A virus outbreak that has killed 21 residents at a veterans’ home in New Hampshire is putting the spotlight on a growing surge of new cases in the Northeast and Mid-Atlantic States that in many places exceeds peaks seen in the spring.
The New Hampshire Veterans Home in Tilton had no cases for the first eight and a half months of the pandemic, Gov. Chris Sununu said at a news conference Thursday. But now, an outbreak has torn through that the home says infected 51 residents and 67 staff members — and killed 21 residents.
New Hampshire is now averaging almost 600 cases a day, roughly six times its highest previous average, reached in May, and hospitalizations are also at record levels.
Cases are escalating across the region. Maine, Massachusetts, Pennsylvania, Delaware and New Jersey all set single-day case records on Thursday, and Pennsylvania and New Jersey did so on Friday as well. More than 50,000 cases have been identified in Pennsylvania in the past seven days, the most in any week of the pandemic. The Cumberland, Md., area has the third-highest rate of new cases among all American metropolitan areas.
At the New Hampshire Veterans Home, the assumption is that an asymptomatic staff member unknowingly brought the virus in, said Margaret LaBrecque, who leads the home’s administration. High temperatures were first detected among a group of residents on the morning of Nov. 10, she said. From there, the virus spread quickly, as it has continued to do in long-term care facilities around the country.
Ms. LaBrecque said that residents were “very resilient but are worried for their comrades,” and that staff members were tired from working overtime, but “hopeful that we can get through this difficult time.”
But the broader surge has more complicated roots.
“I think we got here because of deficient national leadership, pandemic fatigue and cold weather,” said Dr. Larry Chang, an infectious-disease expert at Johns Hopkins University School of Medicine, adding that the virus has much more potential to spread since only about 15 percent of the country’s population is known to have been infected.
He said that new lockdowns could still keep the surge from worsening.
“We’re currently already seeing severely strained health systems across the East Coast,” Dr. Chang said, noting that Covid admissions had quadrupled at the Johns Hopkins Hospital compared to those in the summer.
“One of the big questions is, how big of a surge we’re going to see, on top of the surge we’re currently experiencing, from Thanksgiving and Christmas holidays,” Dr. Chang said. “Will that lead to broadly overwhelmed hospitals and many more needless deaths?”
Bahrain became the second country to give emergency authorization to Pfizer’s coronavirus vaccine on Friday, the government-run Bahrain News Agency reported.
The tiny Persian Gulf kingdom, an oil-dependent country with large numbers of low-wage migrant workers, has one of the world’s highest rates of coronavirus cases per capita, according to data compiled by The New York Times.
On Wednesday, Britain became the first country to approve the Pfizer vaccine, the product of a collaboration with Germany’s BioNTech. Until then, no country had authorized a fully tested coronavirus vaccine.
Britain and Bahrain beating the United States to emergency authorization — on a vaccine codeveloped by an American company, no less — could intensify pressure on regulators in the United States, who have been under fire for not moving faster to get doses to people. (On Friday morning, Dr. Stephen M. Hahn, the head of the U.S. Food and Drug Administration, said he was “hopeful” that the agency would approve a vaccine after an advisory committee meeting set for Dec. 10.)
Russia and China have approved other coronavirus vaccines without waiting for large-scale efficacy tests, and last month Bahrain approved the use of a vaccine from Sinopharm, a Chinese company, for frontline workers.
The two-dose Pfizer vaccine must be stored at extremely cold temperatures, which complicates the logistics of transporting it around the world. Pfizer expects to ship up to 50 million doses of the vaccine before the end of the year.
The approval in Bahrain “will add a further important layer to the Kingdom’s national Covid-19 response, which has strongly prioritized protecting the health of all citizens and residents during the pandemic,” said Dr. Mariam Al Jalahma, the chief executive of the country’s National Health Regulatory Authority.
Lindsey Dietschi, an executive in charge of Pfizer’s work in the Persian Gulf, called the approval a “historic moment” in the fight against Covid-19. “This authorization is a goal we have been working toward since we first declared that science will win,” she said.
As coronavirus infections soar nationwide, federal health officials on Friday urged state and local governments to implement 10 essential public health measures, including universal use of face masks outside the home.
The guidance from the Centers for Disease Control and Prevention also calls for those who have been exposed to or infected by the virus to be secluded from others; an increase in coronavirus testing, especially for workers whose jobs bring them into contact with the public or with vulnerable individuals; the prioritization of contact tracing and case investigations; the protection of high-risk people and essential workers; and postponement of travel.
The agency also urged communities to plan for the distribution and administration of vaccines once they become available.
Though the agency has issued all of the recommendations piecemeal in earlier guidance documents, the new summary issued Friday represented the first time the C.D.C. had published a comprehensive list of strategies.
“No single strategy can control the epidemic,” according to the new guidance, written by the agency’s Covid-19 response team. “Full implementation of and adherence to these strategies will save lives.”
The document places a high priority on keeping schools open, from kindergarten through grade 12. Schools should be both “the last settings to close” and “the first to reopen” because of the critical role they play in providing meals and support services to children, and because school closures exact a disproportionate toll on low-income families.
Restaurant dining, on the other hand, was identified as one of the “particularly high-risk scenarios” for spreading infection because consistent use of face masks is impossible.
The report notes that outdoor settings that draw crowds have also been linked to spread of the virus and suggests switching to takeout food service. Exercise should be done in outdoor settings, with a mask and social distancing, the agency said. Work should be done remotely whenever possible, and social gatherings should be limited, the agency said.
President-elect Joseph R. Biden Jr. said on Thursday that he would implore Americans to wear masks for a little more than three months toward the beginning of his term.
“Just 100 days to mask,” Mr. Biden told CNN. “I think we’ll see a significant reduction.”
But until he is sworn in on Jan. 20, Mr. Biden’s ability to take direct action is limited.
On Thursday evening, the New York Young Republican Club held its 108th annual gala, in person.
It did not feature Sarah Palin, who had been booked for the event but canceled because of concerns about flying from Alaska during a pandemic, according to someone familiar with her thinking. It was not held at the Caldwell Factory in Manhattan, the site listed on the club’s Facebook page. A spokesman for the venue said that no events had been booked there for months.
And in the end, the event was not even held in New York State.
Images posted on Twitter on Thursday night showed dozens of attendees gathered on the New Jersey side of the Hudson River, inside Maritime Parc, a restaurant in Liberty State Park, seated and standing close together and wearing no masks. Some of those who posted about the event tagged and taunted Gov. Andrew M. Cuomo of New York.
The president of the club, Gavin M. Wax, 26, quickly found a replacement for Ms. Palin: Representative Matt Gaetz of Florida, a close ally of President Trump. The event’s other headline speaker was James O’Keefe, the conservative activist who runs the New York-based Project Veritas. He declined to confirm his attendance, but later offered a New York Times reporter the opportunity to use a hidden camera to spy on The Times on behalf of his group. (The reporter declined.)
Mr. Wax declined to be interviewed by phone. But in a series of text messages, Twitter direct messages, tweets and emails, he insisted that the club was following virus protocols and that Democrats were hypocritically trying to shut down the party, even as they themselves took part in seemingly ill-advised indoor events.
New Jersey limits indoor gatherings during the pandemic to 10 people. An exception for “religious and political activities protected under the First Amendment” allows for indoor gatherings to 25 percent of a room’s capacity or 150 people, whichever is lower. Indoor, maskless gatherings of more than 10 people without social distancing are forbidden.
On Friday, the restaurant was ordered shut by the Jersey City Department of Health and Human Services, which directed Maritime Parc’s management to submit a plan describing how it will comply with the state’s orders “regarding capacity mandates and mask wearing.”
Coronavirus infections have been growing at an alarming rate in Miami-Dade County, Fla., leading government and hospital officials to plea with the public on Friday to stay home over the holidays and adhere to guidance on mask wearing, hand washing and social distancing.
Over the past two months, Covid-19 hospitalizations have more than doubled in the county to 850, and the positive test rate has nearly doubled to 9.77 percent.
“We’re gravely concerned about overwhelming our health care system capacity,” Mayor Daniella Levine Cava said in a virtual news conference that she led from home. She has been isolating with her husband, a doctor, since Monday, when both tested positive for the coronavirus.
Hospital administrators there and in neighboring Broward County, like many across the country, are warning that the virus is so widespread that medical reinforcements aren’t available. For instance, the traveling nurses Miami-Dade and Broward were able to bring in for July’s spike were already deployed elsewhere.
“The surge that took place then cannot take place again,” said Aurelio M. Fernandez III, chief executive of the Memorial Healthcare System, which serves South Florida. “There aren’t enough resources. We can convert rooms overnight, but there’s not enough nurses. There’s not enough clinicians. There’s not enough respiratory therapists.”
In September, Gov. Ron DeSantis, a Republican, signed an executive order banning the enforcement of mask ordinances, curfews and other measures, so local officials are unable to do little other than ask people for compliance. His order also prohibited local governments from shutting down businesses and limited the ability to reduce businesses’ indoor capacity. Mr. DeSantis reiterated this week that there would be “no fines, no lockdowns, no school closures” in the state, which — along with only Texas and California — has had more than one million infections.
Still, Miami-Dade has a mask mandate and a curfew, and the police issue citations for violations that they hope to enforce at some point. Ms. Levine Cava, a new mayor who took office last month, said her office was planning a public service campaign asking for cooperation on obeying the rules and getting tested.
She also said that the Miami-Dade County League of Cities planned to send a letter urging Mr. DeSantis to give power back to local governments when cases rise in their areas.
Regarding her own condition, Ms. Levine Cava, sounding congested, said her symptoms were mild but called the virus a “beast.”
In other developments from across the U.S.:
A couple that had tested positive for the coronavirus and then boarded a United Airlines flight were banned on Friday by the airline while it investigates the matter, a spokeswoman said. Wesley Moribe, 41, and Courtney Peterson, 46, of Wailua, Hawaii, were arrested last Sunday and charged with reckless endangerment because they had placed “the passengers of the flight in danger of death,” the Kauai police said. The two posted bail and are scheduled to appear in court on Jan. 6, according to Justin Kollar, the Kauai County prosecuting attorney. If convicted, they could face up to a year in jail or a $2,000 fine.
Oregon has paid out more than $6 billion in unemployment benefits since the pandemic struck, and as in many other states, the rush of applications forced the Oregon Employment Department to go into overdrive, calling in the National Guard to help expedite the jobless applications.
Now a processing center that was opened to meet the surge in demand is itself suffering a coronavirus outbreak, in what might be described as an encapsulation of the intertwined crises brought on by the virus.
David Gerstenfeld, acting director of the Oregon Employment Department, said at a news briefing this week that the outbreak at the Wilsonville center, south of Portland, would accelerate plans to have unemployment processors work from home.
“Needless to say this is incredibly distressing for us to see so many of our colleagues contracting Covid-19,” he said. “We have been adding more and more protective measures over time. And despite doing that, seeing this relentless spread of the virus is very sobering.”
As of Thursday, 12 people who worked at the center had contracted the virus, putting it on an increasingly long list of workplaces in Oregon that have seen outbreaks. The list includes prisons, Amazon and Walmart distribution centers, food processing plants, a Home Depot, a Thai restaurant and the Clackamas County Sheriff’s Office.
The state largely escaped the spring surge of the virus, but infections have been rising sharply for more than a month, escalating by 33 percent in the last two weeks alone to reach a seven-day average of more than 1,300 — more than three and a half times its average in its summer surge.
The outbreak at the unemployment processing center comes as an estimated 70,000 Oregonians brace for the loss of unemployment benefits before the end of the year as federal pandemic assistance expires.
“The loss of the safety net is going to be incredibly difficult,” Mr. Gerstenfeld said. “We know that too many Oregonians are facing desperate times.”
Movement between Italian regions will be all but barred between Dec. 21 and Jan. 6, with people allowed to travel only for work, health reasons or emergencies, the Italian government announced on Thursday.
And the restrictions will be even tighter on Christmas, Dec. 26 and New Year’s Day, when Italians won’t be allowed to leave their towns.
“The Christmas festivities are coming,” Prime Minister Giuseppe Conte said during a news conference on Thursday. “We have to ward off the risk of a third wave.”
New cases in Italy have dropped in recent weeks, with 23,219 reported on Thursday according to a New York Times database, but the numbers remain well above the previous peak in March. And the country recorded 993 deaths, a new daily high, on Thursday, surpassing the deadliest day in March.
The government said it needed to prevent a rebound of the contagion during extended family gatherings and large parties. Mr. Conte pleaded with Italians to avoid organizing dinners or lunches with anyone they do not live with, especially during the holidays when, he said, “the celebrations become more intense.”
Other measures announced Thursday include a ban on New Year’s Eve dinners in hotels, allowing room service only that night. Ski slopes will be closed from the Alps to the Apennines, a coordinated decision by Italy, France and Germany.
The new decree also imposed quarantines on travelers from abroad during the holidays.
“It’s going to be a Christmas different from all the others,” Mr. Conte said.
In other developments around the world:
China plans to approve 600 million coronavirus vaccines for sale by the end of the year, Wang Junzhi, a biological products quality control expert with the Chinese Academy of Sciences, said on Friday. The government has already made unproven candidates widely available in an effort to demonstrate their safety and effectiveness. But it has not announced any efficacy data yet, and a spate of quality scandals in recent years has made the Chinese public skeptical of vaccines.
Most establishments in Seoul, the capital of South Korea, will be required to close by 9 p.m. starting on Saturday, the city’s mayor said. The country reported more than 600 new cases on Friday, its highest tally in nearly nine months.
Japan is facing a new coronavirus crisis, Prime Minister Yoshihide Suga said during a Friday news conference, noting a rise in the number of severely ill patients had begun to put a strain on hospitals. Japan is experiencing a third outbreak, which has brought some of the country’s highest single-day tallies of new infections and deaths since the pandemic began, driven largely by clusters in the Tokyo metropolitan area. While the prime minister fell short of declaring a state of emergency, he urged the public to take precautions.
Career scientists at the Centers for Disease Control and Prevention warned Vice President Mike Pence on Friday that, while a coronavirus vaccine is on the way, the pandemic remains a devastating threat — particularly to health care workers and hospital systems that are cracking under the strain of an explosion of cases.
“Hospitalizations are still rising and it’s a real problem,” said Dr. Henry Walke, who directs the C.D.C.’s Division of Preparedness and Emerging Infections. “Health care providers are overstressed, beds are full.”
Mr. Pence, seeking to put a more upbeat spin on the situation, declared that America is in a “challenging time,” but also in a “season of hope.”
The visit to the agency’s headquarters in Atlanta, live streamed on the White House website, was notable not so much for what was said, but for who said it. The C.D.C.’s career scientists have been largely kept out of public view since late February, when Dr. Nancy Messonier, who directs the National Center for Immunization and Respiratory Diseases, briefed reporters on the coming pandemic and warned that “the disruption to everyday life might be severe,” including school and business closures.
President Trump, who declared the pandemic a national emergency a few weeks later, was furious and, according to some reports, threatened to fire her.
But on Friday, Dr. Messonier was seated at a table along with Dr. Walke and Dr. Jay Butler, the C.D.C.’s deputy director for infectious diseases, who took Mr. Pence through a slide presentation showing how the vaccine would be distributed. When Dr. Butler praised “the foresight of Dr. Messonnier and her staff,” Mr. Pence acknowledged her.
“Dr. Messonnier, it’s great to see you again,” he said. “It’s been a while.”
The coronavirus pandemic has inflicted an economic battering on state and local governments, shrinking tax receipts by hundreds of billions of dollars. Now devastating budget cuts loom, threatening to cripple public services and pare work forces far beyond the 1.3 million jobs lost in eight months.
Governors, mayors and county executives have pleaded for federal aid before the end of the year. Congressional Republicans have scorned such assistance, with the Senate majority leader, Mitch McConnell of Kentucky, calling it a “blue-state bailout.”
But it turns out this budget crisis is colorblind. Six of the seven states that are expected to suffer the biggest revenue declines over the next two years are red — states led by Republican governors and won by President Trump this year, according to a report from Moody’s Analytics.
Those on the front lines agree. “I don’t think it’s a red-state, blue-state issue,” said Brian Sigritz, director of state fiscal studies at the National Association of State Budget Officers. The National Governors Association’s top officials — Andrew M. Cuomo of New York, a Democrat, and Asa Hutchinson of Arkansas, a Republican — issued a statement this fall saying, “This is a national problem, and it demands a bipartisan and national solution.”
There is an urgent need to address long-term symptoms of the coronavirus, leading public health officials said this week, warning that hundreds of thousands of Americans and millions of people worldwide might experience lingering problems that could impede their ability to work and function normally.
In a two-day meeting on Thursday and Friday, the federal government’s first workshop focused on long-term Covid-19, public health officials, medical researchers and patients said the condition needed to be recognized as a syndrome.
“This is a phenomenon that is really quite real and quite extensive,” Dr. Anthony S. Fauci, the nation’s top infectious diseases expert, said at the conference on Thursday.
While the number of people affected is still unknown, he said, if long-term symptoms afflict even a small proportion of the millions of people infected with the coronavirus, it is “going to represent a significant public health issue.”
Such symptoms — ranging from breathing trouble to heart issues to cognitive and psychological problems — are plaguing an untold number of people worldwide. Even for people who were never sick enough to be hospitalized, the aftermath can be long and grueling.
The Centers for Disease Control and Prevention recently posted a list of long-term symptoms, including fatigue, joint pain, chest pain, brain fog and depression, but doctors and researchers said they still know little about their extent or causes, which patients will develop them or how to address them.
Some call patients with lingering health issues “Covid long-haulers,” but some survivors and experts feel that name trivializes the experience, lessening its importance as a medical syndrome that doctors and insurers should recognize. Patients and experts are now weighing what term should be adopted officially.
In an inadvertent but stark illustration of the difficulty of the recovery process, two of the four patients scheduled to speak at the meeting were unable to because they had recently been hospitalized.
The American economic recovery continues to slow, stranding millions who have yet to find a new job after being thrown out of work by the coronavirus pandemic.
The latest evidence came Friday when the Labor Department reported that employers added 245,000 jobs in November, the fifth month in a row that the pace of hiring has tapered off. The figure for October was revised downward to 610,000, from the initially stated 638,000.
The unemployment rate in November was 6.7 percent, down from the previous month’s rate of 6.9 percent. But that figure does not fully capture the extent of the joblessness because it doesn’t include people who have dropped out of the labor force and are not actively searching for work.
By Ella Koeze·Unemployment rates are seasonally adjusted.·Source: Bureau of Labor Statistics
November’s job totals were dragged down in part by the loss of 93,000 temporary census workers who are no longer needed now that the official counting has wound down.
More than half those knocked out of a job early in the pandemic have been rehired, but there are still roughly 10 million fewer jobs than there were in February. Many people in that group are weeks away from losing their unemployment benefits, as the emergency assistance approved by Congress last spring is set to expire at the end of the year.
“We’re in an unusual position right now in the economy,” said Ernie Tedeschi, an economist at the accounting firm Evercore ISI. “Far off in the distance there is sunlight” because of progress on a vaccine, he said, but until then, “we’re going to have a few of the toughest months of this pandemic, and there will be a lot of scars left to heal.”
The number of people who have been unemployed long-term is still rising
Share of unemployed who have been out of work 27 weeks or longer
By Ella Koeze·Data is seasonally adjusted.·Source: Bureau of Labor Statistics
Covid-19 caseloads have doubled in the past month, leading to new restrictions and tamping down shopping and other commerce. In much of the country, colder weather is likely to discourage outdoor dining, which many restaurants have depended on. And Congress has been unable to agree on a new spending package to help struggling businesses and households.
Speaker Nancy Pelosi flashed fresh optimism on Friday that the House and Senate could soon reach a bipartisan deal on an elusive pandemic stimulus plan after she and Senator Mitch McConnell, the Senate majority leader, agreed to try to find an agreement that could be merged with an enormous year-end spending package.
“That would be our hope because that is the vehicle leaving the station,” Ms. Pelosi, Democrat of California, said at a news conference in the Capitol Friday morning, a day after her conversation with Mr. McConnell, Republican of Kentucky. The phone call marked their first conversation since the election.
Though Ms. Pelosi conceded there were still obstacles to an agreement, she insisted there would be “sufficient time” to close a deal before the Dec. 11 government funding deadline. She pointed to lower-than-expected job gains reported on Friday as an added accelerant.
“There is momentum. There is momentum,” Ms. Pelosi said. “The tone of our conversations is one that is indicative of the decision to get the job done.”
Mr. McConnell expressed similar resolve on Thursday, although he stopped short of endorsing the $908 billion outline proposed by a bipartisan group of moderates that Ms. Pelosi has said should be the starting point for talks, instead pressing for a far smaller bill.
Stimulus talks have been stalemated for months, with lawmakers unable to resolve differences over issues like liability protections for businesses, a Republican demand that Democrats have resisted, and providing federal aid to state and local governments, a top priority for Democrats that many Republicans oppose. They are also still struggling to resolve a number of policy disputes in the must-pass bills needed to keep the government funded beyond Dec. 11, though most involved in the process say that a resolution is feasible before the end of the year.
After months of insisting they would not accept a slimmed-down relief bill, Democrats now appear poised to accept less than one third of the spending they initially proposed to prop up small businesses, help the uninsured and jobless, boost state and local governments, and meet immediate public health needs, leaving other priorities unaddressed until President-elect Joseph R. Biden Jr. takes office Jan. 20.
The emerging compromise would revive lapsed federal unemployment benefits at $300 a week for 18 weeks, and provide billions of dollars in funding for small businesses, schools and the imminent distribution of a vaccine.
While a bipartisan group of senators is expected to continue working on finalizing legislative text through the weekend, there remain a number of significant hurdles. The policy divides that have helped derail attempts to reach agreement earlier this year persist even as lawmakers circulate a tentative outline.
Pressed on her reversal, Ms. Pelosi was defensive on Friday, saying her earlier, multitrillion-dollar proposals that the Senate called nonstarters were important parts of a negotiating strategy that may now yield results. She insisted that Mr. Biden’s election and the looming arrival of two vaccines amounted to “a total game-changer.”
“President-elect Biden has said this package would be at best just a start,” she said. “That’s how we see it, as well. It is less money, but over a shorter period of time, and we need to do it to saves lives and livelihood with the hope that much more help is on the way.”
Of all the toxic dumps in New Jersey, perhaps none was more infamous than PJP Landfill.
It was here, at the edges of the Hackensack River in Jersey City, that underground fires erupted spontaneously for more than a decade, belching acrid smoke so thick it could snarl traffic on an adjacent bridge, the Pulaski Skyway, a key link for commuters to New York City.
Firefighters tried dousing the smoldering land in the mid-1980s with 300,000 gallons of water a day, but residents complained that the spraying did not help.
Now, 30 years after the dump was held up as the poster child for toxic nightmares by the New Jersey congressman who wrote the Superfund law, plans for a phoenixlike rebirth await: It is being converted into a public park with one of the nation’s first memorials to victims of Covid-19.
As part of a $10 million makeover, more than 500 trees will be planted in a grove of the newly named Skyway Park — one for every Jersey City resident who has died of the coronavirus, the mayor, Steven M. Fulop, announced on Thursday.
Each person’s name will also be included on a memorial wall, giving relatives of the dead a place to mourn. Many families were unable to observe traditional funeral rituals as the pandemic ravaged the Northeast.
“We wanted to do something significant for those families that didn’t get to grieve properly, and we’re taking a step forward in that direction,” Mr. Fulop said. “It has been a tough year for the city.”
Once the park is complete — likely next summer or fall — walkways will wend along the river, through a pollinator garden and beside green spaces lined with flowers and reedy grasses native to the low-lying wetland area. A pedestrian bridge designed in the image of the Pulaski will connect two sides of the 32-acre site, which is bisected by a stream known as the Sip Avenue Ditch.