Covid-19 Live Updates: As U.S. Breaks Hospitalization and Case Records, N.Y. Adds New Restrictions


Credit…Mark Abramson for The New York Times

With coronavirus cases surging in New York and across the country, Gov. Andrew M. Cuomo said on Wednesday that private indoor gatherings statewide would be limited to 10 people and that gyms, bars and restaurants must close nightly at 10 p.m.

The restrictions will take effect Friday, and Mr. Cuomo said that local governments will be responsible for enforcing them. The limit on gatherings will apply to private homes. The curfew will apply only to bars and restaurants licensed by the state liquor authority, and restaurants can continue to provide takeout after 10 p.m. but only for food.

Mr. Cuomo said that officials were moved to announce the new restrictions as they confronted an increase in cases that they believed stemmed from these areas.

“Bars, restaurants, gyms, house parties,” Mr. Cuomo said on a conference call with reporters. “That’s where it’s coming from, primarily.”

After months where the New York City area had seemed to keep the virus relatively contained, the virus has again increased sharply in the tri-state area, heightening fears of a second wave in a region once at the center of the U.S. outbreak.

Though cases and hospitalizations are significantly lower than they were in the worst of the spring, officials in all three states have acknowledged that they are considering additional restrictions that would roll back the slow, cautious reopening process — particularly as cooling weather drives people indoors, where the virus more easily spreads.

In a marked difference from the spring, the jump in cases in all three states arrives this time as the virus is surging around the country. The United States has been shattering daily records for new cases, pushing the seven-day average to more than 123,000 per day, as of Tuesday, according to a New York Times database. For the first time, new cases surpassed 139,000 on Tuesday.

And 61,964 people were hospitalized across country with Covid-19 on Tuesday, according to the Covid Tracking Project, a number higher than at any point during the pandemic, including the first peak in the spring.

“We’re seeing a national and global Covid surge,” Mr. Cuomo said on a conference call with reporters on Wednesday. “And New York is a ship on the Covid tide.”

In New York City, Mayor Bill de Blasio again on Wednesday warned that a second wave in the city was imminent. He said on Twitter that the citywide seven-day average rate of positive test results was at 2.52 percent — a rate last seen in early June, when the city had only just begun reopening nonessential business after a devastating spring that saw thousands die.

“This is our LAST chance to stop a second wave,” Mr. de Blasio wrote on Twitter. “We can do it, but we have to act NOW.”

Though the city last month saw clusters of the virus emerge in parts of Brooklyn and Queens, cases have since been rising across all five boroughs, including Staten Island, which has long bristled at virus-related limits. Over the past week, New York City has seen an average of 1,142 cases a day, a jump of 77 percent from just two weeks prior.

In New York State, the seven-day average rate of positive test result rate was 2.23 percent on Tuesday, the highest the figure has been since early June when the state was doing less testing than it is now. On Wednesday, the state reported 1,628 hospitalizations, its highest total since mid-June. The number of people hospitalized in the state peaked in April, with several days where it exceeded 18,000.

Adding to concerns, cases have surged in regions outside the New York City area that had suffered less intense outbreaks in the spring and moved more quickly to reopen.

In New Jersey, Gov. Philip D. Murphy has put new limits on indoor dining that begin Thursday night in what he said was a bid to avoid the sweeping shutdowns that brought the region’s economy to a standstill in March. New Jersey has seen its hospitalizations more than double in the last month, from 653 to 1,801 — a threshold last crossed in June.

The number of people hospitalized with the virus has also surged in Connecticut, where the outbreak was less severe in the spring and where officials were slightly quicker to reopen. The state now has 548 patients hospitalized, its highest total since May 29, according to state data. The Hartford Courant reported on Tuesday that the seven-day average rate of positive test results was at 4.1 percent, its highest rate since June 1.

Gov. Ned Lamont has also limited all private gatherings in the state to 10 people. The state lowered capacity limits on restaurants and has allowed the hardest-hit municipalities to reimpose limits on other businesses.

Another official who attended an election night event at the White House has tested positive for the coronavirus. The latest person is the White House political director, Brian Jack, according to two people familiar with the diagnosis on Wednesday.

Mr. Jack tested positive over the weekend, one of the people said.

Credit…Patrick Semansky/Associated Press

The other three people who have tested positive after attending the election night event are Mark Meadows, Mr. Trump’s chief of staff; Ben Carson, the housing secretary; and David Bossie, an adviser to Mr. Trump who is leading the charge on lawsuits and other efforts related to contesting the election outcome in several states.

Several hundred people gathered at the event in the East Room for several hours, many of them not wearing masks as they mingled and watched election returns.

Another West Wing aide also tested positive, the two people said, but it was unclear when the other official did so and whether the official attended the election night party.

After another event at the White House — a celebration of Mr. Trump’s nomination of Judge Amy Coney Barrett to the Supreme Court on Sept. 26 — more than a dozen aides, reporters and guests who were in attendance or came into contact with people who were there tested positive for the virus.

Credit…Maddie McGarvey for The New York Times

Breaking from its tentative recommendations on mask use thus far, the Centers for Disease Control and Prevention said on Tuesday that using masks benefits wearers, which is a step beyond its previous declaration that said wearing masks would only protect those around them.

“Experimental and epidemiological data support community masking to reduce the spread” of the virus, the C.D.C. said in a document that details scientific evidence supporting mask use. “Individual benefit increases with increasing community mask use,” it said.

The unequivocal statements are a departure from the agency’s previous language, which suggested that “the latest science may convince” Americans to wear masks and that mask use could prevent an infected person from spreading the virus to others. “The main protection individuals gain from masking occurs when others in their communities also wear face coverings,” it said.

The agency also offered an economic argument, saying that increasing the proportion of people who wear masks by 15 percent could prevent the need for lockdowns and cut associated losses of up to $1 trillion, or about 5 percent of gross domestic product.

The new document listed several studies that “have confirmed the benefit of universal masking,” as well as some observational studies that have given evidence of its usefulness, including an example of two masked hair stylists who had been experiencing symptoms but did not transmit the virus to any of their 67 masked clients who were later contacted. The document also referred to a study of 124 Beijing households in which mask use significantly cut transmission of the virus, and an outbreak aboard the U.S.S. Theodore Roosevelt in which face coverings appeared to have reduced risk of infection by 70 percent.

Experts said they were thrilled to see the change in the C.D.C.’s stance, and particularly the emphasis on face coverings that protect wearers.

“That matters for public-health messaging, because we don’t have people yet who are completely convinced about the benefits of masking until they see the C.D.C. say that it also protects you and your family,” said Dr. Monica Gandhi, an infectious-disease expert at the University of California, San Francisco.

“I would encourage every American to adhere to masking guidelines now that we hear more clearly today that this will protect you and others,” Dr. Gandhi said. “We cannot afford more lockdowns, but we can do our part to stop Covid-19 transmission and disease.”

Credit…Doug Mills/The New York Times

As President Trump pushes to overturn the results of the election while the pandemic rages on, his only public statements about the coronavirus in the last few days have been to make clear his pique that good news about a vaccine had not come until after Election Day.

Meanwhile, the Strategic National Stockpile, the U.S. emergency reserve, has only 115 million N95 masks, far short of the 300 million the administration had hoped to amass by winter, Rear Adm. John Polowczyk, who retired on Monday as the national supply chain commander, said in a recent interview, though he added that the government is continuing to expand its supplies of protective gear.

The pandemic caught the nation flat-footed in March, but epidemiologists have been warning for months of a fall and winter wave as people are driven indoors, schools resume in-person classes and Americans grow tired of months of precautions. Yet shortages of personal protective equipment are back, especially among rural hospitals, nursing homes and private medical practices that lack access to the supply networks that serve larger hospital chains.

Governors are once again competing with one another and big hospital chains for scarce gear. Nursing homes are grappling with staff shortages, which have left hospitals unable to discharge patients to their care.

In the absence of leadership, local officials feel as if they are struggling alone. New weekly cases among nursing home residents jumped fourfold from the end of May to late October, and deaths have more than doubled in 20 states, according to R. Tamara Konetzka and Rebecca J. Gorges, researchers at the University of Chicago who analyzed data from the Centers for Disease Control and Prevention.

Even many large hospital chains, which say they have adequate supplies of medical gear, continue to operate in crisis mode. That often means requiring employees to repeatedly reuse respirator masks that are meant to be discarded after each use.

Credit…Julio Cortez/Associated Press

The University of Maryland halted its football-related activities on Wednesday and canceled its game this weekend against Ohio State after eight players tested positive for the virus within the past seven days.

“We realize that this news is disappointing to all of the Maryland fans out there who were looking forward to the Terps taking on an outstanding Ohio State team, but the responsible thing for us to do is pause football activities,” said Damon Evans, Maryland’s athletic director, in the announcement.

Michael Locksley, the team’s coach, said it would continue to meet virtually while in-person activities were on pause.

The cancellation means three out of the top five teams in The Associated Press Top 25 poll will be sidelined this weekend because of the virus.

The University of Alabama, ranked No. 1, was scheduled to play Louisiana State University before positive test results among L.S.U. players prompted the Southeastern Conference to postpone the game. Texas A&M, ranked No. 5, was supposed to play at the University of Tennessee but had to stop practicing after several members of their organization tested positive for the virus on Monday.

In total, four SEC games set for this weekend were delayed because of positive tests across programs.

“Numbers around contact tracing have emerged as one of our biggest challenges to playing,” said SEC Commissioner Greg Sankey in a call with reporters Wednesday. “Adjustments have to continually be made.”

The Big Ten, unlike the SEC and some other conferences, planned to not reschedule games this season that cannot be played because of the pandemic.

Credit…Nic Bothma/EPA, via Shutterstock

South Africa will open its borders to all international travelers, President Cyril Ramaphosa announced Wednesday, even as the number of new coronavirus cases rises in some parts of the country, leaving some officials concerned that a rollback on travel restrictions could invite a second wave.

“We are also opening up international travel to all countries subject to the necessary health protocols and the presentation of a negative Covid-19 certificate,” said Mr. Ramaphosa during an address to the country. He did not say when the new rules would replace a current, lengthy no-fly list that bans tourists from dozens of European countries and the United States.

The announcement came ahead of what would normally be the beginning of peak tourist season, when colder weather in the northern hemisphere starts luring up to 10 million foreigners to the country’s pristine beaches and game safaris.

South Africa has recorded more than 740,000 coronavirus cases and nearly 20,000 deaths since the spring, according to a New York Times database. Cases have dropped from a high of 12,000 new daily infections in July to fewer than 2,000 a day for the past three months.

Still, localized spikes in cases have worried officials for several weeks, including in the Eastern Cape province and in Cape Town, a major tourist destination.

The government also declared five days of mourning for victims of the pandemic and for women and children who are victims of violence. South Africa has one of the world’s highest rates of violence against women, which Mr. Ramaphosa called a “second pandemic.”

He said the national flag would fly at half-mast, and urged all citizens to wear black armbands on Nov. 25.

Credit…Joel Angel Juarez for The New York Times

Covid-19 hospitalizations in the United States hit an all-time high of 61,964 on Tuesday, and new daily cases passed 139,000 for the first time, as the raging pandemic continued to shatter record after record and strain medical facilities.

The number of people hospitalized with the coronavirus, tallied by the Covid Tracking Project, has more than doubled since September, and now exceeds the peak reached early in the pandemic, when 59,940 hospitalized patients were reported on April 15. A second peak in the summer fell just short of matching that record.

Those spikes in April and July lasted only a few days and quickly subsided, but as winter approaches experts do not expect that this time.

The United States, which surpassed 10 million known cases on Sunday, is averaging more than 111,000 new cases a day, a record, according to a New York Times database.

More than 139,800 new cases were announced in the United States on Tuesday, the highest total of the pandemic.

The country has surpassed 100,000 cases every day for a week, pushing the seven-day average to more than 123,000 per day. Four states set single-day case records; 34 states and Guam added more cases in the last week than in any other seven-day stretch. More than 1,440 new deaths were reported on Tuesday, pushing the seven-day average to more than 1,000 new deaths a day for the first time since August 19.

While the number of patients continues to climb, a shortage of nurses and other medical personnel is limiting the ability to add more hospital beds to care for them.

The critical staff shortage, especially in Western states that struggle to attract doctors and other medical workers even in the best of times, is causing growing alarm, and driving some places to take extraordinary measures.

El Paso, a border city of 680,000, now has more people hospitalized with Covid-19 than most states — 1,076 as of Tuesday — and is more than doubling its supply of mobile morgues, to 10 from four.

The University Medical Center, a teaching hospital in El Paso, set up tents to care for patients in a parking lot. A downtown convention center became a field hospital, and the state began airlifting dozens of intensive care patients to other cities to free up more space.

Gov. Douglas J. Burgum of North Dakota, which has the worst infection and death rates per person in the country, announced on Monday that health care workers who have tested positive but have no symptoms could continue to work in hospitals and nursing homes under certain restrictions, including that they treat only Covid-19 patients.

The Centers for Disease Control and Prevention’s guidelines allow the use of asymptomatic personnel during severe staff shortages. Mr. Burgum said his state was about two or three weeks away from facing “severe constraints” in hospital capacity.

In Wisconsin, now among the hardest-hit states, a major health care provider, Aurora Health Care, announced it would pause testing sites in Sinai, Green Bay and Kenosha and focus on bedside care, a spokeswoman for the health care system said. Hospitalizations in the greater Milwaukee area have increased fivefold in the past two months.

When cases spiked in New York in April and in the South over the summer, health care professionals flew in from elsewhere to help. But now, officials describe a kind of national gridlock.

“Everywhere is either hard hit or is watching their Covid numbers go up, and are expecting to get a lot of flu patients,” said Nancy Foster, a vice president of the American Hospital Association. “The ability of health care professionals to pick up and leave their hometowns is very limited.”

Credit…Taylor Glascock for The New York Times

People with intellectual disabilities and developmental disorders are three times as likely to die from Covid-19, the illness caused by the coronavirus, compared with other people who contract the disease, according to a large analysis of insurance claims data.

The finding raises complex questions about how new vaccines should be allocated when they become available in limited supplies.

So far, the guidelines for distributing vaccines in the U.S. have recommended giving first priority to workers in emergency services, health care and other essential roles, as well as people who are at heightened risk for severe disease if they become infected, including some older adults and those with certain chronic illnesses.

The guidelines, which are still evolving, have not specifically emphasized vaccinating children and adults with intellectual disabilities like Down syndrome and developmental disorders.

The new analysis was performed by FAIR Health, a nonprofit group that claims to host the nation’s largest private health insurance claims database, in collaboration with Dr. Marty Makary, a professor of health policy and management at the Johns Hopkins University School of Medicine, and the West Health Institute, a group of nonprofit organizations focused on aging and on lowering health care costs for older people.

The analysis was evaluated only by an academic reviewer, and it has not been published in a scientific journal.

“There has always been some hesitancy to treat people with intellectual disabilities and people who are institutionalized as equal, in terms of consideration for scarce medical resources — and that also includes prisoners, by the way,” said Arthur Caplan, director of medical ethics at the New York University Grossman School of Medicine. “There will be some balking and battling, on grounds that I would consider discriminatory.”

People with intellectual disabilities are vulnerable to the virus for several reasons. Many live in group homes or receive care from aides, therapists or teachers who must be in close physical proximity in order to assist them. And many are medically frail to begin with, with high rates of other underlying health conditions, particularly respiratory problems.

“Historically, it’s been a challenge for this population to receive good medical care,” said Scott Landes, an associate professor of sociology at Syracuse University. “If you’ve got someone whose cognitive ability is severely reduced, just understanding what’s going on and why they have to wear a mask would be very confusing.”

Credit…Amit Dave/Reuters

Two months ago, India looked like a coronavirus disaster zone.

Reported infections neared 100,000 a day, deaths were shooting up, and India seemed ready to surpass the United States in total recorded cases.

Today, India’s situation looks much different. Reported infections, deaths and the share of people testing positive have all fallen significantly. By contrast, infections in Europe and the United States are surging.

But doubts persist about the reasons for India’s drop, and some researchers say that cases are falling off at least in part from a change in testing. The experts generally agree that the number of infections has far outstripped efforts to track them in India, like elsewhere, and that infections in the country could still get considerably worse.

There has also been a shift in collective thinking, and experts worry that India has begun to lower its guard.

The overall mood seems to be, “Let’s move on.”

Mobility data show that Indians have returned to shopping areas and public spaces. Many are not wearing masks. A large chunk of the population seems resigned to the threat of infection.

In many places, said Naresh Trehan, a cardiologist and the head of the Medanta hospital chain, based near New Delhi, “People are partying like there is no tomorrow. So if you do things like that, you are bound to suffer.”

Many doctors here believe it’s just a matter of time before cases start shooting up again. Other countries, including the United States, France and Germany, thought the worst virus days were behind them, only to hit new highs.

The Institute for Health Metrics and Evaluation at the University of Washington projects that India’s cases will soon increase again and exceed one million daily infections by year’s end, assuming that the country does not widely embrace wearing masks.

“India could light up like a Christmas tree in the next three or four months,” said Michael Osterholm, an epidemiologist at the University of Minnesota. “We welcome, obviously, the decrease in cases, but realizing just as every other country that as soon as you let off the brake, then it comes.”

Credit…Natalia Kolesnikova/Agence France-Presse — Getty Images

Russia’s coronavirus vaccine has shown strong effectiveness in early data from a clinical trial, according to a statement on Wednesday from the Russian financial company promoting the shot.

The Russian Direct Investment Fund said that the vaccine, called Sputnik V, demonstrated 92 percent efficacy, based on results from 20 people in the trial who developed Covid-19 after getting either the experimental vaccine or a placebo shot. Because few scientific details were given, independent vaccine experts could not fully assess its veracity.

“It’s very hard to say much with 20 cases and no other details,” said Jesse Goodman, a professor of medicine and infectious diseases at Georgetown University.

The scientists behind the Russian vaccine have not released the trial blueprints, known as protocols, which are needed for a thorough review of the data. The Russian developer, the Gamaleya Research Institute of Epidemiology and Microbiology, plans to publish details of the interim results in a peer-reviewed article, the Russian Direct Investment Fund said in its statement.

The results are not implausible, especially considering the news from earlier in the week that Pfizer and BioNTech’s vaccine was “more than 90 percent effective” in preventing the illness. Like all vaccines now in clinical trials, the Pfizer and Sputnik V vaccines present a coronavirus protein called “spike” to the immune system.

Because Pfizer’s data was so strong, “it boosts my confidence in other vaccines as well,” said Natalie Dean, a biostatistician at the University of Florida who specializes in infectious disease outbreaks.

There are now 11 vaccines in late-stage clinical trials worldwide, including three in Russia.

Since August, Russia has sought to get ahead in the global race to market vaccines by announcing its product was effective before clinical trials showed that to be the case, and by approving it for emergency use at home. China has also approved a vaccine for emergency use before its trials are completed. The World Health Organization rebuked Russia for skipping steps in the approval process.

Trial results are based on a statistical analysis of study subjects who come down with Covid-19. If more people receiving the placebo than the vaccine become ill, then the vaccine is effective.

The Pfizer and BioNTech results were based on 94 confirmed cases, making them more statistically compelling than the 20 cases in the Russian data. In the vaccine trial by Pfizer and BioNTech, half of the participants received two doses of the vaccine three weeks apart, and half received a placebo. The first analysis was based on 94 volunteers who had developed Covid-19. To calculate the efficacy rate, an independent board of experts compared how many of those 94 cases were in the placebo group, and how many were in the vaccinated group. (If all 94 had been in the placebo group, for example, the vaccine would be considered 100 percent effective.)

Gamaleya Research Institute plans to test the two-shot vaccine on 40,000 people. So far, about 16,000 people have received both doses. Separately, the Russian Ministry of Health has vaccinated about 10,000 volunteers under the emergency use approval, according to the statement released on Wednesday.


Credit…Xinhua News Agency

Lebanon is imposing a new lockdown that will shut many businesses and limit road traffic as the small Mediterranean country tries to limit a spike in coronavirus cases that has stretched hospital resources.

The new lockdown, which the government announced on Tuesday, will begin Saturday and last until Nov. 30. Many businesses and government offices will close, cars will be allowed on the road on alternate days based on the last number of their license plates and a nighttime curfew will be enforced, although its hours have yet to be decided.

While the measures have been billed as a “total lockdown,” the country’s sea, air and land borders will remain open, as will establishments deemed “essential,” such as pharmacies, bakeries, banks and electricity and communications facilities.

Lebanon, a small, beleaguered country of 5.4 million bordered by Syria and Israel, reported surprisingly low infection numbers early in the pandemic, mostly because of a strict early lockdown that included an airport closure.

But cases have risen steadily in recent months, as have virus-related deaths, a rise that medical workers have blamed on spotty mask-wearing and lax observance of social distancing guidelines.

The new lockdown comes amid an economic crisis that has seen unemployment spike and the currency lose about 80 percent of its value against the United States dollar since last year.

A huge explosion in the Beirut port in August killed nearly 200 people and caused billions of dollars in damages.

Since February, 96,907 people have contracted the virus and 749 people have died in connection to the virus, according to a Times database.

In other developments around the world:

  • Spain’s government announced Wednesday that it would require travelers arriving in Spain from high-risk countries to prove they tested negative for the coronavirus within 72 hours before landing. The order, which goes into effect Nov. 23, has long been demanded by some regional politicians, particularly in Madrid, whose regional leader, Isabel Díaz Ayuso, has blamed untested travelers arriving at Madrid’s airport for helping to spread the virus in the capital region.

  • Singapore and Hong Kong said that a travel bubble between the two Asian financial centers will begin this month, allowing travelers to bypass quarantine. The arrangement, set to begin on Nov. 22, would allow one designated “bubble” flight into each city every day, each carrying a maximum of 200 passengers. Travelers must test negative for the virus and fly only on the designated flights.

  • The European Union’s executive arm proposed a “European Health Union” in a bid to coordinate a patchwork of Covid-19 measures across the bloc and centralize responses to the pandemic. The proposal by the European Commission, which would need to be approved by the European Parliament and member countries, would create an E.U.-wide plan to prepare for future health crises, as well as coordinate Covid-19 testing across the bloc.

RIO DE JANEIRO — Brazil’s health regulatory agency on Wednesday allowed a Chinese vaccine trial that was halted earlier in the week to resume, saying its experts were convinced that the death of a volunteer last month did not raise concerns about the trial’s safety.

The agency, Anvisa, startled health experts and triggered a political outcry after it announced on Monday night the suspension of the CoronaVac trial in Brazil, citing an unspecified “serious” event. The vaccine, which was developed by the Chinese company Sinovac, is among 11 experimental vaccines around the world that have shown enough promise to move into a late stage of research known as Phase 3 trials.

It’s not unusual for a large vaccine trial to be paused to investigate possible safety concerns, and several others have been paused and restarted as well.

Sinovac’s Brazilian partner, Instituto Butantan, called the decision to halt the study unwarranted and found itself in the middle of a political clash that dominated headlines in Brazil on Tuesday. President Jair Bolsonaro, who had previously spoken dismissively about the Chinese vaccine, hailed the trial’s suspension as a political victory.

Instituto Butantan is run by the government of the state of São Paulo, which is governed by one of Mr. Bolsonaro’s political rivals, João Doria.

“This is the vaccine Doria wanted everyone in São Paulo to take,” the president wrote on Facebook. “Yet another victory for Bolsonaro.”

Mr. Bolsonaro chided his health ministry last month after learning that it planned to purchase millions of doses of the Chinese vaccine.

Officials at Anvisa struggled to explain their decision on Tuesday after it became clear that the trial volunteer whose death prompted the suspension was being investigated as a suicide. Health officials overseeing the study reported the death to Anvisa as a routine matter, but did not regard it as problematic for the trial.

In a statement issued Wednesday morning, Anvisa said its experts had concluded the trial may resume and that the brief suspension should not cast aspersions about the “quality, safety or efficacy” of CoronaVac.

Credit…John Moore/Getty Images

Two critical unemployment programs are set to expire at the end of the year, potentially leaving millions of Americans vulnerable to eviction and hunger and threatening to short-circuit an economic recovery that has already lost momentum, writes The New York Times’ Ben Casselman.

Here’s a breakdown of what’s at stake:

  • As many as 13 million people are receiving payments under the programs, which Congress created last spring to expand and extend the regular unemployment system during the pandemic.

  • Leaders of both major parties have expressed support for renewing the programs in some form, but Congress has been unable to reach a deal to do so. It remains unclear how the results of Tuesday’s election will affect prospects for an agreement.

  • The programs are some of the last vestiges of the trillions of dollars in aid that included direct checks to most U.S. households, $600 a week in supplemental unemployment benefits and hundreds of billions of dollars in support for small businesses.

  • Much of that assistance expired over the summer, however. Economic gains have slowed significantly since then, and studies have found that millions of Americans fell into poverty as aid dried up.

  • The year-end benefits cliff could be even more damaging. Many families have depleted any savings they built when the $600 supplement was available. A partial federal eviction moratorium is scheduled to expire at the end of the year, although it could be extended. And benefits checks won’t just shrink, as they did over the summer — they will disappear.

“The safety net still has kind of held up until now, and I think we have been maybe lulled into a sense of complacency,” said Andrew Stettner, an expert on unemployment benefits at the Century Foundation, a progressive policy research group.

Credit…Stephanie Keith for The New York Times

As New York City faces the prospect of a second wave of coronavirus infections, Staten Island finds itself at the leading edge of the resurgence. The borough’s seven-day average rate of positive test results is the highest in the city.

On Wednesday, Mayor Bill de Blasio said that the seven-day average positivity rate citywide was 2.52 percent. He has said that the public schools system would shut down if that figure reached 3 percent.

“This is our LAST chance to stop a second wave,” he said on Twitter. “We can do it, but we have to act NOW.”

Two Staten Island ZIP codes have risen above 5 percent, prompting the mayor to target the borough for a “Day of Action” on Tuesday, sending a flood of volunteers to raise awareness about the problem and to combat growing fatigue with the limitations that have become a daily part of life for millions of New Yorkers.

But Staten Island has long diverged from the rest of the city both culturally and politically, and some borough residents bristle at restrictions in a way that can at times more closely resemble the backlash in Republican strongholds in other parts of the nation — places that are now grappling with their own rise in cases.

Many here take coronavirus precautions seriously, pulling masks over their faces as they emerge from their cars. But some say they’ve seen other Staten Islanders begin to let down their guard. Whether the borough can beat back this latest surge is a question that could help determine whether the city at large can keep the pandemic at bay.

The uptick in Staten Island is happening in an area of New York where Republican leaders have fought restrictions by Democrats who control the city. Residents have strong social ties to New Jersey, and the borough is home to many police officers and firefighters. Staten Island is a solitary stronghold in the city for President Trump, who has downplayed the importance of masks and the seriousness of the virus.

Credit…Joel Angel Juarez for The New York Times

Infectious disease experts warned on Wednesday that the surge in Covid-19 cases in many parts of the United States is likely to get much worse over the next few weeks. And despite the recent promising news about a vaccine by the drugmakers Pfizer and BioNTech, wide distribution of a vaccine will take time.

“It’s helpful to know there is an end in sight, but that end is not going to appear magically in January, February or March,” said Dr. Andrew Pavia, an infectious disease specialist at University of Utah School of Medicine, at a news conference by the Infectious Diseases Society of America on Wednesday about the spread of Covid-19 in rural areas.

“That end is next summer or fall,” Dr. Pavia said. “That’s a hard message to give, but it’s critical.”

On Monday, Pfizer said an early analysis of its vaccine trial found the vaccine to be more than 90 percent effective in preventing Covid-19. But that initial finding could change as the trial goes on.

Mr. Pavia noted that in his region, the Mountain West, the health care system was already strained as the holiday season loomed.

“The situation in the hospitals is going to be quite a bit worse in the next two to three weeks than it is today.” he said. “If Thanksgiving does the same thing to us that Memorial Day did and Labor Day did, and people gather, as we all want to do, without taking precautions, we could see another acceleration going into Christmas.”

He noted that even if a vaccine is approved soon, people must continue to rely on masks and social distancing for months to come, because initial vaccine supplies will be limited and will be reserved for health care workers and other front line workers.

Dr. Pavia and Dr. Daniel McQuillen, who is the president-elect of the association, called for an end to the politicization of the pandemic, and for leaders to send a clear, consistent message backed by scientific data to promote health precautions that can be taken by individuals.

Dr. McQuillen said public health agencies and political leaders, including President Trump, “need to tell the truth, and tell people what the reality is and how we’re going to get out of it, without any sugarcoating.”

Dr. Pavia added: “We have to take politics out of this. Whether you’re a Republican or a Democrat, you’re susceptible to the virus, and masks work just as well.”

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