With coronavirus cases surging in New York and across the country, Gov. Andrew M. Cuomo said on Wednesday that private indoor and outdoor gatherings statewide would be limited to 10 people and that gyms, bars and restaurants must close daily at 10 p.m.
The restrictions will take effect Friday, and Mr. Cuomo said that local governments will be responsible for enforcing them. The limit on gatherings will apply to private homes. The curfew will apply only to bars and restaurants licensed by the state liquor authority, and restaurants can continue to provide takeout and delivery after 10 p.m., but only for food.
Mr. Cuomo said that officials were moved to announce the new restrictions as they confronted an increase in cases.
“Bars, restaurants, gyms, house parties,” Mr. Cuomo said on a conference call with reporters. “That’s where it’s coming from, primarily.”
After months when the New York City area had seemed to keep the pandemic relatively contained, the virus has again increased sharply in New York, New Jersey and Connecticut, the region that was once at the center of the U.S. outbreak.
Though cases and hospitalizations are significantly lower than they were at the spring peak, officials in all three states have acknowledged that they are considering additional restrictions that would roll back the slow, cautious reopening process — particularly as cooling weather drives people indoors, where the virus more easily spreads.
In a marked difference from the spring, the wave in the metropolitan area coincides with a surge nationwide. The United States has been shattering daily records for new cases, pushing the seven-day average to more than 123,000 per day, as of Tuesday, according to a New York Times database. For the first time, new cases surpassed 140,000 on Wednesday.
And 65,368 people were hospitalized across the country with Covid-19 on Wednesday, according to the Covid Tracking Project, the largest number at any point during the pandemic.
“And New York is a ship on the Covid tide,” Mr. Cuomo said Wednesday on a conference call with reporters.
In New York City, Mayor Bill de Blasio said on Twitter that the citywide seven-day average rate of positive test results was at 2.52 percent — a rate last seen in early June, when the city had only just begun reopening nonessential business after a devastating spring that saw thousands die.
“This is our LAST chance to stop a second wave,” Mr. de Blasio wrote on Twitter. “We can do it, but we have to act NOW.”
Cases have since been rising across all five boroughs, including Staten Island, which has long bristled at virus-related limits. Over the past week, New York City has seen an average of 1,142 cases a day, a jump of 77 percent from just two weeks earlier.
Mr. Cuomo said on Wednesday that parts of Staten Island would be designated a “yellow zone” in his color-coded tier system of restrictions, which requires more testing in schools.
The state has also designated parts of Port Chester, a suburban community of about 29,000 in Westchester County on the border with Connecticut, as an “orange zone,” which closes schools for at least four days, limits capacity at religious institutions, bans indoor dining and closes high-risk businesses like gyms and hair salons.
In New York State, the seven-day average rate of positive test results was 2.43 percent on Wednesday, the highest the figure has been since late May when the state was doing less testing than it is now. The state also reported 1,628 hospitalizations, its highest total since mid-June, though far short of the peak in April of more than 18,000.
In New Jersey, Gov. Philip D. Murphy has put new limits on indoor dining that begin Thursday night, in what he said was a bid to avoid the sweeping shutdowns that brought the region’s economy to a standstill in March. New Jersey’s coronavirus hospitalizations have more than doubled in the last month, from 653 to 1,801.
The number of people hospitalized has also surged in Connecticut, to 548, the highest total since May 29, according to state data.
Gov. Ned Lamont of Connecticut has also limited all private gatherings in the state to 10 people, lowered capacity limits on restaurants and allowed the hardest-hit municipalities to reimpose limits on other businesses.
Some have pleaded. Some cajoled. Some scolded. Some invoked the past, some the future.
Since Election Day, more than one-third of the governors across the United States have issued public appeals for people to take coronavirus prevention measures seriously, as the number of cases and hospitalizations spike in most of the country.
In a televised address, Gov. Mike DeWine of Ohio invoked the Veterans Day holiday on Wednesday, noting that previous generations had laid down their lives to protect the country.
“Today we all must do something far less dramatic, but very important,” he said. “Wear a mask, so that your friends, neighbors and family members might live.”
To put teeth into that admonition, the governor announced that stores would be closed for 24 hours if a team of inspectors found that workers or customers at any retailer ignored the mask rule two times. In other measures, he banned dancing and games at social gatherings, and said participants in banquets, weddings and funeral receptions could not longer congregate.
If the numbers continued to mount, Gov. DeWine said, there would be new restrictions on bars, restaurants and gyms within a week, and universities would be asked to stick to remote learning in January.
In Wisconsin, Gov. Tony Evers made a similar prime-time speech on Tuesday night, advising residents to change their lives to help contain the virus.
“It’s not safe to have others over — it’s just not safe,” Mr. Evers said, adding that virtual hangouts were better for the foreseeable future. “So please, cancel the happy hours, dinner parties, sleepovers and play dates at your home. ”
Numerous governors warned that new mandatory measures, which many have avoided, might be coming if mounting case counts put severe pressure on medical facilities.
In Nevada, Gov. Steve Sisolak cautioned residents that they had roughly 14 days to get in line. “Nevadans need to accept and understand this reality now, and change behaviors immediately,” he said at a news conference Tuesday. “In the next two weeks, we must see a significant reversal of the current trends, which are deeply concerning now.”
Many governors have pleaded for patience, recognizing that combating Covid-19 has been a difficult slog. Gov. Jared Polis of Colorado, stressing the positive preliminary results that Pfizer announced on Monday for its experimental vaccine, said, “I hope the good news about a vaccine inspires us to double down on social distancing in Colorado.”
Some governors appealed to patriotism, or unity, or protecting the family.
In Idaho, where virus prevention measures have drawn protests about tyranny, Gov. Brad Little cited Veterans Day too.
“Our veterans bravely encountered bullets and bombs so that you can have the freedom to control your own actions,” the governor wrote in an opinion piece. “And your personal actions are the one and only thing that will defend our veterans from succumbing to the enemy virus.”
Inevitably some, including the governors of North Carolina, Iowa and Indiana, have imposed new measures in all or part of their states, often focused on indoor gatherings. In New York, Gov. Andrew M. Cuomo said on Wednesday that private indoor and outdoor gatherings statewide would be limited to 10 people and that gyms, bars and restaurants must close nightly at 10 p.m. starting Friday.
The Federal government got in the act too, with the National Park Service announcing this week that the 98th National Tree Lighting Ceremony would not include a live audience. The ceremony will be streamed at thenationaltree.org on Thursday, Dec. 3, and the tree on display there throughout the season.
California is about to broach the one million case mark, a threshold reached only by Texas so far, with more than 996,000 cases as of Wednesday and a recent average of more than 6,400 cases a day. San Francisco has banned indoor dining again starting next Sunday, paused high school reopenings and limited gyms and movie theaters to 25 percent of capacity.
Gov. Gavin Newsom called the state’s numbers “sobering” and predicted that they would probably climb with the onset of winter, in a “twindemic” of Covid-19 and flu.
Gov. Gary Herbert of Utah took some of the most drastic recent measures, declaring a new state of emergency on Sunday and instituting a statewide mask mandate.
One of the bluntest entreaties came in Maryland, which lowered the ceiling on indoor dining capacity to 50 percent of capacity Wednesday and capped indoor gatherings at 25 people. In a news conference last week, Gov. Larry Hogan warned against complacency.
“I mean, it’s simple, it’s not that hard,” he said. “Just wear the damn masks.”
Three more White House staff members have tested positive for the coronavirus, including at least one, the political director, Brian Jack, who attended an election night event at the White House, people familiar with the diagnoses said on Wednesday.
Mr. Jack tested positive over the weekend, one of the people said.
Three other people had previously tested positive after attending the election night event: Mark Meadows, President Trump’s chief of staff; Ben Carson, the housing secretary; and David Bossie, an adviser to Mr. Trump who is leading the charge on lawsuits and other efforts related to contesting the election outcome in several states.
Several hundred people gathered at the event in the East Room for several hours, many of them not wearing masks as they mingled and watched election returns.
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.
Two weeks ago, as the coronavirus began to spread widely again in Newark, officials imposed New Jersey’s toughest new restrictions since the spring lockdown, mandating an 8 p.m. indoor closing time for all restaurants, bars and nonessential businesses citywide.
But the number of new cases in Newark, the state’s largest city, kept climbing, with 842 new reported infections over the last four days. Of those people tested in Newark over three days last week, 19 percent were found to have the virus, city and county officials said — more than double the statewide rate, and almost eight times the rate in New York State.
The uptick mirrors a spike in Covid-19 hospitalizations across New Jersey to levels not seen since June.
On Tuesday, New Jersey recorded 3,777 new infections, the most since April — a figure the governor called “devastating.” Hospitals also reported 15 coronavirus deaths, adding to the state’s pandemic death toll of more than 16,400.
Alarmed by the new data, Newark’s mayor, Ras J. Baraka, implemented a sweeping set of rules on Tuesday designed to avoid a repeat of the springtime outbreak. Mr. Baraka ordered a 9 p.m. weekday curfew for residents of three ZIP codes, and canceled all team sports activities citywide, effective immediately. He barred Newark’s nursing homes from accepting visitors for two weeks, and capped gatherings — indoors and outdoors — at 10 people until at least Dec. 1.
Aides said Mr. Baraka would not hesitate to shut down businesses, issue fines and suspend liquor licenses if needed.
The tough talk created tension between Gov. Philip D. Murphy and Mr. Baraka, allies and fellow Democrats. Mr. Murphy this week imposed a 10 p.m. closing time on restaurants and bars, among other restrictions, but he has resisted ordering a statewide lockdown.When asked about Newark’s rules, Mr. Murphy’s top lawyer, Parimal Garg, said that state law superseded municipal actions.
Perry N. Halkitis, a dean of biostatistics and urban-global public health at the School of Public Health at Rutgers University,said that an emphasis on quelling indoor drinking during late-night hours, when inhibitions drop, was appropriate. He also said he was equally concerned about private indoor gatherings that are harder to monitor.
“You really love your family?” said Dr. Halkitis. “For Thanksgiving, you should not be with them.”
School officials in Philadelphia, San Diego, Minneapolis and several other large cities hit pause on their reopening plans this week, joining a number of districts across the United States that have delayed bringing students back to classrooms because of surging coronavirus cases.
Washington and Boston have also reversed course on reopenings recently, and Chicago has not yet set a return date. Any school district that has not already reopened its classrooms is now facing significant headwinds to do so in 2020.
Although research indicates that children are less likely than adults to spread the virus, many health experts say that schools cannot safely reopen while community transmission is rampant — even though remote schooling can carry a heavy social and economic cost.
“Most of the country — when you look at the map, a lot of them have case rates that I would say are too high to open schools,” said Benjamin Linas, an associate professor of medicine and epidemiology at Boston University. “It’s a crisis for public education.”
There are many parts of the United States — including Florida, Texas and New York City — where schools are fully or partially open. Baltimore still plans to bring some students back to classrooms next week, though it has slashed the number of schools that will reopen.
With the country posting record numbers of cases and hospitalizations, the window for reopening is closing rapidly. Much will depend on the course the pandemic takes over the next few months, as colder weather drives people to spend more time indoors, where the virus spreads more easily. Gatherings for Thanksgiving, Christmas and other holidays are also likely to sow new outbreaks.
“If we put a plan in place and really try to control the epidemic, I think it’s possible that schools could stay open or reopen in January or February,” Dr. Linas said. “But that is going to require a national Covid strategy.”
Young, healthy people who contract the coronavirus are often asymptomatic, very rarely need hospital care and can transmit the virus to a roommate unwittingly even when following strict quarantine orders, according to two new studies from the U.S. Navy.
The findings support the need for strong measures, like daily testing, that go beyond the temperature checks and symptom reporting now commonly deployed to prevent transmission in offices, dormitories and other group settings, the authors said.
“These findings all point to the need for ongoing testing strategies,” said Dr. Andrew G. Letizia, a commander and infectious disease specialist at the Naval Medical Research Center, in Silver Spring, Md., and lead author of one of the studies. “We need to augment public health measures and reinforce them with regular testing” in such settings.
The new reports, both posted Wednesday by The New England Journal of Medicine, clarify much of what is known or suspected about the coronavirus’s effect on young adults, while also exposing the limits of quarantine measures.
One study, led by Dr. Letizia, detailed the rate of new infections detected among nearly 2,000 recruits under quarantine near Parris Island Marine Corps Recruit Depot, in South Carolina, over the summer. It was conducted in collaboration with researchers at the Icahn School of Medicine at Mount Sinai in New York.
The other report described an outbreak on the U.S.S. Theodore Roosevelt, an aircraft carrier on which nearly a quarter of the crew — more than 1,200 seamen and women — tested positive last spring.
“The approaches learned from the U.S.S. Theodore Roosevelt and Parris Island can be applied, with varying degrees of relevance, to land-based shared living situations,” wrote Dr. Nelson L. Michael, of the Walter Reed Army Institute of Research, in an accompanying editorial, “such as college dormitories, prisons, and residential care facilities, as well as sports training environments, meat-processing facilities, and isolated energy plants.”
Infectious disease experts warned on Wednesday that the surge in coronavirus cases in many parts of the United States is likely to get much worse over the next few weeks. And despite the recent promising news about a vaccine by the drugmakers Pfizer and BioNTech, wide distribution of a vaccine will take time.
“It’s helpful to know there is an end in sight, but that end is not going to appear magically in January, February or March,” said Dr. Andrew Pavia, an infectious disease specialist at University of Utah School of Medicine, at a news conference by the Infectious Diseases Society of America on Wednesday about the spread of Covid-19 in rural areas.
“That end is next summer or fall,” Dr. Pavia said. “That’s a hard message to give, but it’s critical.”
On Monday, Pfizer said an early analysis of its vaccine trial found the vaccine to be more than 90 percent effective in preventing Covid-19. But that initial finding could change as the trial goes on.
Dr. Pavia noted that in his region, the Mountain West, the health care system was already strained as the holiday season loomed.
“The situation in the hospitals is going to be quite a bit worse in the next two to three weeks than it is today,” he said. “If Thanksgiving does the same thing to us that Memorial Day did and Labor Day did, and people gather, as we all want to do, without taking precautions, we could see another acceleration going into Christmas.”
He noted that even if a vaccine is approved soon, people must continue to rely on masks and social distancing for months to come, because initial vaccine supplies will be limited and will be reserved for health care workers and other front line workers.
Dr. Pavia and Dr. Daniel McQuillen, who is the president-elect of the association, called for an end to the politicization of the pandemic, and for leaders to send a clear, consistent message backed by scientific data to promote health precautions that can be taken by individuals.
Dr. McQuillen said public health agencies and political leaders, including President Trump, “need to tell the truth, and tell people what the reality is and how we’re going to get out of it, without any sugarcoating.”
Dr. Pavia added: “We have to take politics out of this. Whether you’re a Republican or a Democrat, you’re susceptible to the virus, and masks work just as well.”
The University of Maryland halted its football-related activities on Wednesday and canceled its game this weekend against Ohio State after eight players tested positive for the virus within the past seven days.
“We realize that this news is disappointing to all of the Maryland fans out there who were looking forward to the Terps taking on an outstanding Ohio State team, but the responsible thing for us to do is pause football activities,” said Damon Evans, Maryland’s athletic director, in the announcement.
Michael Locksley, the team’s coach, said it would continue to meet virtually while in-person activities were on pause.
The cancellation means three out of the top five teams in The Associated Press Top 25 poll will be sidelined this weekend because of the virus.
The University of Alabama, ranked No. 1, was scheduled to play Louisiana State University before positive test results among L.S.U. players prompted the Southeastern Conference to postpone the game. Texas A&M, ranked No. 5, was supposed to play at the University of Tennessee but had to stop practicing after several members of their organization tested positive for the virus on Monday.
In total, four SEC games set for this weekend were delayed because of positive tests across programs.
“Numbers around contact tracing have emerged as one of our biggest challenges to playing,” said SEC Commissioner Greg Sankey in a call with reporters Wednesday. “Adjustments have to continually be made.”
The Big Ten, unlike the SEC and some other conferences, planned to not reschedule games this season that cannot be played because of the pandemic.
South Africa will open its borders to all international travelers, President Cyril Ramaphosa announced Wednesday, even as the number of new coronavirus cases rises in some parts of the country, leaving some officials concerned that a rollback on travel restrictions could invite a second wave.
“We are also opening up international travel to all countries subject to the necessary health protocols and the presentation of a negative Covid-19 certificate,” said Mr. Ramaphosa during an address to the country. He did not say when the new rules would replace a current, lengthy no-fly list that bans tourists from dozens of European countries and the United States.
The announcement came ahead of what would normally be the beginning of peak tourist season, when colder weather in the northern hemisphere starts luring up to 10 million foreigners to the country’s pristine beaches and game safaris.
South Africa has recorded more than 740,000 coronavirus cases and nearly 20,000 deaths since the spring, according to a New York Times database. Cases have dropped from a high of 12,000 new daily infections in July to fewer than 2,000 a day for the past three months.
Still, localized spikes in cases have worried officials for several weeks, including in the Eastern Cape province and in Cape Town, a major tourist destination.
The government also declared five days of mourning for victims of the pandemic and for women and children who are victims of violence. South Africa has one of the world’s highest rates of violence against women, which Mr. Ramaphosa called a “second pandemic.”
He said the national flag would fly at half-mast, and urged all citizens to wear black armbands on Nov. 25.
Lebanon is imposing a new lockdown that will shut many businesses and limit road traffic as the small Mediterranean country tries to limit a spike in coronavirus cases that has stretched hospital resources.
The new lockdown, which the government announced on Tuesday, will begin Saturday and last until Nov. 30. Many businesses and government offices will close, cars will be allowed on the road on alternate days based on the last number of their license plates and a nighttime curfew will be enforced, although its hours have yet to be decided.
While the measures have been billed as a “total lockdown,” the country’s sea, air and land borders will remain open, as will establishments deemed “essential,” such as pharmacies, bakeries, banks and electricity and communications facilities.
Lebanon, a small, beleaguered country of 5.4 million bordered by Syria and Israel, reported surprisingly low infection numbers early in the pandemic, mostly because of a strict early lockdown that included an airport closure.
But cases have risen steadily in recent months, as have virus-related deaths, a rise that medical workers have blamed on spotty mask-wearing and lax observance of social distancing guidelines.
The new lockdown comes amid an economic crisis that has seen unemployment spike and the currency lose about 80 percent of its value against the United States dollar since last year.
A huge explosion in the Beirut port in August killed nearly 200 people and caused billions of dollars in damages.
Since February, 96,907 people have contracted the virus and 749 people have died in connection to the virus, according to a Times database.
In other developments around the world:
Spain’s government announced Wednesday that it would require travelers arriving in Spain from high-risk countries to prove they tested negative for the coronavirus within 72 hours before landing. The order, which goes into effect Nov. 23, has long been demanded by some regional politicians, particularly in Madrid, whose regional leader, Isabel Díaz Ayuso, has blamed untested travelers arriving at Madrid’s airport for helping to spread the virus in the capital region.
Singapore and Hong Kong said that a travel bubble between the two Asian financial centers will begin this month, allowing travelers to bypass quarantine. The arrangement, set to begin on Nov. 22, would allow one designated “bubble” flight into each city every day, each carrying a maximum of 200 passengers. Travelers must test negative for the virus and fly only on the designated flights.
The European Union’s executive arm proposed a “European Health Union” in a bid to coordinate a patchwork of Covid-19 measures across the bloc and centralize responses to the pandemic. The proposal by the European Commission, which would need to be approved by the European Parliament and member countries, would create an E.U.-wide plan to prepare for future health crises, as well as coordinate Covid-19 testing across the bloc.
People with intellectual disabilities and developmental disorders are three times as likely to die from Covid-19, the illness caused by the coronavirus, compared with other people who contract the disease, according to a large analysis of insurance claims data.
The finding raises complex questions about how new vaccines should be allocated when they become available in limited supplies.
So far, the guidelines for distributing vaccines in the U.S. have recommended giving first priority to workers in emergency services, health care and other essential roles, as well as people who are at heightened risk for severe disease if they become infected, including some older adults and those with certain chronic illnesses.
The guidelines, which are still evolving, have not specifically emphasized vaccinating children and adults with intellectual disabilities like Down syndrome and developmental disorders.
The new analysis was performed by FAIR Health, a nonprofit group that claims to host the nation’s largest private health insurance claims database, in collaboration with Dr. Marty Makary, a professor of health policy and management at the Johns Hopkins University School of Medicine, and the West Health Institute, a group of nonprofit organizations focused on aging and on lowering health care costs for older people.
The analysis was evaluated only by an academic reviewer, and it has not been published in a scientific journal.
“There has always been some hesitancy to treat people with intellectual disabilities and people who are institutionalized as equal, in terms of consideration for scarce medical resources — and that also includes prisoners, by the way,” said Arthur Caplan, director of medical ethics at the New York University Grossman School of Medicine. “There will be some balking and battling, on grounds that I would consider discriminatory.”
People with intellectual disabilities are vulnerable to the virus for several reasons. Many live in group homes or receive care from aides, therapists or teachers who must be in close physical proximity in order to assist them. And many are medically frail to begin with, with high rates of other underlying health conditions, particularly respiratory problems.
“Historically, it’s been a challenge for this population to receive good medical care,” said Scott Landes, an associate professor of sociology at Syracuse University. “If you’ve got someone whose cognitive ability is severely reduced, just understanding what’s going on and why they have to wear a mask would be very confusing.”
Russia’s coronavirus vaccine has shown strong effectiveness in early data from a clinical trial, according to a statement on Wednesday from the Russian financial company promoting the shot.
The Russian Direct Investment Fund said that the vaccine, called Sputnik V, demonstrated 92 percent efficacy, based on results from 20 people in the trial who developed Covid-19 after getting either the experimental vaccine or a placebo shot. Because few scientific details were given, independent vaccine experts could not fully assess its veracity.
“It’s very hard to say much with 20 cases and no other details,” said Jesse Goodman, a professor of medicine and infectious diseases at Georgetown University.
The scientists behind the Russian vaccine have not released the trial blueprints, known as protocols, which are needed for a thorough review of the data. The Russian developer, the Gamaleya Research Institute of Epidemiology and Microbiology, plans to publish details of the interim results in a peer-reviewed article, the Russian Direct Investment Fund said in its statement.
The results are not implausible, especially considering the news from earlier in the week that Pfizer and BioNTech’s vaccine was “more than 90 percent effective” in preventing the illness. Like all vaccines now in clinical trials, the Pfizer and Sputnik V vaccines present a coronavirus protein called “spike” to the immune system.
Because Pfizer’s data was so strong, “it boosts my confidence in other vaccines as well,” said Natalie Dean, a biostatistician at the University of Florida who specializes in infectious disease outbreaks.
There are now 11 vaccines in late-stage clinical trials worldwide, including three in Russia.
Since August, Russia has sought to get ahead in the global race to market vaccines by announcing its product was effective before clinical trials showed that to be the case, and by approving it for emergency use at home. China has also approved a vaccine for emergency use before its trials are completed. The World Health Organization rebuked Russia for skipping steps in the approval process.
Trial results are based on a statistical analysis of study subjects who come down with Covid-19. If more people receiving the placebo than the vaccine become ill, then the vaccine is effective.
The Pfizer and BioNTech results were based on 94 confirmed cases, making them more statistically compelling than the 20 cases in the Russian data. In the vaccine trial by Pfizer and BioNTech, half of the participants received two doses of the vaccine three weeks apart, and half received a placebo. The first analysis was based on 94 volunteers who had developed Covid-19. To calculate the efficacy rate, an independent board of experts compared how many of those 94 cases were in the placebo group, and how many were in the vaccinated group. (If all 94 had been in the placebo group, for example, the vaccine would be considered 100 percent effective.)
Gamaleya Research Institute plans to test the two-shot vaccine on 40,000 people. So far, about 16,000 people have received both doses. Separately, the Russian Ministry of Health has vaccinated about 10,000 volunteers under the emergency use approval, according to the statement released on Wednesday.
As President Trump pushes to overturn the results of the election while the pandemic rages on, his only public statements about the coronavirus in the last few days have been to make clear his pique that good news about a vaccine had not come until after Election Day.
Meanwhile, the Strategic National Stockpile, the U.S. emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear.
The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.
Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care.
In the absence of leadership, local officials feel as if they are struggling alone. New weekly cases among nursing home residents jumped fourfold from the end of May to late October, and deaths have more than doubled in 20 states, according to R. Tamara Konetzka and Rebecca J. Gorges, researchers at the University of Chicago who analyzed data from the Centers for Disease Control and Prevention.
Even many large hospital chains, which say they have adequate supplies of medical gear, continue to operate in crisis mode. That often means requiring employees to repeatedly reuse respirator masks that are meant to be discarded after each use.