Coronavirus spread in U.S. alarms officials as Americans grow weary of limits

The coronavirus is racing through the U.S. with alarming speed, with more than 150,000 cases of COVID-19 detected for three days running and hospitalizations at their highest levels since the pandemic began, prompting governors to plead for pre-vaccine discipline or issue the types of restrictions Americans were hoping to avoid.

Many cases in communities aren’t recorded and some of the infected don’t get sick at all, but the underlying trends are ringing alarm bells as the country waits for promising vaccines from Pfizer and other drugmakers.

The seven-day average of COVID-19 deaths has reached more than 1,000 per day in the U.S. Nearly 70,000 people are hospitalized, up from 36,000 a month ago. That level exceeds the early crush in the spring and the summertime surge in the Sun Belt.

The virus is rampant in the Upper Midwest. Wisconsin has opened a field hospital, and North Dakota and South Dakota are No. 1 and No. 2 in per capita death rates over seven days. Elsewhere, governors in northeastern states are worried about a second surge and El Paso, Texas, called in mobile morgues.

“Our future is in our hands,” said Michael Osterholm, a University of Minnesota infectious disease expert and member of presumptive President-elect Joseph R. Biden’s COVID-19 advisory board, told NBC’s “Meet the Press.” “We are in a very dangerous period.”

If Americans don’t buckle down and stop “swapping air” with others, then the breakdown will bring a “sense of reality,” Dr. Osterholm said.

Ohio Gov. Mike DeWine, a Republican, said hospitals in his state are not overwhelmed but some have deferred elective surgeries, an early signal of a potential problem.

“We don’t like to see that. We don’t like to see any kind of health care delays,” Mr. DeWine told CNN’s “State of the Union.”

He told Ohioans to “tough it out” for a few more months to provide a bridge to the vaccine.

“If we wear a mask, we are keeping our kids in school and we are protecting our elderly and we are protecting our hospitals,” Mr. DeWine said.

Experts say the country is in a tough spot. The coronavirus is spreading exponentially but the bulk of the population is still susceptible to COVID-19, so the safest path to widespread immunity is through a vaccine, which is weeks away from becoming available to the first recipients.

State and local leaders are issuing restrictions and demanding compliance even as Americans tire of rolling restrictions that have upended their lives, ruined the economy and threatened holiday gatherings.

Governors and city officials across the country are telling people not to mix households on Thanksgiving or to at least limit the sizes of their gatherings.

Some leaders are imposing nighttime curfews at bars and restaurants. Chicago Mayor Lori Lightfoot issued an order that allows people to leave home only for work or school or for essential needs such as food and medicine.

Virginia Gov. Ralph Northam, a Democrat, said public and private gatherings as of Sunday must be limited to 25 people, down from 250. Also, children 5 and older — previously 10 and older — must wear masks in public indoor spaces. Alcohol sales and on-site consumption in restaurants and bars is prohibited after 10 p.m.

Oregon Gov. Kate Brown, a Democrat, announced a two-week freeze, effective this Wednesday, that forces restaurants and bars to rely on takeout service and closes gyms and recreational facilities.

“We’ve really painted ourselves into a corner as a nation,” said Michael Mina, assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “We’ve essentially allowed this virus to get so out of control that we are now going to see lockdowns and shutdowns that we were trying to avoid.”

President Trump said tens of millions of doses of vaccine could be available by December under his Operation Warp Speed, but he has been largely silent about the crisis as he focuses on contesting election results that showed him losing to Mr. Biden.

“This administration will not be going into a lockdown,” Mr. Trump said Friday.

He said Pfizer’s vaccine, which was 90% effective in a preliminary analysis, will be distributed “very, very quickly” once the company requests emergency-use authorization from the Food and Drug Administration, possibly this month.

The White House expects to have 20 million doses available by December to begin vaccinating health care workers, the vulnerable and elderly right after approval. Doses eventually will be available to anyone free of charge as the U.S. brings in 25 million to 30 million doses per month, said Moncef Slaoui, who is leading the vaccine effort.

He said the operation is supporting six front-runners using three platforms: messenger RNA from Pfizer and Moderna, adenovirus candidates from AstraZeneca and Johnson & Johnson, and recombinant vaccines from Novavax and Sanofi-GSK.

Moderna is finalizing preliminary data and should be following Pfizer in giving a readout soon.

Mr. Trump said New York may have to wait for vaccine doses because of a desire by Gov. Andrew Cuomo, a Democrat, to check federal regulators’ work with a state review of the vaccines.

“That pains me to say that,” Mr. Trump said. “The governor, Gov. Cuomo, will have to let us know when he’s ready for it.”

New York Attorney General Letitia James said the state would sue if Mr. Trump withholds doses.

Mr. Biden, meanwhile, will begin consulting with Pfizer and other vaccine makers this week, but his team would like to be able to speak with government officials involved in the vaccine rollout, said Ron Klain, who is poised to be Mr. Biden’s chief of staff. He said the General Services Administration’s reluctance to kick-start the transition is making it difficult to talk with government officials.

“It’s great to have a vaccine, but vaccines don’t save lives. Vaccinations save lives,” Mr. Klain told NBC’s “Meet the Press.”

Mr. Biden has called the COVID-19 situation “alarming” with “virtually nowhere getting spared.”

He called on the Trump administration to surge testing kits and protective gear to areas in need.

“This week’s news on progress toward a safe and effective COVID-19 vaccine is positive, but it will be many months before there is widespread vaccination in this country,” Mr. Biden said Friday. “This crisis demands a robust and immediate federal response, which has been woefully lacking. I am the president-elect, but I will not be president until next year.”

Dr. Anthony Fauci on Sunday said federal officials working on COVID-19 should be able to confer with Mr. Biden’s transition team. He said it would be best to pass the baton without slowing down as the nation faces a mounting crisis.

“Of course it would be better if we could start working with them,” Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN.

In the meantime, Dr. Mina said, the nation needs a widespread, rapid-antigen testing regime that lets a wide swath of the public screen themselves at home frequently. He said companies are working on simple tests that can detect when people are most infectious, but federal regulators haven’t acted fast enough to release them.

“We have to treat the public health problem first,” Dr. Mina said. “And if we do that, then the medical problems resolve themselves.”

FDA officials say they are working around the clock to provide new testing options while weighing thorny questions about how sensitive the tests should be and the role of health professionals in the process.

The FDA has approved 25 tests for at-home collection, in which a sample is sent to a lab. It hasn’t authorized any fully at-home tests so far, though it released guidance for developers and says it is supportive of their efforts.

Dr. Fauci said there will be no national lockdown in the meantime but there needs to be ubiquitous, no-excuses adherence to mask-wearing, physical distancing and hand-washing.

“Everybody’s got to do it. There’s no excuse not to do it right now,” Dr. Fauci told CNN.

“There is light at the end of the tunnel,” he said of the vaccine. “That should, I believe, motivate people to double down and say, ’We’re going to do this uniformly.’”