New Jersey and Delaware have experienced rising numbers, as has Texas, which just recently endured a midsummer surge. Wisconsin, a critical swing state in the presidential election, has been hammered. It had logged record highs in case counts for 20 straight days as of Thursday, and recorded more than 17,000 new confirmed infections in a single week.
Among the latest data points in the early-autumn surge: President Trump’s coronavirus diagnosis Friday, which instantly rocked the presidential campaign, became the biggest news story on the planet and provided a reminder, if any were needed, that this pandemic shows no signs of diminishing.
Covid-19, the disease caused by the novel coronavirus, has killed at least 208,000 people in the United States and is continuing to spread easily through many regions of the country. Infectious-disease experts had hoped transmission could be driven to low levels before cold weather arrived. That hasn’t happened, and Trump and first lady Melania Trump on Friday became part of ominous daily case counts that alarm the nation’s top doctors.
“I’m concerned we are going into the fall and ultimately the winter season, when the weather changes, [and] we are stuck at this baseline of 40,000 new infections every day,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview before news broke about the president’s infection.
On Thursday, Wisconsin Gov. Tony Evers (D) delivered a radio address pleading with residents to do anything and everything to slow the startling rate of infections in the state.
“Folks, if we are going to get this virus under control, then wearing a mask is the absolute least we need you to do,” said Evers, whose own statewide mask mandate is facing a legal challenge and attacks from Republicans. “We have got to put the brakes on this pandemic to keep our friends, family, employees and co-workers, and neighbors safe.”
Places west of the Mississippi River are also struggling. Montana has set highs in case counts for 16 straight days. Kansas, Nebraska and Utah are reporting spikes in infections. And although deaths and hospitalizations have dropped in recent weeks in populous states such as California and Florida, that progress has been offset by increased transmission elsewhere.
Colder weather historically gives a boost to respiratory viruses. People spend more time indoors. Dry indoor air helps viruses remain viable and dries out nasal passages, potentially facilitating infections. People who are exposed to less sunlight can experience lowered immune responses. The coronavirus is different from the seasonal flu, but like the flu, it may show some seasonal variation.
Fauci and other infectious-disease experts say a cold-weather surge is not inevitable. They urge people to adhere to simple public health guidelines that are effective in limiting transmission — wearing a mask, maintaining physical distance, avoiding crowds, interacting with people outside rather than inside if possible, and frequent hand-washing.
But many Americans continue to not take the pandemic seriously, or to miscalculate the risk factors. “We’re starting to see upticks because there isn’t universal adherence to those public health measures,” Fauci said.
The president’s coronavirus diagnosis came after he mocked his opponent, former vice president Joe Biden, for wearing a mask so often. Trump has rarely been seen wearing a mask, and there is little evidence that White House staffers are rigorous about mask-wearing or physical distancing.
David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia, had said in early September that a presidential candidate might get infected on the campaign trail because of the highly contagious nature of the virus.
“The idea that you can sequester a virus effectively when you’re engaging with high-risk behavior — which is mixing with people — eventually you’re going to get burned with this virus. This has shown that time and time again. There is no impenetrable barrier for a virus,” Rubin said.
Columbia University epidemiologist Jeffrey Shaman, like other infectious-disease experts, expressed alarm at the complacency of many Americans and their political leaders. He cited Florida, where Gov. Ron DeSantis (R) has ordered all school districts to open for in-person learning and on Sept. 25 declared that all bars, restaurants, nightclubs and other businesses can operate at full capacity. Crowds immediately packed into such watering holes as the iconic beachfront Elbo Room in Fort Lauderdale, with few patrons wearing masks.
Some advocates of reopening the economy have argued that herd immunity may kick in more quickly with this coronavirus, but there is no evidence of that, Shaman said. Nor is the virus becoming less deadly.
“There’s no evidence that we suddenly have this wonderful get-out-of-jail-free card,” Shaman said.
Even as the shift toward loosening restrictions continues throughout much of the country, the persistence of the virus has given some elected officials pause.
Boston’s mayor this week halted the city’s shift into its next phase of reopening, saying it would not open indoor performance venues as planned, and would limit gyms, museums and libraries to 40 percent capacity. Trampoline parks, roller rinks and fitting rooms at retail shops must all stay closed.
“Anyone who’s upset with me, and us in Boston for not doing this, think about some of the decisions you might be making by going to a party,” Mayor Martin J. Walsh (D) said. “The reason why we’re doing this is because we’re seeing our numbers go up here in the city of Boston. We want to make sure we stop that increase before it comes to a point where we’re having the entire city shut down again.”
Quirks in testing rates, along with variations in how states record positive results from “rapid response” antigen tests, have hampered monitoring of national trends. As a result, it is impossible to declare with certainty that the long-feared fall surge in cases has begun. But the numbers point in a troubling direction.
“We continue to be very worried about capacity, especially going into the winter months,” said Suresh Gunasekaran, chief executive of University of Iowa Hospitals and Clinics in Iowa City.
Gunasekaran said that of the hospital’s 850 beds, only about 20 to 30 have consistently been filled by covid-19 patients. But state data show that hospitalizations have risen of late, and already, the state’s biggest hospital is operating at about 90 percent capacity.
“It’s not going to get any easier or better” as time goes on, he said. “We worry going into the winter. . . . This is just one additional disease that wasn’t affecting hospitalizations a year ago.”
In Wisconsin, Evers pleaded with those planning backyard barbecues with extended family or friends to reconsider. He asked those planning community events to hold them virtually. He begged people supporting local restaurants to eat outside or grab food to go.
“Skip the play dates, dinner parties, family get-togethers and work conferences, or any other gatherings with people you don’t live with for the time being,” Evers implored.
Ajay Sethi, an epidemiologist and director of the public health master’s program at the University of Wisconsin-Madison, said the cold-weather spike came earlier than expected: “We’ve been talking about the surge in the winter, but it’s happening before the winter.”
Like many states, Wisconsin faces the potential for a deadly flu season to collide with the ongoing pandemic. Already, some hospitals in the state are swelling to capacity.
People flouting recommendations to wear masks and social distance bear some blame, he said. “In Wisconsin, we’re not doing the right thing, and the evidence is a surge in covid cases,” Sethi said.
Jacqueline Dupree contributed to this report.