Sasha Jacquez tests The University of Texas at El Paso student Ariona Gill for coronavirus. Photo / AP
Deaths per day from the coronavirus in the US are on the rise again, just as health experts had feared, and cases are climbing in practically every state, despite assurances from President Donald Trump over the weekend that "we're rounding the turn, we're doing great".
With Election Day just over a week away, average deaths per day across the country are up 10 per cent over the past two weeks, from 721 to nearly 794 as of Sunday, according to data from Johns Hopkins University. Newly confirmed infections per day are rising in 47 states, and deaths are up in 34.
Health experts had warned that it was only a matter of time before deaths turned upward, given the record-breaking surge in cases engulfing the country. Deaths are a lagging indicator — that is, it generally takes a few weeks for people to sicken and die from the coronavirus.
Michael Osterholm, a University of Minnesota expert on infectious diseases who warned over the summer of a fall surge, said what's happening now is a confluence of three factors: "pandemic fatigue" among people who are weary of hunkering down and are venturing out more; "pandemic anger" among those are don't believe the scourge is a real threat; and cold weather, which is forcing more Americans indoors, where the virus can spread more easily.
"When you put those three together, we shouldn't be surprised what we're seeing," Osterholm said.
The virus is blamed for more than 8.6 million confirmed infections and over 225,000 deaths in the US, the highest such totals anywhere in the world.
Deaths are still well below the US peak of over 2,200 per day in late April. But experts are warning of a grim fall and winter, with a widely cited model from the University of Washington projecting about 386,000 dead by February 1. A vaccine is unlikely to become widely available until mid-2021.
The seven-day rolling average for daily new cases hit a record high on Sunday of 68,767, according to Johns Hopkins, eclipsing the previous mark of 67,293, set in mid-July. The US recorded more than 80,000 new cases on both Friday and Saturday — the highest marks ever — though testing has expanded dramatically over the course of the outbreak, making direct comparisons problematic.
The true number of infections is thought to be far higher because many Americans have not been tested, and studies suggest people can be infected without feeling sick.
On Wall Street, stocks had their worst day in more than a month, amid the surging caseload and mounting doubts that Washington will come through with more relief for the economy before Election Day. The S&P 500 slid 1.9 per cent on Monday, while the Dow Jones Industrial Average shed 650 points, or 2.3 per cent.
In the Texas border city of El Paso, authorities instructed people to stay home for two weeks and imposed a 10pm-5am curfew because of a surge that has overwhelmed hospitals. The state is converting part of the city's civic centre into a hospital.
Violators of the curfew are subject to $500 fines, though the order does not apply to people who are going to or from work or are out for other essential reasons, such as food shopping and medical care.
"We are in a crisis stage," El Paso County Judge Ricardo Samaniego, the county's top elected official, as he issued the stay-at-home order over the weekend.
On Monday, the county reported a record high in daily cases, with 1443, and 853 patients hospitalised because of the virus, up from 786 a day earlier. The state has provided over 900 medical personnel to El Paso, some of whom will staff the convention center site.
Just last week, Trump during the last presidential debate downplayed the virus's effect in the Lone Star State, saying: "There was a very big spike in Texas, it's now gone."
On Sunday, White House chief of staff Mark Meadows said that "we're not going to control the pandemic" and that the focus should be on containment and treatment.
Trump, who spent several days in the hospital after contracting the virus, said repeatedly over the weekend that the country is "rounding the turn". His remarks came amid another outbreak in the White House inner circle. Several close aides to Vice President Mike Pence tested positive, including his chief of staff.
Europe, which had aggressively tackled the virus with shutdowns, mask mandates and other steps in the spring, is also seeing an alarming resurgence.
In France, with one-fifth the population of the US, a doctor warned that his country has "lost control of the epidemic" after health authorities reported more than 52,000 new cases. Spain, the first European country to surpass one million confirmed Covid-19 cases, announced a nationwide curfew and a cap of six people on social gatherings.
Italy, where the virus cut a deadly swath in the spring, ordered restaurants and bars closed by 6pm and shut down gyms, pools and movie theaters.
In the US, Oklahoma is one of the states consistently breaking records for new cases, and the strain is being felt in hospitals. Bed space is running out, and an equally daunting problem is a shortage of nursing staff.
Dr Sam Ratermann, director of the hospitalist programme at INTEGRIS Grove Hospital in Grove, Oklahoma, said his organization is offering a hiring bonus of up to $25,000 for experienced nurses. He said patients are being transferred from "hospital to hospital across the state" for lack of beds.
"Even when we have open ICU beds across the state, we don't have staff to fill them," Ratermann said. "There's going to be a point where there's no beds and we can't even care for our local citizens."
In Kentucky, the state shattered its record for the number of new cases per week, with 9335.
"We must do better," Democratic Governor Andy Beshear said, adding that he plans to make recommendations soon for counties with high rates of infection.
The University of Minnesota's Osterholm has been predicting the darkest days will be in the weeks or months ahead. He said he expects increased competition for drugs and shortages of hospital specialists, N95 masks and other protective gear.
A strong national response plan was needed, along with consistent messaging that emphasised mask wearing and other preventive measures, Osterholm said.
"But our response has been ... I don't know what our response has been," he said.