to leave office for two more months. And with U.S. cases now exceeding 10 million and surges reported much of the country, the pandemic shows every sign of exploding further in that period, deepening Mr. Biden’s challenge.
Mr. Biden has vowed that on Day 1 of his administration, he will move rapidly to confront the pandemic by appointing a “national supply chain commander” and establishing a “pandemic testing board,” similar to Franklin D. Roosevelt’s wartime production panel.
His aides have assembled a group of roughly two dozen health policy and technology experts to look at the development and delivery of a vaccine, improvement of health data and the securing of supply chains, among other issues.
Aides said Mr. Biden would use the power of the presidency to invoke the Defense Production Act, a Korean War-era law, more aggressively than Mr. Trump has, to order businesses to build up stocks of necessary supplies.
While Mr. Biden would like to see a national mask mandate, his advisers have concluded that he does not have the legal authority to impose one. So he will try to increase mask wearing in other ways. He has already said that, as president, he would require masks on all federal property, using an executive order that could have wide reach and is likely to come in the first hours or days of his presidency.
In addition to mandating masks in federal buildings, Mr. Biden has said he would require them on “all interstate transportation.”
As he campaigned for the presidency, Joseph R. Biden Jr. spent months sequestered in his home in Delaware, and when he began holding live rallies, they were distanced, careful affairs. The Democratic National Convention was largely virtual. Even the jubilant crowd for his speech on Saturday, the day his victory in the election became clear, wore masks and largely observed social distancing.
But what will his inauguration look like?
When the president-elect takes office in January, the coronavirus pandemic may well be at its apex, Dr. Scott Gottleib, a former commissioner of the Food and Drug Administration, said on Sunday.
New cases in the country are surging, pushing the total reported in the pandemic past 10 million; hospitals are filling up; and there are few signs that anything is likely to change the trend for the better before Inauguration Day.
“We’re going to be right in the thick of probably the worst part of this epidemic wave that we’re going through right now,” said Dr. Gottlieb, who served under President Trump, in an appearance on the CBS program “Face the Nation.”
As Mr. Biden “takes office, we’ll be coming down to the other side of the epidemic curve, hopefully,” he said. “And the only question is going to be, how many people have died in the course of this and how many people have been infected?”
Congress’s inauguration committee is still planning for an “outside, full-scale” event, according to Senator Roy Blunt, Republican of Missouri, who chairs the joint Senate-House panel that organizes the ceremony.
On ABC’s Sunday show “This Week,” Mr. Blunt said the election was not over because of the legal challenges still pending. The senator also said that he expected to see “both Vice President Biden and President Trump on the stage on Inaugural Day, and that’ll be a powerful message no matter which one of them is sworn in.”
The platform for the ceremony is already under construction outside the Capitol Building. “It’s easier to scale back than scale up,” Mr. Blunt said.
Dr. Gottlieb said that pandemic precautions would probably mean that there will be no large crowds of tens of thousands or hundreds of thousands of people.
The Biden team has “shown they’re willing to forgo the usual trappings of running for office so that they don’t expose people unnecessarily,” he said. “I suspect they are going to take a similar approach to how they handle the inauguration.”
Schools in a province that includes Cambodia’s capital, Phnom Penh, will shut again for two weeks to curb any potential spread of coronavirus from Hungary’s foreign minister, who led a delegation to the Southeast Asian country last week and tested positive for coronavirus the day he left.
The country is anxious to keep the virus out. It has logged only 294 coronavirus cases for the entirety of the pandemic and no deaths, according to a Times database.
The schools, which closed in March, had a limited reopening last Monday. But now, as a precaution, classes at public and private schools in Kandal Province will move back online, the education ministry said, according to local media. The authorities decided on the closures after officials were unable to gather sufficient information from about 900 parents and guardians of students who interacted with the Hungarian delegation during the visit.
The Hungarian foreign minister, Peter Szijjarto, met with Cambodian officials, including the Prime Minister Hun Sen of Cambodia, on Tuesday, the last day of the visit. Mr. Szijjarto then flew to Thailand, where he tested positive. He was quarantined and evacuated back to Hungary on Wednesday. So far, only a Cambodian bodyguard who had contact with Mr. Szijjarto has tested positive, the Cambodian health ministry said on Saturday.
But the Cambodia’s prime minister, Hun Sen, said the country should take no risks.
“I regard this matter as a severe problem for Phnom Penh, and I ask the Phnom Penh authority, the health sector, ministries, institutions and media covering Szijjarto to quarantine their staff,” Mr. Hun Sen said, according to the Phnom Penh Post on Sunday. “If not, the risk is very high for our country.”
Prime Minister Hun Sen said that he had tested negative, and that he and other ministers who met Mr. Szijjarto would quarantine for two weeks.
He also described the precautions he was taking to the Phnom Penh Post, including reducing time in his office and at home staying largely in two rooms. He said all documents that he received or sent were sprayed with antiseptic, and that workers at his house wore gloves.
The mutation of the coronavirus in mink, which has caused Denmark to order the killing of all farmed mink, has sharpened the worry among scientists that the pathogen could spread to other wild and domestic animals.
The most disturbing possibility is that the virus could mutate in animals and become more transmissible or more dangerous to humans. In Denmark, the virus shifted from humans to mink and back to humans, which is when a mutation that could potentially undercut the effectiveness of a vaccine was discovered.
Thus far, mink are the only animal known to have been infected by the virus and then passed it back to humans, but scientists have been actively investigating the potential for coronavirus infections in other wild and domestic animals, concerned that the virus could become permanently established in a wild species.
“The last thing we need is for SARS-CoV-2 to move into an animal reservoir from which it could re-emerge,” Tony Goldberg, a veterinarian at the University of Wisconsin, Madison, said.
Genetic studies suggest that chimpanzees, other apes and old world monkeys are among the species most susceptible to the coronavirus. Chimpanzee reserves and sanctuaries are taking increased precautions to avoid humans infecting the animals. Among domestic animals, dogs and cats can become infected, but they exhibit little if any illness, and there are no known cases of pets passing the virus back to humans.
Many scientists are actively monitoring wild populations of bats and other animals for any sign of coronavirus infection.
Kate Sawatzki, the animal surveillance coordinator for a testing project in pets and other animals at the Cummings School of Veterinary Medicine at Tufts University, said: “To date, we have tested 282 wildlife samples from 22 species, primarily bats in New England rehabilitation facilities, and we are happy to report that none have been positive.”
Early in the pandemic, medical researchers rallied around a hypothesis to explain why many coronavirus patients were ending up in the hospital with injured lungs and other organs, struggling to breathe: Perhaps a severe immune reaction, called a cytokine storm, was the culprit.
But several recent studies have now cast doubt on aspects of that idea, revealing that certain drugs administered to quell supposed cytokine storms are not nearly as effective as originally thought.
In a cytokine storm a body’s defenses go rogue, spewing out powerful compounds — cytokines and other drivers of inflammation — that fatally damage tissues and organs. The hypothesis was that such storms could explain why some patients who died from Covid-19 were found to have little or no virus in their bodies, because their immune systems eliminated it.
Attention focused on one cytokine in particular, interleukin-6, or il-6. Early reports from China and Italy indicated that administering drugs that blocked il-6 helped some coronavirus patients recover. Anti-il-6 drugs quickly became a standard of care at many hospitals for treating Covid-19.
But rigorous studies are failing to find that anti-il-6 drugs are effective for this purpose. Two published in JAMA Internal Medicine and one in the New England Journal of Medicine found no evidence that a commonly used il-6 inhibitor, tocilizumab, a rheumatoid arthritis treatment, reduced the death rates in severely ill coronavirus patients.
A review of five existing studies by Dr. Carolyn Calfee, an intensive care medicine specialist at the University of California in San Francisco, found that il-6 levels of seriously ill coronavirus patients were not even highly elevated compared with levels in other critically ill patients.
Dr. Calfee noted that the cytokine storm hypothesis, while colorful, was vague, lacking diagnostic criteria that would show that such a thing was taking place. “It has no definition,” she said.
She added that the new findings should be teaching doctors a lesson: “We have to be really humble about biologic complexity.”
As the coronavirus devastates New York City’s retail economy, making it hard for stores to pay rent, co-op buildings with ground-floor stores are losing a vital source of income. Already stressed co-op shareholders have had to pick up the slack, in some cases with maintenance charges increasing by as much as 40 percent.
“It’s a huge problem,” said Michael Wolfe, the president of Midboro Management, who added that residents are grumbling about the extra costs, as they also struggle with reduced work, furloughs and layoffs.
But Mr. Wolfe said that most residents realize that “anything is better than a vacancy,” adding that co-ops would face long odds at finding replacement tenants during the pandemic.
Also driving the decision to accommodate stores rather than evict them is a desire to preserve the convenience of having on-site shops, board members say. Other co-ops want to preserve jobs of employees who have become like family members after years of operating businesses under the same roof, like at 230 West 105th Street, a 14-story co-op.
Its board has hiked maintenance fees 15 percent, which for a one-bedroom means a jump to about $1,400 from $1,200 a month, to make up for discounts offered to the four stores that ring the prewar building’s base. That aid, which is benefiting a clothing store, coffee shop, deli and cobbler, is the equivalent of as much as a 50 percent rent cut, according to the board.
“One shareholder called the move unconscionable,” said Robert Chasen, the treasurer of the 70-unit doorman building. According to Mr. Chasen, about half of the apartments in the building are occupied by people on fixed incomes or who are working class.
“But most neighbors say they are supportive,” he said. “These stores contribute to our neighborhood.”
Queen Elizabeth II of England was seen wearing a face mask for the first time on Wednesday at a private ceremony during the prelude to Remembrance Sunday, which mourns the British and Commonwealth troops who have died in conflicts.
Wearing a black mask with white edging, the queen supervised the laying of a bouquet of flowers on the grave of the Unknown Warrior as a “personal tribute,” according to a statement from Buckingham Palace. The soldier was buried in Westminster Abbey on Nov. 11, 1920, after the end of World War I, and the grave has become a national symbol of remembrance.
Queen Elizabeth, 94, requested the service, according to the BBC, after learning that Remembrance Sunday events would be scaled down because of coronavirus restrictions. She watched Sunday’s service, which was held in central London, from a balcony. Other senior royals, along with Prime Minister Boris Johnson, also attended the ceremony, which was closed to the public but broadcast online.
The queen’s appearance was her first in public since October, when she and her grandson Prince William met scientists at the Defense Science and Technology Laboratory, the BBC noted. Neither wore face masks on that occasion, though Buckingham Palace representatives said at the time that other precautions had been taken to protect the queen’s health.
Concerns over an outbreak in the royal family grew in March, when Prince Charles, the queen’s son and heir to the throne, tested positive for the coronavirus.
Reports also emerged in British news outlets on Monday that Prince William had contracted the virus in April but did not reveal his diagnosis for fear of alarming the public. His representatives have declined to comment.
Officials have recommended that face masks be worn indoors in England, where a new national lockdown began on Thursday, in an effort to break a second coronavirus surge. Britain averaged about 22,800 new infections a day this past week, according to a Times database. As of Sunday, the country had reported at least 1.1 million cases and 48,888 deaths.
PARIS — On a recent breezy day, Jérôme Callais wrapped a secondhand biography of Robespierre tightly in cellophane, covering the burgundy leather hardcover with an expert flick of the wrist and positioning it near a weighty tome on Talleyrand inside his dark green bookstand above the Seine.
In normal times, Parisiens and tourists from around the world would be browsing his wares, and those of the roughly 230 other open-air booksellers known as “les bouquinistes,” whose boxy metal bookstalls stretch for nearly four miles along the Left and Right banks of the river.
But as lockdown restrictions to curb the coronavirus pandemic keep browsers at bay, the booksellers’ livelihood is in jeopardy. Over four-fifths of the stands are more or less permanently shuttered. Many are bracing for what they fear may be the final chapter for a centuries-old métier that is as iconic to Paris as the Louvre and Notre Dame.
“We’re trying to keep this ship from sinking,” said Mr. Callais, 60, who is also the president of the Association of Bouquinistes. “But Covid has made most of our customers disappear.”
Even before France imposed a new nationwide lockdown last month to combat a resurgence of the virus, the tourists had largely stopped coming. And the beloved Parisien pastime of flânerie — strolling aimlessly to enjoy life — has been all but snuffed out, stifled by curfews and quarantines that have deprived the booksellers of die-hard clients.
Sales have plunged an average of 80 percent this year, Mr. Callais said, throwing many vendors into precarious straits, especially those who milked Eiffel Tower key chains, Mona Lisa coffee mugs and other kitschy souvenirs over books as cash cows when tourists jammed the quais.
David Nosek is one of the bouquinistess trying to stay open. “The bouquinistes have been here since the Middle Ages,” he said. “I’d like to think that the coronavirus won’t finish us off.”
It’s been a year of sacrifice, social distancing and skyrocketing stress. Can we at least enjoy Thanksgiving?
Yes, health experts say, but it will require a little more planning than usual.
For families with a college student heading home for an extended stay — many schools have cut short their semester and won’t resume classes until January — aim to start taking action two weeks in advance. Have your student get a flu vaccine, minimize contact with other people, and consistently wear a mask.
“Once at home, the most cautious recommendation would be to stay physically distant for the first 14 days from other household members, wear a mask, no kissing or hugging, wipe surfaces down and use separate eating utensils,” said Dr. Anita Barkin, a co-chair of the American College Health Association’s Covid-19 Task Force. The group recently released guidelines for returning home that offer risk-reduction strategies for students, day-of-travel suggestions and tips for at-home quarantining.
Public health officials have cautioned against family and friends gathering in homes for the traditional Thanksgiving meal. Homes are now a main source of coronavirus transmission, accounting for up to 70 percent of cases in some areas. A recent study by the Centers for Disease Control and Prevention of 101 households in Tennessee and Wisconsin found that people who carried the virus, most of whom had no symptoms, infected more than half of the other people in their homes.
If you do plan to share the holiday, health experts say, keep the event small. “You don’t want to be the Grinch that stole Thanksgiving,” said Dr. Anthony S. Fauci, the nation’s top infectious disease expert. “But this may not be the time to have a big family gathering.”
And keep the setting well-ventilated. Depending on the home, weather conditions and other variables, research shows that opening multiple windows — the wider, the better, and in every room if possible — can increase the air exchange rate to as much as three times an hour. Move the dinner outside, if possible.
Ask your guests to be vigilant in reducing their contacts and potential exposures for at least a week, and preferably two weeks, before Thanksgiving. Wear masks when not eating, and avoid sharing serving utensils and other hand-held items.
Fran Keller, 52, an entomologist in Davis, Calif., is hosting the first Thanksgiving she can remember — she usually goes to her eldest sister’s, but this year the crowd felt too large for comfort. Joining her will be her son (who lives with her), her daughter and her daughter’s family. They will sit at separate tables because her daughter has asthma.
“I will hug my daughter, but only if it’s OK with her,” Ms. Keller said.