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Voters who have not yet submitted ballots by mail headed to the polls Tuesday amid what one top health official called “the most concerning and most deadly phase” of the coronavirus pandemic. The virus has claimed at least 231,000 lives in the United States, and record numbers of coronavirus-related hospitalizations are forcing doctors in rural states to get creative. Meanwhile, the Centers for Disease Control and Prevention said people who are in isolation after testing positive can still cast ballots in person.

Here are some significant developments:

As the presidential election collides with a global pandemic, the CDC said people who are sick with the coronavirus can still vote in person Tuesday.

In updated guidance published Sunday, the agency said voters who have tested positive or may have been exposed to the coronavirus should follow the standard advice to wear a mask, stay at least six feet away from others and sanitize their hands before and after voting. “You should also let poll workers know that you are sick or in quarantine when you arrive at the polling location,” the CDC’s website states.

For tens of thousands of Americans, that may be the only option: People who received their test results in the past few days missed the cutoff to request an absentee ballot in most states, and getting an exemption typically requires surmounting arduous logistical hurdles, as The Post previously reported. But the prospect of casting a ballot alongside someone who is sick is unlikely to defuse the tension surrounding mask-wearing at polling places — something that remains optional in multiple states.

While turnout numbers and exit polls consume much of the national attention, the steady rise of new infections across the country shows no sign of abating. The United States reported more than 86,000 new coronavirus cases Monday, pushing the total count to nearly 9.3 million, according to data tracked by The Post. Twelve states — Arkansas, Iowa, Kentucky, Missouri, Montana, Nebraska, New Mexico, Ohio, Utah, West Virginia, Wisconsin and Wyoming — reported record numbers of hospitalizations.

More infection is likely across the United States in the coming months, even though the country is better prepared to deal with another wave of the virus, according to former Food and Drug Administration commissioner Scott Gottlieb.

“The sheer fact that we’re going to be infecting so many people right now is probably going to mean the death tolls get well above 1,000 for a sustained period of time. It’s a very grim couple of months,” he said Tuesday morning on CNBC’s “Squawk Box.”

Rural areas are feeling the strain. In Utah, overwhelmed hospitals are repurposing pediatric beds for adult patients and plan to soon start bringing in doctors who don’t typically work in hospitals, the Salt Lake Tribune reported.

“We’re asking people to do things that they trained for, maybe when they were a resident, but they haven’t done in three years,” Russell Vinik, chief medical operations officer at University of Utah Health, told the newspaper Monday.

Reopening plans have been rolled back, and restrictions have been tightened in three New England states — Connecticut, Massachusetts and Maine — as well as in Illinois. But officials nationwide have avoided sweeping shutdowns such as those imposed in the spring and have been hesitant to tell schools to switch back to virtual learning.

“Everybody’s concluded that closing schools last spring was probably a bad idea,” Massachusetts Gov. Charlie Baker (R) said at a Monday news briefing where he announced new rules, including requiring residents to wear masks in public even if they are able to stay more than six feet away from others. “Schools aren’t spreaders, and it’s hugely important for the educational and social development of kids and the psychological development of kids that they be in school.”

The scientific community remains fiercely divided over whether it’s safe for schools to be open, especially when many lack adequate ventilation or room for social distancing.

Meanwhile, in a blow to restaurant owners, Connecticut instituted a ban on dining “igloos” and other podlike structures that are becoming a popular alternative to indoor dining. As The Post previously reported, experts say that sharing a meal with members of one’s own household in a well-ventilated pod is a relatively safe activity, but the enclosures also run the risk of replicating the same conditions that make indoor dining dangerous in the first place.

Navajo Nation-run casinos are trying to rebound with the help of lawmakers who approved legislation on Monday that would reopen casinos in Arizona and New Mexico to the alarm of the tribe’s health director, Associated Press reported. Navajo president Jonathan Nez will have 10 days to decide on the legislation once it reaches him, according to the outlet. More than 11,870 Navajo have tested positive for the virus and over 580 have died, according to the Navajo Department of Health.

In Europe, the return to shutdown restrictions in many countries is putting leaders on the defensive. On Tuesday, French Health Minister Olivier Véran pushed back against suggestions that bookshops and other small stores in Paris should be allowed to remain open, telling RTL Radio that a Parisian was contracting the coronavirus every 30 seconds, according to Reuters. He also warned that the success of the shutdown would determine whether Christmas parties and other end-of-the-year celebrations can happen in December.

France may reimpose an evening curfew in Paris, amid concerns that the number of coronavirus cases continues to climb. On Monday, France reported a record 52,518 new cases — the fifth-highest total in the world behind the United States, India, Brazil and Russia, according to data from Johns Hopkins University.

England’s chief medical officer, Chris Whitty, told Parliament on Tuesday that the country’s lockdown measures set to end Dec. 2 could offer “a realistic possibility” for the country to resume with looser restrictions. He said he thinks the lockdown could lower the reproduction number of the virus in the country. The United Kingdom has reported more than 1 million cases since the start of the pandemic. On Tuesday, it reported 397 coronavirus-related deaths — the highest since May, Reuters reported.

In Russia, the daily number of new coronavirus cases has eclipsed 18,000 for four straight days, a steep increase from about 5,000 confirmed infections each day in early September. Most concerning is the situation in Russia’s outlying regions, where hospitals are largely ill-equipped to handle the spike in patients, compared with Moscow. Amid widespread reports of hospital bed, staff and drug shortages hitting far-flung areas, Russia’s top public health official said this week that cases have spiked in 40 percent of the 85 regions and declined in just two of them. Oleg Gridnev, deputy head of the Health Ministry, said last week that 90 percent of the bed capacity for coronavirus patients in Russia is already occupied.

Some European countries are turning to mass testing. In Britain, officials said they will pilot mass testing in Liverpool, one of the hardest-hit areas. The whole city’s population, even those who don’t have symptoms, will be offered regular testing at sites such as nursing homes, schools and workplaces.

The tests on offer will be a mix of swab tests and rapid or “lateral flow” tests, which are faster because they do not require a lab but are often not as accurate. The mass testing will begin Friday, a day after England enters its second national lockdown. If successful, the government will look at rolling it out to other cities. Prime Minister Boris Johnson said regular, mass testing could be a “powerful new weapon in our fight against covid-19.”

The initiative follows others in Europe, including one in Slovakia, which aims to be among the first countries to test its entire adult population.

Similarly, in Germany, officials are hoping that rapid antigen testing can prevent them from having to ban visitors from nursing homes again. Chancellor Angela Merkel said Monday that the government has ordered millions of tests and will provide nursing homes with 20 per resident each month, according to the Associated Press. But experts note that antigen tests are more likely to produce false negatives than the more accurate PCR method, which is considered the gold standard for testing.

Elsewhere in Europe, the Danish Parliament said it suspended voting after several politicians tested positive for the coronavirus, according to Reuters.

Underscoring how the virus has spread to even the most isolated parts of the world, the World Health Organization said Tuesday that more than 5,000 “suspected” coronavirus infections have been recorded in North Korea. The country has officially recorded zero confirmed coronavirus cases, something that outside experts find doubtful.

In its latest situation report, the WHO said North Korea has tested 10,462 people and detected 5,368 “suspected” cases as of Oct. 22, with 846 new suspected infections reported in the third week of October alone. The apparent surge came less than two weeks after a large-scale military parade in Pyongyang on Oct. 10, when North Korean leader Kim Jong Un thanked the public for keeping the country virus-free.

Jacqueline Dupree in Washington and Min Joo Kim in Seoul contributed to this report.