Public health officials in the United States announced more than 152,000 new coronavirus cases on Thursday, the first day over 150,000 since the pandemic began — an alarming record that came just over a week after the country first experienced 100,000 cases in a single day.
The pandemic has risen to crisis levels in much of the nation, especially the Midwest, as hospital executives warn of dwindling bed space and as coroners deploy mobile morgues. More than 100,000 coronavirus cases have been announced nationwide every day since Nov. 4, and six of the last nine days have broken the previous record.
Hospitalizations for Covid-19 also set a record on Thursday, climbing to 67,096, according to the Covid Tracking Project. It was the third straight day of record numbers, and the figure has doubled in just five weeks.
Deaths are rising, too, with more than 1,000 on average each day.
In Illinois, where more than 75,000 cases have emerged in the last week, Gov. J.B. Pritzker suggested that he could soon impose a stay-at-home order.
“We’re running out of time and we’re running out of options,” said Mr. Pritzker, who scolded local officials in parts of his state for disregarding mask rules and restrictions on businesses.
Case numbers are trending upward in 46 states and holding relatively steady in four. No state is seeing cases decline. Thirty-one states — from Alaska and Idaho in the West to Connecticut and New Hampshire in the East — added more cases in the seven-day period ending Wednesday than in any previous week of the pandemic. Vermont, Utah and Oregon were among at least 10 states with single-day case records on Thursday.
But the outlook is especially dire in the Great Lakes region. Pennsylvania, Indiana and Minnesota all exceeded their previous single-day records on Thursday by more than 1,000 cases. Gov. Mike DeWine of Ohio warned that hospitalizations had soared to record levels. Wisconsin surpassed 300,000 known cases this week, an increase of more than 130,000 in just a month.
“Covid-19 is everywhere in our state: It is bad everywhere, and it is getting worse everywhere,” said Julie Willems Van Dijk, the deputy secretary of the Wisconsin Department of Health Services.
Mayor Lori Lightfoot of Chicago announced new restrictions on gatherings on Thursday, limiting them to 10 people whether inside or outside, and issued a non-binding “stay-at-home advisory.” City leaders warned that, without immediate action, Chicago hospitals could soon be overwhelmed.
But patience with coronavirus restrictions has already worn thin in parts of Illinois, where a patchwork of rules and uneven enforcement has frustrated some business owners and politicians.
Mayor Richard C. Irvin of Aurora, the state’s second-largest city, this week questioned whether there was public buy-in for additional restrictions.
“I would say morale is extremely low,” said Mr. Irvin, who has urged residents to take the virus seriously. “I think people — many people, I wouldn’t say all — are to the point where they don’t necessarily care anymore.”
Dr. Anthony S. Fauci, the top infectious disease expert in the United States, urged Americans on Thursday to “double down” on basic precautions as coronavirus cases soared across the country and more Covid-19 patients were hospitalized than ever before.
Appearing on “Good Morning America,” Dr. Fauci reiterated that a nationwide lockdown was unlikely, saying there was “no appetite for locking down in the American public.” But he expressed confidence that virus cases could be reduced without such drastic measures — if Americans “double down” on basic preventive steps, like social distancing and masks.
“I believe that we can do it without a lockdown, I really do,” he said.
Here are three key takeaways about the virus in the U.S. today.
The numbers are grim, and likely to worsen.
Dr. Fauci’s remarks were made just hours before California reported its millionth case on Thursday, the second state to do so (Texas was first). More cases are being recorded than ever before: The 142,000 reported on Wednesday set yet another record as much of the country enters a period of cold weather, indoor life, colds and flus that are expected to add fuel to the contagion.
Even more troubling than the infections are the hospitalization figures, as several parts of the nation report that their hospital facilities and personnel are being stretched beyond capacity. On Wednesday, 65,368 people were hospitalized with Covid-19, a figure that has doubled in little over a month, breaking the record set a day earlier by more than 3,400.
All told, the United States has reported more than 10.5 million cases so far, and more than 241,000 virus-related deaths, the most in the world: The pandemic is killing Americans at a pace of about 1,000 a day.
States and cities are taking more aggressive measures.
Since Election Day, more than a third of the governors across the United States, Republicans and Democrats, have issued public appeals for people to take coronavirus prevention measures seriously, as the latest surge — the biggest so far — washes across the nation. Many also imposed new limits on public and private gatherings.
In many places, the changes are affecting schools and youth activities, even as research is increasingly indicating that children younger than 10 are at less risk of contracting and transmitting the virus.
Detroit’s public school system announced on Thursday that it would shift to online, remote learning until January. New York City is weighing closing its system, the nation’s largest. The governors of seven Northeastern states agreed on Thursday to suspend interstate youth hockey competition for the rest of the year after outbreaks were linked to games.
“Help is on the way,” Fauci says about vaccines in general. “But it isn’t here yet.”
There are signs of hope in scientific developments. The drug maker Pfizer announced this week that its experimental coronavirus vaccine was highly effective, according to an early analysis. Dr. Fauci said on “Good Morning America” that officials hope that “ordinary citizens should be able” to get a vaccine in the spring. Pfizer is expected to submit its data for review to the Food and Drug Administration once it has the necessary safety data next week. No coronavirus vaccine has yet been authorized by the U.S. government.
Moderna, Pfizer’s close competitor, announced on Wednesday that it had also reached a point in its late-stage trial that would allow it to begin analyzing data on its vaccine’s effectiveness. Both companies’ vaccines use the same technology, involving genetic material called mRNA, and both went into large trials on the same date in late July. Pfizer’s study has 44,000 participants, and Moderna’s 30,000.
The accelerating pace of the pandemic has helped to speed up testing for both companies, because researchers have to wait less time to see how many volunteers become infected. While the two companies are the frontrunners at the moment, nine others are pushing ahead with vaccine candidates, including efforts in Britain, China, Russia and Australia, among others.
While companies and government health officials have offered hopeful projections, there is no guarantee that there will not be major delays or failures in the coming months. Pfizer’s vaccine results and other companies’ must still be evaluated for safety over a longer time period, data which aren’t expected to be available until next week. The F.D.A. could take longer than expected to evaluate Pfizer’s results. Complications could arise in what is a complex manufacturing and distribution effort. And supply could be further constrained if other experimental vaccines don’t work as hoped.
In another public appearance on Thursday, at an online forum hosted by the London think tank Chatham House, Dr. Fauci said that he believed that vaccines would soon end the pandemic — although that might not mean the end of the virus, which health experts say could continue to circulate at lower levels.
“Certainly, it is not going to be a pandemic for a lot longer because I believe the vaccines are going to turn that around,” Dr. Fauci said.
But he repeated that basic protective practices remain the most crucial weapon against the virus.
“Help is on the way,” he said, speaking about vaccines in general. “But it isn’t here yet.”
The Ivy League on Thursday canceled winter sports and postponed spring sports, citing spiking coronavirus cases across the United States and student safety.
“Regrettably, the current trends regarding transmission of the Covid-19 virus and subsequent protocols that must be put in place are impeding our strong desire to return to intercollegiate athletics competition in a safe manner,” the league’s council wrote in the announcement on Thursday.
The unanimous decision affects winter sports like basketball, ice hockey, squash, swimming and diving, wrestling and indoor track and field. Additionally, teams in spring sports like lacrosse, baseball and softball will have their seasons delayed through at least the end of February.
Athletes will not lose a year of eligibility whether or not they enroll, the league said, and enrolled student athletes are still permitted to go to practices, “provided they are structured in accordance with each institution’s procedures and applicable state and local regulations.”
Colleges and universities have been linked to at least 252,000 coronavirus cases at more than 1,600 schools and at least 80 deaths, a New York Times survey found.
The Ivy League had put fall sports on hold until January, and on Thursday the conference said it would not stage those seasons during the spring.
Other conferences that had made similar decisions to suspend fall sports have reversed course, taking precautions to keep football afloat through the fall but facing postponements and cancellations because of virus infections. The Southeastern Conference, home to football powerhouses like Alabama and Texas A&M, postponed four games scheduled for this weekend as players and personnel tested positive for the virus.
“It’s a difficult circumstance, no way to paint it otherwise,” the SEC commissioner, Greg Sankey, said in a teleconference with reporters on Wednesday. “But we knew that challenges would emerge for college sports.”
Sankey said other sports — including cross-country, soccer, volleyball and swimming and diving — have taken off without as much disruption; he added that basketball was set to tip off in the next couple weeks.
More than 2,000 nurses in southeastern Pennsylvania are set to go on strike as soon as next week as the United States faces a rising wave of cases in a pandemic that has severely strained the country’s medical system.
Approximately 800 nurses at St. Mary Medical Center in Bucks County will begin a two-day strike on Nov. 17, unless they are able to reach a deal for a new contract with the hospital’s owner, Trinity Health Systems.
In Philadelphia, some 500 nurses at St. Christopher’s Hospital for Children, which is owned by Drexel University and Tower Health, and about 1,000 nurses at Einstein Medical Center, part of the Einstein Healthcare Network, separately voted to authorize a strike but have not yet issued an official notice.
A fourth hospital, Mercy Fitzgerald in Delaware County — also owned by Trinity — reached a contract agreement on Tuesday, a spokesperson for the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP) said. Trinity did not respond to a request for comment.
PASNAP said in a statement released last Friday that its members had been “pushed to the brink by unsafe staffing that seriously undermines patient safety” and that they would take the extraordinary step of striking “to protect their patients and themselves.”
“We’re still exhaling from the first surge, and now we have to inhale again to safely take care of our patients, and of ourselves,” Maureen May, a registered nurse and the president of PASNAP, said in a phone interview.
The nurses, Ms. May said, do not want to abandon their patients now; Pennsylvania has seen a daily average of 3,609 new coronavirus cases over the last week. But PASNAP argues that it would be more irresponsible to continue caring for patients under conditions that they believe are unsafe.
“To take care of a Covid patient, number one, is daunting in itself. And to add two and three and four patients in that mix, because you refuse to staff properly, is just unconscionable,” Maria Plano, an intensive care nurse at St. Christopher’s, said in a phone interview.
“Nobody walked away from what we needed to do. And we won’t walk away now,” Ms. May said. “But we will send a message, via a strike, that you have to do the right thing. This is our message — to the hospitals, to the public — that we’ve had enough.”
Corey Lewandowski, a Trump campaign adviser who has been working on efforts to bring lawsuits contesting the election outcome in several states, tested positive for the coronavirus on Wednesday, a person briefed on the diagnosis said Thursday.
He attended a crowded election night party at the White House that several other people who later tested positive also attended. The latest figure to join their ranks was Jeff Miller, a Republican strategist, according to a person with knowledge of the situation on Thursday.
Several hundred people gathered at the election night event in the East Room for several hours, many of them not wearing masks as they mingled and watched election returns.
Mr. Lewandowski had been in Philadelphia for days since attending the event, and believes he may have contracted it there, the person said.
The other people who had previously tested positive after attending the election night event were: Mark Meadows, President Trump’s chief of staff; Ben Carson, the housing secretary; David Bossie, an adviser to Mr. Trump who is leading the charge on the election-related lawsuits and other efforts; and Brian Jack, the White House political director.
After another event at the White House — a celebration of Mr. Trump’s nomination of Judge Amy Coney Barrett to the Supreme Court on Sept. 26 — more than a dozen aides, reporters and guests who were in attendance or came into contact with people who were there tested positive for the virus. Mr. Trump also tested positive and was hospitalized for a few days in early October.
Richard Walters, the chief of staff of the Republican National Committee, has also tested positive for the virus, according to a person with knowledge with the situation. He did not attend the election night event at the White House.
The proportion of emergency room visits related to children’s mental health has increased significantly during the pandemic, highlighting concerns about the psychological effects that lockdowns and social distancing have had on American youth, according to a new analysis released on Thursday by the Centers for Disease Control and Prevention.
As states locked down to prevent the spread of the coronavirus and schools turned to remote learning, the number of emergency room visits for mental health reasons rose 31 percent among children ages 12 to 17, from March through October, compared with the same period last year, according to the C.D.C. study.
For children 5 to 11 years old, the visits increased 24 percent.
In addition to coping with the adjustments that come from having school online, many children are dealing with anxiety about the virus and the fear of potentially losing someone they love. Sports and other group activities have been canceled, depriving them of an easy way to release stress and be around their peers and friends. All these changes can lead to issues like anxiety, sleep disruption, sadness and unhealthy eating.
The C.D.C. study looked at hospitals in 47 states, representing nearly three-quarters of the country’s emergency room visits.
The increase in the proportion of mental health-related visits may have been influenced by the overall decline in emergency room visits during this period, the C.D.C. noted, as people avoided hospitals when possible to prevent exposure to the coronavirus.
In 2019, one out of 85 pediatric visits to these hospitals from mid-March through mid-October were mental-health related. This year, that number rose to one in 60 visits, according to the study. In 2019, there was an average of 262,714 pediatric emergency room visits weekly during this period, and 3,078 mental-health related visits. In the same period of 2020, there was an average of 149,055 visits weekly during these months, and 2,481 were mental health-related.
The proportion of such emergency room visits was higher among young girls than boys, according to the C.D.C.
Children may be relying more on emergency room treatments, the study noted, because it is more difficult to access mental health services from schools and community agencies that have turned remote during the pandemic.
The study also likely underestimates the overall mental health toll of the pandemic on children, since many families seek mental health care outside of emergency rooms.
California recorded its millionth confirmed coronavirus case on Thursday, becoming the second state, after Texas, to reach that grim milestone.
Citing an alarming increase in cases, San Francisco this week banned indoor dining at restaurants and paused a plan to reopen schools. In Los Angeles, residents have flocked in recent weeks by the thousands to the parking lot of Dodger stadium, one of the largest testing sites in the nation. In Sacramento, the number of people hospitalized with the virus has doubled to 158 in just the past two weeks.
And in San Diego, where rising cases pushed the city to the most restrictive level of the state’s guidelines, indoor activities will be banned as of Saturday in churches, gyms, yoga studios and movie theaters.
“This is one of the most precious, dangerous and fragile moments in our fight against Covid-19,” Mayor Eric Garcetti of Los Angeles said during an evening briefing this week. “This should be a bright flashing light to all of us, to control our behavior, to not do stupid things.”
California has had almost as many cases per person as France or Brazil, among the hardest-hit countries, and nearly three times as many as Germany. From its early and aggressive lockdown in March to the wave of infections that came after Gov. Gavin Newsom reopened the state’s economy in June, California has been whipsawed by the pandemic and the economic pain imposed on its economy, the country’s largest.
The recent surge has come after months of low infection rates aided by unseasonably hot weather in September and October that allowed Californians to meet each other outdoors. Experts are concerned that a cold snap now affecting many parts of the state as well as the arrival of winter rainstorms will contribute to a further rise in infections.
When its large population is taken into account, California is 30th in the nation in per-capita deaths from the virus and 37th in cases, according to The New York Times database.
More than 18,000 people have died from the disease in California, the third-highest toll in the country after New York and Texas.
Representative Don Young of Alaska, the longest-serving member of the House and its oldest member, said on Thursday that he had tested positive for the coronavirus, making him the most senior lawmaker to be affected by the rapidly spreading pandemic.
“I am feeling strong, following proper protocols, working from home in Alaska, and ask for privacy at this time,” Mr. Young, 87, wrote in a tweet. “May God Bless Alaska.”
Details of his condition were not immediately forthcoming, and it was not clear what test he had taken. Given his age, Mr. Young was at elevated risk for of getting severely ill.
The congressman, a Republican, had made headlines early in March when he dismissed the virus as the “beer virus” — an apparent reference to Corona beer — and urged Alaskans to take it in stride.
“It attacks us senior citizens,” he said at the time. “I’m one of you. I still say we have to as a nation and state go forth with everyday activities.”
The state, which managed to keep cases vanishingly low through the middle of the summer, has seen a sharp rise in the prevalence of the virus since the beginning of October. As the situation worsened across the country, Mr. Young adopted a more serious tone, but he told Alaska Public Media in September that he did not require masks at campaign events, saying “that’s self responsibility.”
Mr. Young was just elected to his 25th term in the House after fending off a stiff challenge from a political independent.
He is the latest of two dozen or so members of Congress to test positive for the virus since the spring. A handful of them contracted the virus after attending President Trump’s reception at the White House to announce Justice Amy Coney Barrett as his Supreme Court nominee. But Mr. Young had been in Alaska in the run-up to the election and was unlikely to return to Washington anytime soon.
The House has adopted special pandemic-era rules to allow lawmakers to vote remotely by proxy, but nearly all Republicans have refused to use the system.
Once infected by the coronavirus, people who are older than 85 years old are hundreds of times more likely to die from Covid-19, the disease caused by the virus, than those who are under the age of 40.
The coronavirus is tearing across the United States at a pace that is more fierce than ever. Hospitals are filled to perilous levels. More than 120,000 new cases are being identified every day. And ever higher and more miserable records — of cases in states, of positive testing rates, of hospitalizations — are being set, day after day.
A pandemic that was once raging in New York and later across the Sun Belt is now spread so widely across the country that any number of cities and states might now be considered the worst off, depending on the measurement used.
The Minot, N.D., area has seen more cases per capita in this upsurge than anywhere in the country. Wisconsin’s outbreak has escalated more rapidly than those in other states. The county that includes Los Angeles has reported more Covid-19 cases since the pandemic’s start than anywhere else. Texas has the most cases of any state, and the most cases reported on college campuses.
The list of deeply troubled locations — each with its own, different gauge of the problem — goes on and on. If anything, the sheer number of hot spots comes as a reminder of how widespread this outbreak has grown.
“The entire country is out of control,” said Dr. Dara Kass, an associate professor of emergency medicine at Columbia University Irving Medical Center in New York who treated numerous Covid-19 patients this spring and had the virus herself. “When you see the Dakotas and Montana and Oklahoma and Utah and Iowa and Texas — all these states — overrun with cases, it’s jarring to know that no matter what we do here, it’s going to depend on the action or inaction of leadership and people everywhere else.”
Mayor Bill de Blasio of New York is on the brink of shutting the city’s public schools, where about 300,000 students are in classrooms, as the city faces the major new wave of coronavirus infections that is sweeping the country.
Transmission of the virus in schools has been strikingly low, with a positive-test rate of just .17 percent according to the most recent data, prompting one of the city’s top health officials to declare that the public schools are among the safest public places around. The city’s success at curbing the outbreak after the devastating and lethal wave in the spring had made it the envy of the country.
But the mayor could order the schools closed again by Thanksgiving, if not sooner, city officials say. The move — which is now regarded by some City Hall officials as a question of when, not if — would be perhaps the most significant setback yet for the city’s recovery since the bleak days of spring, when it was a global center of the pandemic and all the schools were shuttered.
New York’s agonizing decision reflects a divisive debate raging in almost every country over the importance of reopening schools while the outbreak grinds on. That fight has sometimes seen parents, teachers, politicians and epidemiologists stake out conflicting positions and has raised difficult questions about the health threats of returning schoolchildren to classrooms — and the educational and economic risks of keeping them out.
Mr. de Blasio has said he would close schools again if 3 percent or more of all coronavirus tests taken in the city turned out positive. On Thursday, Mr. de Blasio said the seven-day average rate of positive test results citywide was 2.6 percent.
“Closing the schools would probably be the single policy most likely to jolt the public into realizing how serious this current situation is,” said Mark Levine, who chairs the City Council’s health committee. “If you recall the spring, it was that moment when we closed the schools when the city really said, ‘Oh, my God, this is real.’”
The city’s approach stands in stark contrast to the strategy adopted in much of Western Europe, where keeping schools open has been a political and societal priority, even as governments have imposed strict lockdowns on public life, shutting or imposing restrictions on restaurants, bars, museums and theaters.
But New York City, which may close its classrooms before it halts indoor dining and office work, has adopted a policy typical of many big American cities. Gov. Andrew M. Cuomo, not the mayor, has the power to prohibit indoor dining; on Thursday, several Democratic candidates for mayor, including Scott M. Stringer, the city comptroller, pushed for a pause.
Last month, Boston canceled in-person classes, which had been offered to high-needs students for just a few weeks. On Tuesday, Philadelphia shelved plans to reopen schools later this month. Both those cities still allow some indoor dining. San Francisco, which paused indoor dining this week, has never reopened its schools for in-person instruction, despite a low transmission rate.
As the predicted fall surge of coronavirus cases engulfs much of the country, the picture for the nation’s schools looks grim. Many schools that reopened this fall are now closing their doors, while others that began the year remotely with hopes of reopening later in the semester are delaying those plans.
The Detroit Public Schools system is among the latest districts to suspend in-person instruction, announcing on Thursday that it would switch to remote learning starting on Monday, and stay with it until Jan. 11, citing the city’s rising positivity rate. As of Monday, Detroit’s seven-day-average positivity rate was 6 percent.
Roughly 10,000 of Detroit’s 50,000 students had chosen to attend school in person. Because of the district’s deal with its teachers, which allowed teachers to choose between teaching in-person or online, some of those students were not actually in classrooms with their teachers, but were receiving online instruction under supervision from other school staff.
In Iowa, where cases have nearly tripled over the last two weeks, multiple districts — including Des Moines, West Des Moines and Iowa City — received waivers from the state this week to switch to remote learning.
In New Jersey, where cases are also increasing precipitously, the East Brunswick Community Schools district, which has been operating on a hybrid model, announced this week that it would be going remote starting Monday and remaining so through Jan. 11.
Meanwhile, several districts have put reopening plans on hold, including Philadelphia; Washington, D.C.; Boston; Anchorage, Alaska; and Minneapolis. Chicago has not set a date for students to return to classes.
Many of the cities where schools are closing or remaining closed still allow for some indoor dining or allow bars to operate, a dichotomy that health experts have seized on as epitomizing the country’s misplaced priorities.
Restaurants, bars and other venues are known to be at a higher risk for transmission than schools, said Dr. Jennifer B. Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security.
“The growth, development and well-being of our children have been deeply harmed by these school closures,” she said. “We should make the safe operation of schools our top priority and do whatever is needed to bring case numbers to where they need to be to allow schools to stay open.”
NEW YORK ROUNDUP
Officials in New York urged residents on Thursday to fight their pandemic fatigue and adhere to precautions and restrictions, including the state’s newly announced limits on private gatherings and earlier closing times for restaurants, bars and clubs.
“Every single thing you do matters,” Mayor Bill de Blasio of New York City said at a news conference on Thursday. “You can stop the disease from being transmitted by doing the right thing, or you can inadvertently transmit the disease by doing the wrong thing.”
On Thursday, Mr. de Blasio said the seven-day average rate of positive coronavirus test results citywide was at 2.6 percent, coming closer to the 3 percent threshold that he has said would prompt him to shut down the city’s public schools. The positivity rate has been rising consistently lately, and is up more than one percentage point from a month ago.
Mr. de Blasio has warned that the city is edging toward a much-feared second major wave of the virus, though he has also said it is not yet too late to reverse the trend.
The new restrictions Gov. Andrew M. Cuomo announced on Wednesday were among its broadest efforts to blunt the spread of the virus since the devastating first wave of infection in the spring, when tens of thousands of people died. The measures, which take effect on Friday evening, limit private indoor gatherings to 10 people. Gyms, restaurants and bars must close at 10 p.m., though restaurants can provide continue to provide takeout and delivery service later than that.
Mr. de Blasio said Thursday he had spoken with Mr. Cuomo about the rules, and that the city would work to enforce them, without giving details. But the restrictions would be most effective, he said, if city residents bought into them.
Mr. Cuomo, who on Thursday reported that the statewide seven-day average positivity rate was 2.6 percent, made a similar plea. “These next weeks are going to be key, and we really need people to buckle down,” he said during a brief media appearance on Spectrum News Albany.
Officials across the country have confronted growing public fatigue with social-distancing rules and other limitations, a reality that the mayor acknowledged.
“Everyone’s feeling a lot about this situation, and it’s so frustrating, and it’s painful — meaning the whole eight, nine months we’ve gone through now,” Mr. de Blasio said.
The mayor also said that new state restrictions would take effect Friday on Staten Island, now a hot spot in the city. They include mandatory testing at schools, capacity limits at houses of worship and a limit on four-person tables at restaurants.
At the news conference on Thursday, the borough president, James Oddo, urged Staten Island residents to “rise up to the occasion” and adhere to mask-wearing guidelines.
Elsewhere in the New York area:
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Gov. Philip D. Murphy of New Jersey announced on Monday that restaurants and bars across the state must close to indoor patrons at 10 p.m., starting Thursday. He has also now given municipalities the flexibility to enforce even stricter, 8 p.m. closing times to address town-by-town hot spots. Local officials are not, however, permitted to enforce gathering limits that differ from the governor’s executive orders, which currently limit indoor gatherings to 25 people. The new flexibility appeared designed to accommodate the mayor of Newark, Ras J. Baraka, an ally of the governor who had already begun enforcing an 8 p.m. closing time for all nonessential businesses.
Top congressional Democrats renewed calls for a sweeping coronavirus relief package on Thursday, insisting that voters had given President-elect Joseph R. Biden Jr. and his party a mandate to fight the pandemic aggressively.
Speaker Nancy Pelosi of California and Senator Chuck Schumer of New York, the minority leader in the Senate, cited record-breaking infections across the country, along with the presidential election results, to justify their position that any package must be much larger than what Republicans had been suggesting.
By holding firm to keeping $2.4 trillion in new spending as their starting point, Democrats appeared to be closing the door on the possibility of a year-end compromise with Republicans, who have proposed spending a fraction of that amount.
“This election was maybe more a referendum on who can handle Covid well than anything else,” Mr. Schumer said. “The Donald Trump approach was repudiated and the Joe Biden approach was embraced. That is why we think there is a better chance of getting a deal in the lame duck.”
Hours after their remarks, the top Democrats talked to Mr. Biden by phone, stressing in a statement afterward that they were on the same page about the “urgent need” for Congress to provide funds to support Americans struggling in the pandemic, as well as the nation’s health care system, before he takes office. It had been unclear how actively Mr. Biden, the incoming head of the party, would involve himself in negotiations before his inauguration.
Leaders in both parties have acknowledged the need for another round of stimulus, but they have yet to agree on the scope and cost of a second package, with Republicans insisting on a much smaller bill than what Democrats — and even the White House — had been advocating ahead of the election.
But the potential for agreement appeared to narrow further on Thursday, with a top Republican indicating that Senator Mitch McConnell, the majority leader, was no longer planning to rely on Treasury Secretary Steven Mnuchin to cut a deal with Democrats.
“There hasn’t been any discussion yet between McConnell and Pelosi, but McConnell is not going to rely on Mnuchin anymore to do the dealing,” Senator Charles E. Grassley of Iowa, the chairman of the Senate Finance Committee, told reporters on Thursday morning. “I think he’s intending to take it over and try to get something going.”
Mr. McConnell, for his part, told reporters on Capitol Hill that “my view is, the level at which the economy is improving further underscores that we need to do something at about the amount that we put on the floor in September and October,” referring to the targeted $500 billion packages Senate Republicans tried to pass before the election.
The price tag Ms. Pelosi and Mr. Schumer were discussing, he said, “is not a place I think we’re willing to go, but I do think there needs to another package.”
But Ms. Pelosi portrayed Republicans as “cold-hearted” for insisting on a smaller relief package and tried to upbraid them.
“It’s like the house is burning down and they just refuse to throw water on it,” she said.
Both sides will also have to reach an agreement on critical spending legislation to prevent a lapse in government funding on Dec. 11, with either an agreement on the dozen annual must-pass bills or another stopgap spending bill.
Vermont’s largest hospital has been working for more than two weeks to break free from a cyberattack that has debilitated many of the health center’s functions just as the state is seeing its coronavirus hospitalization and case numbers spike.
The attack on the University of Vermont Medical Center in Burlington began on Oct. 28, and locked staff out of many of the systems they use every day to provide care. For a while, the hospital was not even able to provide chemotherapy treatments, and even now its ability to do so is limited.
The hospital’s emergency room, urgent care center and maternity ward remain open, but officials are trying to divert more patients to clinics and other hospitals.
“What I can tell you is that this attack was very broad in its reach,” Dr. John Brumsted, the president of the U.V.M. Health Network, said in a statement this week. Hospital officials have declined to divulge many details about the attack or any suspected perpetrators, citing a federal investigation. Several other hospitals have been hit with cyberattacks in recent weeks, and federal authorities and experts have warned about a possible wave of attacks against U.S. hospitals.
With few cases, Vermont had been something of a model during the pandemic, but it reported its most positive tests to date on Wednesday. More people in the state were hospitalized with Covid-19 than at any point since August, according to the Covid Tracking Project.
A breakthrough in the cyberattack came on Thursday when technology experts — including members of the Vermont National Guard — were finally able to get doctors and nurses access to patients’ medical histories that had been blocked, a spokesman said. Even so, they still cannot update or edit them.
Hospitals all over the country have been targeted in a scourge of ransomware attacks in recent months. In September, an attack on Universal Health Services, which runs more than 400 hospitals throughout the country, became the largest medical cyberattack in history.
The attacks have surged in recent weeks. Russian cybercriminals had made a concerted effort to target hospitals, in retaliation, some cybersecurity experts believe, for separate operations by the Pentagon’s United States Cyber Command and Microsoft against Russian hackers in the weeks ahead of the election.
On private message boards, cybercriminals shared a list of more than 400 American hospitals they said they aimed to attack. The list was captured in a private exchange by Hold Security, a Milwaukee-based security firm, and shared with law enforcement last month.
Earlier this year, a woman in Germany was turned away at a hospital in Düsseldorf that was being held hostage in a ransomware attack. She was sent to a hospital 20 miles away and died from treatment delays.
A video showing a man lying dead on the floor of a bathroom inside a packed Naples emergency room incited outrage as it spread across Italy on Thursday, prompting government officials to call for “immediate intervention” as the coronavirus pandemic ripples across the country’s vulnerable south.
Raffaele Nespoli, a spokesman for Cardarelli Hospital in Naples, confirmed the authenticity of the video, saying it was filmed inside the hospital’s emergency room. In a statement Wednesday, the hospital said that a “suspected Covid patient” was found dead in the bathroom of the emergency room, though the cause of death was still under investigation.
The person filming the video, which emerged Wednesday, can be heard saying, “This one is dead,” as the camera points at a man lying underneath a sink. Another patient is seen prostrate on a bed surrounded by uneaten food. “This one we don’t know whether he is alive or dead,” the person filming says.
Hospital officials deemed the footage’s publication “despicable,” and said they were trying to identify who filmed it, arguing that the person was purposefully trying to generate hysteria. But the video struck a nerve in Italy, which was ravaged by the virus in the spring and is dealing with a surging outbreak now.
“The images of the patient found dead in the bathroom of the Cardarelli are shocking,” Foreign Minister Luigi Di Maio, who is from a town near Naples, wrote on Facebook. He called the situation “dramatic and unacceptable” and added “now we need to act immediately, especially in the south, which risks imploding.”
Mr. Di Maio said the video was the latest, and worst, example of public health debacles related to the coronavirus he had seen in the southern region of Campania. He wrote that he had received reports of doctors treating people in cars in parking lots, of patients dying in ambulances because no hospital would take them, and of the sick left at home despite calls for help.
Italy on Wednesday surpassed one million total coronavirus cases. More than half of those people are still positive, according to government statistics, and many of them live in Italy’s south, which is poorer and less equipped to handle an outbreak than the wealthy north.
Preventing a spread of the virus south was a major motivator of Italy’s initial national lockdown in March, and the declining health situation there is a significant contributor to what many observers here consider an increasingly likely nationwide lockdown.
Last week, the government locked down the southern region of Calabria, where the coronavirus is putting enormous stress on a health care system weakened by years of bad management and criminal exploitation.
Calabria’s regional health commissioner resigned last week after an embarrassing interview aired on Italian television. In the video, the official, Saverio Cotticelli, said it was not his responsibility to draft a regional coronavirus plan. To demonstrate as much, he retrieved an official document which he read out loud, and discovered in real time that the responsibility for the plan in fact belonged to him. Then, asked about the number of intensive care beds available in the region, he deferred to a doorman for specifics.
The pandemic transformed maternity wards into ghost towns overnight, as visitor restrictions tightened and grandparents-to-be canceled flights. In its wake, officials closed schools, then reopened them, only to close them again, sending parents scrambling for child care, wrangling remote learners and struggling to do their own jobs. Millions of families lost income and many lost loved ones. For parents in particular, this year has meant recalibrating time and again. Yet, there was also joy — cobbled-together peaceful moments — amid a steady thrum of chaos, which isn’t letting up. We asked mothers and fathers across the country what parenting has been like for them during the pandemic and how, in their own ways, they have each learned to cope.
With the coronavirus raging unchecked and hospitals overflowing in many parts of the U.S., medical workers are beseeching governors, mayors and city councils to impose mask mandates and other stricter measures, often to no avail — and are growing impatient with official inaction.
In South Dakota, which has the highest rate of Covid-19 hospitalizations in the country but no statewide mask mandate, one doctor after another spoke out at a City Council meeting in Sioux Falls on Tuesday, calling for the city to impose its own.
“In South Dakota, we are light-years behind in our response, and it shows,” said Dr. Shannon Emry, a pediatrician. She said doctors and hospital leaders have been pleading for action for weeks. “Have we been too polite in asking for help? Are we not being loud enough? When will people start to believe us, and help out?”
After five hours of public comment at the meeting, Mayor Paul TenHaken cast a tie-breaking vote to reject a proposed mask ordinance.
When doctors in Nebraska took to Twitter last week to call for stricter measures from Gov. Pete Ricketts, the governor’s spokesman dismissed the calls as politically motivated, drawing further criticism from medical workers. Governor Ricketts, who went into quarantine earlier this week after social contact with someone who tested positive, tightened some restrictions in mid-October but has resisted taking further steps.
In North Dakota, where Covid-swamped hospitals are critically short of staff, Gov. Doug Burgum angered the state nurses’ union by announcing on Monday that the state would address the problem by having medical workers who test positive stay on the job to treat coronavirus patients as long as the workers show no symptoms.
In a statement on Wednesday, the North Dakota Nurses Association said the state should be taking actions like imposing a mask mandate to help reduce the burden, and then calling upon infected medical workers only as a last resort.
“N.D.N.A. recommends that all other public health measures to reduce the demand on the health care system and address staffing shortages are deployed before implementing this particular strategy,” the union wrote in a statement.
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