The US recorded 166,555 new coronavirus cases on Saturday, down on more than 184,000 on Friday but still its second-highest daily total and a 12th day in a row above 100,000.
According to Johns Hopkins University, the overall US caseload is now nearly 10.9m and more than 245,000 have died. On Saturday, 1,266 people died. Hospitalisations are rising.
On Sunday Dr Anthony Fauci, the top US infectious diseases expert, said it was “possible” the country would see 200,000 deaths in the next four months, which would put the toll of the pandemic above 400,000 in slightly more than a year.
Another expert said the approach of the crowded and travel-heavy holiday season left him “terrified” .
In Washington DC on Saturday, thousands attended the “Million Maga March”, a gathering of supporters of Donald Trump, who lost the presidential election to Joe Biden but has refused to concede.
The president has heralded news of an imminent Pfizer vaccine but he and members of his family, top aides and senior Republicans have all tested positive for Covid-19.
At campaign and White House events, Trump has refused to enforce mitigation measures such as mask-wearing and social distancing. On Saturday, local media reported that around the White House, where Trump waved to supporters from his presidential motorcade, “it seemed a majority of the protesters gathered were not wearing masks”.
Washington DC has a mask mandate, which states in part: “Persons leaving their residences shall wear a mask when they are likely to come into contact with another person, such as being within 6ft of another person for more than a fleeting time.”
Trump, who has said his administration will not implement any further social lockdowns, has also refused to participate in the Biden transition, meaning information on Covid-19 is not being shared with the president-elect. Biden, who has appointed his own Covid-19 advisory group, supports a national mask mandate.
Across the country, particularly in the hard-hit midwest, states are implementing stricter controls. On Saturday, California, Minnesota and Maryland were among states reporting rapidly rising case numbers and healthcare systems beginning to show the strain. Oregon and New Mexico have implemented new social restrictions, while North Dakota has introduced a mask mandate and Arkansas has established a Covid taskforce. From Monday, the Navajo Nation will enter a three-week stay-at-home advisory period.
On CNN’s State of the Union on Sunday, Fauci was asked what the country needed to do to fight the disease, other than advising the wearing of masks, hand-washing and social distancing.
“Well, what we’ve got to do is make what you just said uniform, not spotty,” he said. “Everybody’s got to do it. There’s no excuse not to do that right now, because we know that can turn things around. I mean, that’s the tool we have.
“We have good news with regard to the vaccines, so there is light at the end of the tunnel. Help is coming.
“It’s going to be a gradual accrual of more normality as the weeks and the months go by, as we get well into 2021,” he said.
Fauci was asked about his own recent statement that a national lockdown is not necessary, despite soaring infections and hospitalisations.
“We’re not going to get a national lockdown,” he said. “I think that’s very clear, but I think what we’re going to start seeing in the local levels, be they governors or mayors, or people at the local level will do, as you said, very surgical type of restrictions, which are the functional equivalent of a local lockdown.
“We’re not going to have a national lockdown. But if things really get bad and you put your foot on the pedal and yet still you have the surge, you may need to take the extra step that you’re talking about.”
Asked about Trump’s refusal to participate in the transition, Fauci said it was “almost like passing a baton in a race, you don’t want to stop and then give it to somebody, you want to just essentially keep going and that’s what transition is. So it certainly would make things [go] more smoothly if we could do that.
“Of course it would be better if we could start working with them.”
Earlier this week, Dr Leana Wen, a doctor and public health professor at George Washington, former Baltimore health commissioner and now a CNN analyst, told the Guardian Biden’s “single biggest challenge is going to be re-establishing trust.
“We won’t be able to stop the surges and infections if half of the country does not follow his guidance,” she said.
From Ohio, Governor Mike DeWine, struggling to control Covid-19, cited coronavirus “fatigue” as a serious problem. He also told CNN agents would start going into retail establishments to enforce a mask order handed down in July.
Speaking to CNN on Saturday, meanwhile, Dr James Phillips, chief of disaster medicine at George Washington University Hospital, said he was “terrified” about the imminent holiday season.
“We’re going to see an unprecedented surge of cases following Thanksgiving this year, and if people don’t learn from Thanksgiving, we’re going to see it after Christmas as well,” Phillips said.
In New York, where cases are rising if not to levels seen elsewhere, Mayor Bill de Blasio has advised against travel for Thanksgiving, when Americans traditionally go home to their families. De Blasio has also warned that schools may close again on Monday. On Saturday the New Jersey governor, Phil Murphy, called case numbers there “alarming and concerning, to say the least”.
In Washington, leaders of the Trump taskforce promised swift distribution of the Pfizer vaccine to the vulnerable and frontline health workers, once it obtains emergency use authorisation from the US Food and Drug Administration, expected by the end of November.