Top federal health officials on Sunday forecast a post-Thanksgiving spike in coronavirus infections, deaths and stress on hospitals and medical staff. At the same time, they said that it was still possible to blunt the deadly rise with the tried and true measures of mask wearing and social distancing.
Dr. Deborah L. Birx, the White House coronavirus response coordinator, urged Americans to take it upon themselves to “protect yourself and your family,” even in states and cities where authorities had not required any such measures. During an appearance on CBS News’s “Face the Nation,” Dr. Birx seemed to be speaking to the political divide in the country, directly addressing “incredibly independent and fabulous Americans” who may be skeptical of measures to limit the spread of the virus.
Taking perhaps the strongest line of several top officials who spoke on Sunday, she said that travelers “have to assume that you were exposed and you became infected and you really need to get tested in the next week.” She urged that travelers avoid anyone in their family over 65 or with underlying illnesses.
It can take a week or more after infection for the virus to show up in testing, and many cases are asymptomatic, so people who feel fine or test negative one or two days after returning home may still be carriers.
Dr. Anthony S. Fauci, one of the federal government’s top infectious disease experts, said that clusters of new infections driven by the Thanksgiving holiday could emerge ahead of Christmas. “We might see a surge superimposed upon that surge that we’re already in,” he said on NBC’s “Meet The Press.”
So far, in the month of November alone, the total number of coronavirus cases in the United States has surpassed 4.1 million, with more than 25,500 deaths. Over the last two weeks coronavirus cases increased 12 percent, deaths 29 percent and hospitalizations 38 percent. Since the pandemic began, more than 13.3 million Americans have been infected and more than 265,900 have died.
“It’s not too late,” to slow that surge, Dr. Fauci said, pleading for mask wearing and physical distancing. Otherwise, he said, local lockdowns might be necessary. “If we can hang together as a country and do these kinds of things to blunt these surges until we get a substantial proportion of the population vaccinated, we can get through this,” he said.
In another appearance, on ABC’s “This Week” Dr. Fauci said the best course for Thanksgiving travelers might be “if it’s possible, to quarantine yourself for a period of time.”
Adm. Brett Giroir, who leads U.S. testing efforts, urged Americans returning from Thanksgiving travel to cut down on unnecessary activity “and if you can get tested that would be a good idea.” But he also said during his appearance on CNN’s “State of the Union” that travelers were not required to quarantine unless they were exposed to someone with Covid-19.
The Centers for Disease Control and Prevention advisory committee is meeting on Tuesday to decide on advice to provide states for vaccination priorities. Dr. Fauci said he expected that among the high priority groups would be patients at nursing homes and the staff who deal with them, a focus echoed by Dr. Birx and Admiral Giroir, who spoke of the need to “immunize for impact.”
Children are not expected to be vaccinated for months because they have not been a major part of vaccine trials, but Dr. Fauci said he expects to move that process forward in January by starting safety and immune response trials in children for the Moderna vaccine. If the vaccine proves safe and the immune response is similar to that in adults, a large trial involving tens of thousands of children would not be necessary, he said.
Mayor Bill de Blasio of New York announced on Sunday that he would reopen the city’s public elementary schools, abruptly shifting policy in the face of widespread criticism that the city was giving more priority to economic activities like indoor dining than to the well-being of its children.
Mr. de Blasio said that the city’s middle and high schools would remain closed for now. But he also signaled that he would overhaul how the city manages its schools during the pandemic, which has forced millions of children in the United States out of schools and is widely perceived to have done significant damage to their education and mental health.
The mayor said the city would abandon a 3 percent test positivity threshold that it had adopted for deciding when to close the school system, the largest in the country with 1.1 million students. And he said the school system would aim to give most parents the option of sending their children to school five days a week, which would effectively end so-called hybrid learning.
When the schools reopen, students can return only if they have already signed up for in-person learning.
Children in pre-K and elementary grades can return starting Dec. 7. Mr. de Blasio also announced that students in later grades with the most complex disabilities can return to classrooms on Dec. 10, though their schools will still be closed to other students.
Starting over the summer, Mr. de Blasio sought to make New York the first big city in the country to fully reopen its public school system. After logistical and political problems forced delays, the city welcomed hundreds of thousands of children back into classrooms about two months ago. But less than eight weeks later, Mr. de Blasio again shut schools down as a second wave of the virus threatened the city.
Even so, the number of infections in the school system remained very low, so Mr. de Blasio’s closure decision became a flash point in a broader debate throughout the country and the world over what should be closed during the pandemic.
With daily coronavirus cases in New Jersey exceeding levels of the surge last spring, Gov. Philip D. Murphy warned on Sunday that his state was “in the fight of our lives.”
Over the past week, New Jersey has witnessed an average of more than 4,000 cases per day, an increase of 28 percent from the average two weeks earlier. At the peak of the surge in April, New Jersey averaged nearly 3,700 cases a day.
Hospitalizations in the state have increased 60 percent in the last two weeks, and deaths have increased by 78 percent over that period.
In an appearance on Fox News Sunday, Mr. Murphy told the host, Bret Baier, “We’re in the fight right now, Bret, there’s just no question about it.”
New Jersey’s coronavirus statistics have worsened as states across the country have struggled with climbing case counts. Some areas of New Jersey, including Newark, have been hit particularly hard. Nearly 17,000 deaths have been attributed to the virus in the state since the start of the pandemic.
Mr. Murphy has appeared to be straddling a line in his public statements between urging vigilance and expressing optimism. As test positivity rates rose above 6 percent earlier this month, he followed through on a threat to tighten some restrictions that had been loosened as rates declined over the summer.
Still, he joined other governors in championing in-person learning, even as some school districts in New Jersey were reverting to remote lessons.
In his television appearance on Sunday, Mr. Murphy, a Democrat, likewise appeared to both assert that many in his state had skipped large Thanksgiving gatherings, while also allowing for the possibility that many had not. “We begged people to have a somber, respectful, small Thanksgiving,” the governor said. “And I want to give a shout out to New Jerseyans because I think overwhelmingly that’s what happened, but there’s a lot of fatigue out there.”
He asked New Jersey residents not to “let your hair down” with the Christmas holidays approaching, while noting that vaccines could help ease the pandemic before too long.
“The great news is there’s light at the end of the tunnel, vaccines in particular,” he said. “But for the next two or three months, we’re in the fight of our lives.”
Mr. Murphy said that he is doing everything possible to avoid a full economic shutdown while there is no additional federal relief available. He has been urging members of Congress to pass a new relief bill to assist businesses, restaurants and the unemployed, he said.
“That would be a game changer,” he said. “Not just in their lives and in their prospects, but it gives us more degrees of freedom in dealing with the virus.”
The Centers for Disease Control and Prevention is considering shortening the recommended isolation period for people with Covid-19 and may issue new guidelines as early as next week, according to two federal officials with knowledge of the discussions.
The agency recommends that infected people isolate for a minimum of 10 days, but a new analysis of previous research suggests that people are most infectious about two days before symptoms begin and for five days afterward.
The analysis underscores data that have accumulated since March. In July, based on similar evidence, the C.D.C. truncated its recommendation for isolation to 10 days from 14 days.
In September, France dropped its required period of isolation to seven days, and Germany is considering shortening it to five days. (Isolation refers to people who are ill; quarantine refers to people who were exposed to the virus and may become ill.)
Setting the isolation period at five days is likely to be much more palatable and may encourage more infected people to comply, said Dr. Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland who led the new analysis, published in the journal The Lancet Microbe.
A recent survey in the United Kingdom showed that only one in five people were able to isolate for 10 days after developing symptoms. “Even if we do more testing, if we can’t ensure people self-isolate, I don’t think we’ll be able to control the spread,” Dr. Cevik said.
Shortening the period of isolation “would really help people comply with the public health guidelines,” said Angela Rasmussen, a virologist affiliated with the Georgetown Center for Global Health Science and Security, referring to the recommended isolation period.
Some people who are older or very sick may be infectious for longer than a week. A few patients who are extremely ill or have impaired immune systems may expel — or “shed” — the virus for as long as 20 days, other studies have suggested. Even in mild cases, some patients may shed live virus for about a week, the new analysis found.
But if a shorter recommended period encouraged more people to isolate, the benefit would more than offset any risk to the community from the small amount of virus that a few patients may still carry after five days, said Dr. Stefan Baral, an epidemiologist at Johns Hopkins University.
But some doctors said they were not convinced by the analysis that five days of isolation would prevent transmission from the majority of people.
“There’s a sweet spot there, I would imagine, but I haven’t figured out where that is,” said Dr. Taison Bell, a critical care and infectious disease physician at the University of Virginia.
The governor of Colorado, Jared Polis, and his partner, Marlon Reis, have tested positive for the coronavirus and are isolating at home, the governor’s office announced Saturday night, saying that neither of them were experiencing any symptoms.
“Marlon and I are feeling well so far, and are in good spirits,” Governor Polis, a Democrat, said in the statement.
He is at least the seventh U.S. state governor — three Democrats and four Republicans — to report receiving a positive test result, though in the case of Mike DeWine of Ohio, the result was almost immediately contradicted by another test and is thought to have been a false positive. Several more governors have quarantined when a family member, staff member or close associate tested positive.
“No person or family is immune to this virus,” Mr. Polis said in the statement.
Like other governors who have tested positive, Mr. Polis urged citizens to follow widely recommended precautions, including wearing a mask, maintaining social distance, avoiding large gatherings and washing hands frequently.
So far, none of the governors have reported experiencing severe illness. The first governor known to have tested positive was Gov. Kevin Stitt of Oklahoma, a Republican, in mid-July.
After bobbing and weaving around the coronavirus pandemic for much of the fall, the N.F.L. nears the final quarter of its regular season facing crises on teams from coast to coast.
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The Denver Broncos appeared to run out of quarterbacks. Blake Bortles, Drew Lock and Brett Rypien were forced to quarantine after coming into contact with a fourth quarterback, Jeff Driskel, who tested positive for the virus on Thursday, according to a person familiar with the situation who spoke on condition of anonymity Saturday night because the team had not publicly revealed details of its predicament. All four players are ineligible to play in the Broncos-Saints game on Sunday, and the league’s rules require any new player added to the roster to quarantine before joining the team.
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The San Francisco 49ers will not be allowed to either play games or hold practice at their home stadium and training facilities for three weeks, after a coronavirus surge in the area prompted county health officials in Santa Clara County, Calif., to ban all contact sports — high school, college and professional— until at least Dec. 21.
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Six more members of the Baltimore Ravens were reported to have tested positive for the virus as an outbreak in the team’s locker room expanded to 18 players. Their next game, scheduled for Tuesday against the Pittsburgh Steelers, has already been postponed twice.
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The league said on Sunday that it had fined the New Orleans Saints $500,000 and taken away the team’s seventh-round draft choice for celebrating without masks in their locker room after defeating the Tampa Bay Buccaneers on Nov. 8.
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The league also said the New England Patriots were also fined $350,000 for violating the league’s safety protocols in October when Cam Newton and others on the team tested positive, forcing the league to reschedule their game against the Kansas City Chiefs.
The league’s troubles have mounted as the total number of virus cases in the United States for the month of November passed four million, more than double the record set in October.
In the Bay Area, where the 49ers are based, reports of new cases have been low compared with other parts of the country, but have increased quickly in recent weeks. Santa Clara County just recorded its worst week of the pandemic, with more than 3,300 cases in the seven days ended Saturday.
“We are at risk of exceeding our hospital capacity very soon if current trends continue,” said Dr. Sara Cody, the health officer for Santa Clara County.
Besides forbidding contact sports, the county is also requiring anyone traveling into the region from more than 150 miles away to quarantine, a rule that will apply to local college and pro sports teams and their visiting opponents. Along with the 49ers, the San Jose Sharks of the N.H.L. and the football programs at Stanford University and San Jose State are affected.
The 49ers, who are scheduled to play the Rams in Los Angeles Sunday afternoon, should be able to return to Santa Clara County before the quarantine goes into effect just after midnight. It was not clear what the team would do after that. The 49ers have two home games and one road game scheduled for the next three weeks.
GLOBAL ROUNDUP
Turkey is showing a sharp rise in Covid-19 infections, in particular in the major cities of the country’s west. Hospitals are feeling the strain, with intensive care units in Istanbul and the capital, Ankara, running at 75 percent capacity, the country’s health minister Fahrettin Koca said.
“There is heavy increase of patients in Istanbul; risk continues,” he said in Turkish on Twitter Saturday, writing in capital letters for emphasis.
“We have 4,903 seriously ill patients detected today, ” he said in another post. “Each of us is responsible for following the measures. This is not a personal choice, but a social necessity.”
Doctors’ associations in Turkey have been warning for weeks about the soaring numbers of infections, and have criticized the government for not being candid about the virus’s spread in the country.
Turkey runs an extensive testing program, but for four months the Health Ministry released figures only for hospitalized patients, not for all those testing positive for the virus, as most countries do. When the ministry began releasing figures for confirmed cases last week, they were running at up to 30,000 a day.
The number of Covid-19 patients in Turkey’s hospitals has more than doubled this month, to 6,714, and the country reported 182 deaths on Saturday, for a total of at least 13,370 since the pandemic’s start.
In other developments around the world:
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Hong Kong reported 115 new coronavirus cases on Sunday, one of the highest totals in a single day since August. New clusters have emerged among customers and employees in three restaurants, and health authorities have called on anyone who visited them in the past two weeks to be tested. Hong Kong has had very few cases for its size, with 6,238 infections and 109 deaths in a population of 7.5 million. But its daily totals have risen lately to rival the worst days of the summer.
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The Czech Republic said on Sunday that it would ease pandemic restrictions because the number of new cases in the country has been falling, The Associated Press reported. The health minister, Jan Blatny, said all stores, restaurants and bars, and most other establishments could reopen with some capacity limits on Thursday. The Czech Republic was among the hardest-hit nations in Europe when a new wave of infections took hold in the autumn, but new case reports have been declining since Nov 4. About one in 20 people in the country have tested positive since the pandemic began, and at least 8,054 have died.
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With tensions rising in England over the extension of some restrictions after the current lockdown ends on Dec. 2, the police in London arrested more than 150 people on Saturday as they moved to stop anti-lockdown protests. The Metropolitan Police said the arrests were for breaking coronavirus regulations, assaulting a police officer and various drug offenses. A new set of rules announced on Thursday will divide England into three tiers of restrictions when the lockdown ends, depending on local conditions; more than 23 million people live in the most restricted tier, where pubs would remain shuttered, among other restrictions.
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Croatia entered a second partial lockdown on Saturday. For a month, the country will shut down or limit most activities besides schools, including bars, gyms, indoor dining at restaurants and gatherings larger than 25 people, according to the U.S. Embassy in Croatia. Reports of new coronavirus cases have risen sharply across the country, with a number of clusters around Zagreb, according to government data. The country’s prime minister wrote on Twitter that the lockdown could be extended past a month if conditions do not improve.
If the ghost of one of the women executed during the 17th century witch trials in Salem, Mass., were to appear among the participants in one of the guided tours seeking to understand what happened to her, she would not count against the strict 12-person limit that the state has imposed on such excursions.
Still, Lance Zaal, the founder of Salem Ghosts, which runs such tours, felt that the quota imposed under coronavirus restrictions seriously hampered his business.
The waiting list in October, prime ghost tour season, stretched to 500 people who could not be accommodated by Halloween, he said, so he recently filed suit in federal court in Massachusetts against Gov. Charles D. Baker and two other top officials responsible for the virus regulations.
Seeing hundreds of demonstrators on social justice issues pack the sidewalks and the commons of various Massachusetts towns, as well as crowded churches, Mr. Zaal decided that his outdoor tours faced unfair discrimination.
“One person’s free speech should not be weighed as more or less important than another’s,” he said.
Terry MacCormack, a spokesman for Mr. Baker, said his administration would not comment on pending litigation.
The 60-minute, $21 tour of nighttime Salem (“The most haunted city in America”) is built around the troubled, tragic history of the witch trials in the 1692-93, when 20 women accused of sorcery were executed.
Mr. Zaal, whose company runs ghost tours in more than 20 cities nationwide, noted that the general drop in tourism had hurt his business and the livelihood of his guides, who are counted in the Salem quota. The company tries to follow all local regulations, he said, with participants asked to wear masks and full refunds available to anyone feeling ill or recently exposed to Covid-19.
Initially, to minimize interactions involving money or credit cards, the company even stopped the sale of its electromagnetic ghost detectors.
Those have resumed, and there have been zero proven cases of ghosts spreading the virus to humans or vice versa, Mr. Zaal said, “It has been very safe between ghosts and humans so far.”
Their meetings used to take place discreetly in the basements of churches, a spare room at the Y.M.C.A., the back of a cafe. But when the pandemic hit last spring, members of Alcoholics Anonymous and other groups of recovering substance abusers found those doors quickly shut.
What happened next is one of those creative cascades the virus has indirectly set off. Rehabilitation moved online, almost overnight, with zeal. Not only are thousands of A.A. meetings taking place on Zoom and other digital hangouts, but other major players in the rehabilitation industry have leapt in, transforming a daily ritual that many credit with saving their lives.
“A.A. members I speak to are well beyond the initial fascination with the idea that they are looking at a screen of Hollywood squares,” said Dr. Lynn Hankes, 84, who has been in recovery for 43 years and is a retired physician in Florida with three decades of experience treating addiction. “They thank Zoom for their very survival.”
People in the field say that online rehab is likely to become a permanent part of the way substance abuse is treated. Being able to find a meeting to log into 24/7 has welcome advantages for people who lack transportation, or are ill or juggling parenting or work challenges that make an in-person meeting tough on a given day. Online meetings can also be a good steppingstone for people just starting rehab.
Some participants say the online experience can have a surprisingly intimate feel to it.
“You get more a feel for total strangers, like when a cat jumps on their lap or a kid might run around in the background,” said a 58-year-old A.A. member in early recovery in Portland, Ore., who declined to give his name, citing the organization’s recommendations not to seek personal publicity.
At the same time, he and others say they crave the raw intensity of physical presence.
“I really miss hugging people,” he said. “The first time I can go back to the church on the corner for a meeting, I will, but I’ll still do meetings online.”
Outdoor activities have become a popular pastime during the coronavirus pandemic as adventure seekers and couch surfers alike take to hiking trails for a bit of a reprieve.
But while hiking might be a relatively safe, socially distanced activity, the challenges of weather, nature and physical strain have led to a rash of injuries and some deaths on the trails.
In September, three hikers died in six days in the White Mountains in New Hampshire. A hiker in Mount Rainier National Park in Washington who encountered a whiteout was revived after his heart stopped for 45 minutes. And a woman who went missing for two days on Mount Whitney in California died from her injuries after being rescued in November.
The increase in parkgoers — upward of 90 percent over the previous year in some parks — has added pressure to staff members and the authorities, who are already under financial and staffing constraints because of the pandemic.
“People need to be careful, especially now, as resources for search and rescue can be thin,” said Lisa Herron, a spokeswoman for the United States Forest Service at Lake Tahoe Basin in California.
The agency has not yet compiled data on injuries and deaths for the year, but several park rangers and rescue agency representatives say anecdotally the incidents have increased with the surge in visitors.
El Dorado County, Calif., one of the five counties surrounding Lake Tahoe, has back country and wilderness — including Desolation Wilderness, which is accessible only on foot or horseback — and has had an increase in calls this year for aid related to illness, injury and being lost, according to the sheriff’s office.
Sgt. Eric Palmberg of the El Dorado County Sheriff’s Office said many of the calls involved people “way out of their experience level and possibly taking more risks, due to the pandemic and being cooped up at home.”
Art Basel Miami Beach, the annual fair that usually draws the contemporary art world to South Florida and was scheduled for this week, has been canceled — a cultural casualty of the coronavirus.
But the city’s art scene is anything but quiet these days.
Previously closed museums announced ambitious new in-person exhibitions. Galleries were rolling out formidable solo shows, as were hotel lobbies and poolside bungalows. One leading fair had sprung back to life: Design Miami, partly owned by Art Basel, was being staged in a scaled-down manner, with 10 galleries setting up inside a storied building on the mainland.
The local pandemic toll is jarring: During the past seven days, Miami-Dade County, recorded 49 new deaths from Covid-19, and nearly 13,000 new infections.
While the city’s in-person art-scene activity was being billed as masked, socially distant, and crowd controlled, it was hard to ignore the symbolism of the Miami Beach Convention Center — the planned site of the Basel fair — currently being used as a coronavirus testing site.
“I understand some are saying ‘Oh my God, this will be a disaster to do this kind of thing,’” Craig Robins, founder of Design Miami, said. “It’s the opposite. It’s not about a bunch of people flying in from around the world. It’s about a bunch of people spending the season in South Florida and doing things that they feel are within boundaries that are responsible.”
And it’s about promoting homegrown talent.
A pre-Thanksgiving opening featured the solo debut of Reginald O’Neal, who grew up in one of Miami’s poorest neighborhoods and whose work includes portraits of his incarcerated father and younger brother, both in their prison jumpsuits.
A Miami Art Week without a big Basel party could be a possible blessing, said Mr. O’Neal, allowing the city’s own talent to take center stage and avoid being overshadowed.
“It feels like this gives Miami the opportunity to shine on itself, not just to international people,” he said. “To show ourselves we’re going to be supportive to our own community.”
As coronavirus infections surge in people, the virus is also spreading in mink. Oregon reported its first cases at a mink farm this week with 10 infected animals but no deaths. Mink farms in Utah, Michigan and Wisconsin have also reported infections.
Six other countries have reported infected mink: the Netherlands, Denmark, Sweden, Italy, Spain and Greece. Some workers also were infected, as would be expected, because in most cases it is humans who pass the virus to farmed mink.
In the Netherlands and Denmark, genetic tests show that after humans passed the virus to mink, the mink passed it back again, with some mutations. No such mink-to-human transmission has been detected yet in the U.S., but scientists there and elsewhere are deeply concerned about the spread of the coronavirus to a variety of animals.
One of the mutations that arose in Denmark worried scientists, because it appeared in laboratory tests that this mutated version of the virus might be less well controlled by vaccines. However, no further evidence has supported that concern, and the variant in question hasn’t been found in people since September, according to Danish authorities.
In Denmark and the Netherlands, mink are being killed in large numbers because of virus outbreaks. The Netherlands had decided before the pandemic to phase out mink farming over animal welfare concerns; given the ease with which mink are infected, the country decided to accelerate its timetable and eradicate mink farming by 2021.
Several million mink have been culled in Denmark, but an effort to kill the remaining 14 million animals in the country has become embroiled in political disputes and public embarrassments. A government minister resigned because it appeared the government lacked the authority to order healthy mink killed, and local news outlets have reported that buried mink carcasses may be festering and emerging from the ground as their corpses bloat with gases.
According to Fur Commission USA, an industry organization, about 275 U.S. mink farms produce about 3 million pelts a year. The Department of Agriculture has ordered quarantines of infected farms and testing, and has posted strict guidelines on movement of mink from farm to farm, but it has not ordered mass culls. Thousands of mink have apparently died from coronavirus infections at American farms.