As the coronavirus races across the country, it has reached every corner of a nursing home in Kansas, infecting all 62 residents inside. There are so few hospital beds available in North Dakota that patients sick with the virus are being ferried by ambulance to facilities 100 miles away. And in Ohio, more people are hospitalized with the virus than at any other time during the pandemic.
After weeks of warnings that cases were again on the rise, a third surge of coronavirus infection has firmly taken hold in the United States. The nation is averaging 59,000 new cases a day, the most since the beginning of August, and the country is on pace to record the most new daily cases of the entire pandemic in the coming days.
But if earlier surges were defined by acute and concentrated outbreaks — in the Northeast this spring, and in the South during the summer — the virus is now simmering at a worrisome level across nearly the entire country. Illinois, Kentucky, Michigan, Montana, North Dakota, Ohio, South Dakota, Utah, Wisconsin and Wyoming each set seven-day case records Tuesday. Even New Jersey, once a model for bringing the virus under control, has seen cases double over the past month.
“It is a really dangerous time,” said Dr. Tom Inglesby, an infectious-disease expert at the Johns Hopkins Bloomberg School of Public Health.
“The majority of states are on the rise,” he said. And at the same time, “there are very few places where things are stable and going down.”
The latest wave threatens to be the worst of the pandemic yet, coming as cooler weather is forcing people indoors and as many Americans report feeling exhausted by months of restrictions. Unlike earlier waves, which were met with shutdown orders and mask mandates, the country has shown little appetite for widespread new restrictions.
“We’re seeing spread virtually everywhere,” said Gov. Mike DeWine of Ohio, where 69 of 88 counties are now considered “high incidence,” meaning at least 100 virus cases per 100,000 people in the past two weeks. But at a news conference Tuesday, DeWine, a Republican who was among the first governors to shut down businesses this spring and who imposed a statewide mask mandate this summer, did not announce new measures to curb the spread.
“The fastest way we can do it is not for me to issue some order that you can’t enforce or would be difficult to enforce but rather for every Ohioan to take this seriously,” he said, grabbing his cloth mask and holding it up.
The newest surge sets the stage for a grueling winter that will test the discipline of many Americans who have spent warmer months gathering in parks and eating outdoors, where the virus is known to spread less easily. At the current rate of growth, new daily confirmed cases could soon surpass 75,687, the record set July 16.
The rising case count has so far not translated to increased deaths: About 700 people are dying on average each day, a high but steady rate. So far, more than 220,000 Americans have died from the virus.
The latest developments represent a serious new level of spread. Deaths are considered a lagging indicator of new infection, and experts believe the daily toll is likely to rise in the coming months. Nationwide, hospitalizations, the most accurate gauge of how many people are sick from the virus, are already trending upward, at a pace slightly lower than new infections.
In North Dakota, which is leading the nation in new coronavirus cases per capita, hospitalizations and deaths are at a high, and just 20 intensive care beds were available statewide.
“Is bed capacity an issue? Yes,” said Tim Blasl, president of North Dakota Hospital Association, who described patients who have had to drive far out of their way to find an open bed in the rural state. But, he added, “Are people receiving care? Yes.”
With no statewide mask mandate, some mayors are resorting to options they had long resisted. On Monday, the mayor of Fargo used his emergency powers to issue a mandatory mask order, the first of its kind in the state. Hours later, the City Council of Minot, the fourth-largest city in North Dakota, issued a similar order.
“We were hoping we had escaped the COVID-19,” Mayor Tim Mahoney of Fargo, a practicing surgeon, said in an interview. “Now we’re just like everybody else in the country. It has hit us with a vengeance.
“We kind of thought we’d outsmart it, and you can’t outsmart this virus.”
In other parts of the country, officials are also returning to another tried-and-true method of containing the virus: stay-at-home orders. On Tuesday, local health officials ordered students at the University of Michigan in Ann Arbor to stay in their residences except for essential activities effective immediately, in an effort to control an escalating community outbreak.
Since Oct. 12, cases associated with the university have made up about 61% of confirmed and probable local infections, said Jimena Loveluck, the health officer for Washtenaw County, who warned that many cases have been tied to parties and other big gatherings.
“During the day, on campus, everyone’s fine and following the rules,” said Emma Stein, a senior news editor at The Michigan Daily, the student paper, who is confined at home with her eight roommates. “But at night, on weekends, they don’t.”
The order could leave the campus unusually quiet ahead of Oct. 31, when the university is expected to play its first home football game of the season against its biggest in-state rival, Michigan State. For added deterrence, health officials are considering an extra kick: Within the week, officials said, the health department may start fining people who violate the order to stay at home.
In a sign of how quickly the virus is spreading in many parts of the Midwest and the Great Plains, infections recently overtook a private nursing home in northern Kansas.
The nursing home, Andbe Home, noticed the first sign of a problem Oct. 7, when a single resident tested positive. But within days, the virus had run rampant, sneaking from room to room.
Two weeks later, all 62 residents who live there have been infected, and 10 have died. At least 12 employees have also tested positive.
“It is with great sadness and concern that I announce that we have a full COVID outbreak in our home, despite the precautions we have been taking since March,” Megan Mapes, the administrator of the Andbe Home, wrote on Facebook. The home has since barred all visitors, and residents are isolated in their rooms.
The nursing home is in Norton County, the hardest-hit county in Kansas right now relative to its population of 5,400. The county is grappling with two serious outbreaks — in the nursing home and in the Norton Correctional Facility, a state prison where 18 prisoners and three officers have tested positive. Of the 340 total cases reported in the county, more than 300 have come this month.
Tammy Steinmetz has not been able to talk to her father, who is 89 and has dementia, since he tested positive for the virus as part of the nursing home outbreak this month. She used to see him every week, bringing him homemade meals of catfish caught by his great-grandchildren in a nearby lake.
“I just want to be able to see my dad,” Steinmetz said. “I’m just completely at a loss. You think everybody’s doing everything to keep everybody safe, and then next thing you know everything is just different.”
This article originally appeared in The New York Times.