America on Friday hit its highest daily number of coronavirus cases since the pandemic began, recording at least 81,400 new infections and surpassing the previous record set during the summertime surge of cases across the Sun Belt.
The impact is being felt in every section of the country -- a lockdown starting Friday at the Oglala Sioux Tribe reservation in South Dakota; a plea by a Florida health official for a halt to children's birthday parties; dire warnings from Utah's governor; and an increasingly desperate situation at a hospital in northern Idaho, which is running out of space for patients and considering airlifts to Seattle or Portland, Ore.
"We've essentially shut down an entire floor of our hospital. We've had to double rooms. We've bought more hospital beds," said Dr. Robert Scoggins, a pulmonologist at the Kootenai Health hospital in Coeur d'Alene, Idaho. "Our hospital is not built for a pandemic."
Among those joining Scoggins at a meeting of northern Idaho's Panhandle Health District was board member Walk Kirby.
"People are dying, they're going to keep dying and catching this stuff," Kirby said. "How many people won't wear a mask? The same people that won't get vaccinated for it."
Utah's Gov. Gary Herbert proclaimed Friday "a record day for Utah -- but not a good one" as covid-19 cases reached an all-time high for the state.
"Up until now, our hospitals have been able to provide good care to all covid and non-covid patients who need it," he said. "But today we stand on the brink. If Utahans do not take serious steps to limit group gatherings and wear masks, our health care providers will not have the ability to provide quality care for everyone who needs it."
By public health order, masks are required in 21 counties, said Herbert, urging Utah residents to wear one whenever they are around someone outside their immediate household.
More than 8.4 million Americans have been infected with the coronavirus as of Friday, and at least 223,000 have died, according to a rolling tally by Johns Hopkins University.
The U.S. surge mirrors a similarly widespread spike in Europe, where Rome, Paris and other major cities are reining in nightlife as part of the increasingly drastic measures undertaken to slow the spread of the pandemic. French authorities said the country had recorded over 1 million confirmed coronavirus cases since the start of the pandemic, becoming the second country in Western Europe after Spain to reach that number.Gallery: Coronavirus outbreak in the United States
The head of the World Health Organization warned that countries in the Northern Hemisphere are at a "critical juncture" as cases and deaths continue to rise.
"The next few months are going to be very tough, and some countries are on a dangerous track," said WHO director-general Tedros Adhanom Ghebreyesus at a news briefing Friday.
More than 170 counties across 36 states were designated rapidly rising hot spots, according to an internal federal report produced Thursday for officials at the Department of Health and Human Services, and obtained by The Washington Post.
"One key way we got through previous waves was by moving health care workers around. That's just not possible when the virus is surging everywhere," said Eleanor J. Murray, an epidemiologist at Boston University.
Equally alarming, Murray said, is that no one knows how high this wave will grow before peaking.
"We are starting this wave much higher than either of the previous waves," she said. "And it will simply keep going up until people and officials decide to do something about it."
"I worry sometimes about being too pessimistic," she said. "We are not making predictions and saying this dark winter is somehow inevitable. We're trying to warn people this is how it will be if we don't do something about it.
"But it doesn't have to be that way."
In Texas, Gov. Greg Abbott is sending more medical reinforcements to the El Paso area in response to a surge of coronavirus infections. The Texas Department of State Health Services and the Texas Division of Emergency Management will provide more medical personnel and equipment this week.
El Paso County reported 3,750 new coronavirus infections this week, including 1,161 Thursday. That number accounts for 17.5% of the 21,321 cases reported this week by the state's 254 counties.
In Idaho, even as the health care situation worsened, a regional health board voted to repeal a local mask mandate. It acted moments after hearing how the Kootenai Health hospital in Coeur d'Alene had reached 99% capacity.
The state is experiencing its largest coronavirus spike since the pandemic began, with new cases increasing statewide by 46.5% over the past two weeks. Gov. Brad Little, a Republican, has declined to take steps such as requiring masks statewide to slow the virus's spread.
Dr. Joshua Kern, vice president of St. Luke's in the Magic Valley region that includes Twin Falls and Jerome, said Thursday during a virtual news conference that he and other medical professionals are scared.
"The purpose of any intervention around coronavirus has been to prevent the hospitals from being overwhelmed, and here I am today saying the hospital is being overwhelmed," he said.
"Frankly there's nowhere to send them," he added. "Boise hospitals are very full, most of the hospitals in this area are experiencing similar issues. Salt Lake's hospitals have full ICUs. There's not really a cavalry to come. We're it."
In Georgia, a rural community hospital hit hard by the pandemic has closed after more than 70 years in southwestern Georgia.
WALB-TV reported that residents and workers gathered in Cuthbert, Ga., for a ceremony to say goodbye to Southwest Georgia Regional Medical Center, which had operated in Randolph County since 1947 and closed Thursday.
Financial problems at the hospital were worsened by the pandemic, which forced many patients to delay or cancel elective procedures. Workers wearing masks stood outside the hospital as a speaker talked about the shutdown.
In Louisiana, House Republicans filed a petition Friday to revoke Gov. John Bel Edwards' coronavirus restrictions for a week, as lawmakers finished a special session in which they sought more power over the Democratic governor's emergency actions but appeared likely to see that effort vetoed.
Republicans are invoking a never-before-used process outlined in state law that allows a majority of House lawmakers to nullify the governor's public health emergency declaration -- and all restrictions tied to it -- with a petition.
House Speaker Clay Schexnayder said Edwards refused to address legislative concerns about his virus rules "in any substantive way."
"The Legislature will make no apologies for simply standing up for the people we collectively represent," Schexnayder, a Gonzales Republican, said in a statement. "The House has exhausted every available legislative remedy and has been left with no other option but to exercise its legislative right to terminate the governor's emergency order."
The issue likely will be settled in court, since Edwards indicated no plans to end enforcement of his rules.
NORTHEAST CASES RISE
For a while, as new cases surged in the Midwest and elsewhere, the level of new cases remained low in the Northeast, which had been hit hard earlier in the pandemic. Several states, including New Jersey and Connecticut, imposed 14-day quarantine requirements for travelers arriving from dozens of states with higher rates of positive tests.
This week, however, rates in New Jersey and Connecticut rose to the point where they qualify for their own quarantine restrictions.
After some confusion, the Democratic governors of New Jersey, Connecticut and New York, where rates remain lower, decided to keep their travel rules in place, but not add one another to their quarantine lists.
On Thursday, Chicago Mayor Lori Lightfoot, a Democrat, announced new restrictions on businesses.
Hours later, White House coronavirus response coordinator Dr. Deborah Birx warned that closing public spaces may not be enough.
"It won't be as simple as closing public spaces," Birx said, pointing to increased gatherings in people's homes. "What has happened in the last three to four weeks is that people have moved their social gatherings indoors."
Meanwhile, it's been "several months" since President Donald Trump met with the White House coronavirus task force, said Dr. Anthony Fauci.
Fauci, director of the National Institute of Allergy and Infectious Diseases, told MSNBC on Friday that the task force now meets about once a week, versus its daily gatherings early in the pandemic. The team also holds a regular call with governors, and its medical experts meet virtually, as well, Fauci said.
"I definitely don't have [Trump's] ear as much as Scott Atlas right now, that has been a changing situation," Fauci said. "We certainly interact with the vice president at the task force meetings, and the vice president makes our feelings and what we talk about there known to the president."
The frequency of the meetings started to ebb "sometime a few months ago when things pivoted around to more of the economic reopening, as it were, of the country," Fauci said.
For now, Operation Warp Speed, created by the Trump administration to spearhead development of coronavirus vaccines and treatments, is focused on getting vaccines through clinical trials in record time and manufacturing them quickly.
The next job will be to monitor the safety of vaccines once they're in widespread use. But the administration last year quietly disbanded the office with the expertise for exactly that job. Its elimination has left that long-term safety effort for coronavirus vaccines fragmented among federal agencies, with no central leadership, experts say.
A Health and Human Services spokesperson declined to answer detailed questions about why the vaccine office, set up in 1987, was closed or how the health agencies were planning to track the safety of vaccines once they are injected into millions of people.
In a brief statement, she said that Operation Warp Speed was working closely with the Centers for Disease Control and Prevention "to synchronize the IT systems" involved in monitoring vaccine safety data.
Scientists at the CDC and the Food and Drug Administration have decades of experience tracking the long-term safety of vaccines. They've created powerful computer programs that can analyze large databases.
"It's like satellites looking at the weather," said Dr. Bruce Gellin, president of the Sabin Vaccine Institute, who headed the National Vaccine Program Office from 2002-17.
Information for this article was contributed by Rebecca Boone, David Crary, Melinda Deslatte, Amy Forliti, Dave Collins, Brady McCombs and Freida Frisaro of The Associated Press; by William Wan, Jacqueline Dupree and Lena H. Sun of The Washington Post; by Josh Wingrove of Bloomberg News; and by Carl Zimmer of The New York Times.