The crisis has especially deepened at hospitals, with the situation so bad in North Dakota that the governor this week said nurses who test positive but have no symptoms can still work.
Idaho clinics struggled to handle the deluge of phone calls from patients. And one of Utah’s biggest hospital systems is bringing in nearly 200 travelling nurses, some of them from New York City.
It comes as California on Thursday became the second state — behind Texas — to eclipse a million known cases, while the country has surpassed 10 million infections, according to data compiled by Johns Hopkins University.
The virus is blamed for more than 242,000 deaths and over 10.5 million confirmed infections in the US, with the country facing what health experts say will be a dark winter because of disregard for mask-wearing and other precautions, the onset of cold weather and crowded holiday gatherings.
“It should frighten all of us,” Dr David Peterman, chief executive of Idaho’s Primary Health Medical Group, said of the virus numbers.
“It’s easy to look at TV, and say, ‘I’m not in the intensive care unit, my grandmother’s not in the intensive care unit.’ But if I say to you your doctor cannot treat your child with an ear infection because I cannot answer your phone call, or your doctor is on quarantine, or our clinics are full with people with coronavirus?”
Deaths per day in the US have soared more than 40% over the past two weeks, from an average of about 790 to more than 1,100 as of Wednesday, the highest level in three months.
That is still well below the peak of about 2,200 deaths per day in late April, in what may reflect the availability of better treatments and the increased share of cases among young people, who are more likely than older ones to survive a bout with Covid-19.
But newly confirmed cases per day in the US have rocketed more than 70% over the past two weeks, reaching an average of about 127,000 — the highest on record. And the number of people hospitalised with the virus hit an all-time high of more than 65,000.
Amid the staggering numbers, Philadelphia dropped plans to start bringing students back to school on November 30.
Michigan’s largest school district, Detroit, said it will suspend in-person classes next week for its roughly 50,000 students, joining other districts that have shifted to online-only classes.
“The district relied on science and the data to reopen schools for in-person learning this summer and fall and relied on the same to decide that it was no longer safe for our students and employees to work in an in-person school environment,” Detroit superintendent Nikolai Vitti said.
In New York City, the looming threat of a shutdown of the 1.1-million-student school system had families and teachers watching case numbers closely.
Mayor Bill de Blasio has said that in-person schooling will be halted if the rate of tests coming back positive for the virus in the city reaches 3%.
Meanwhile some state leaders maintained a hands-off approach, pushing “personal responsibility” rather than government-imposed restrictions such as mandatory mask-wearing.
Reflecting what has largely been a divide between red and blue states, Republican governor Kevin Stitt of Oklahoma has refused to impose a mask mandate, citing concerns about enforcement and a “one-size-fits-all” approach.
Instead, he held a news conference this week with doctors who implored residents to wear masks.
In North Dakota, nurses opposed GOP governor Doug Burgum’s move to allow health care workers who test positive to remain on the job, saying scientifically proven measures such as a mask mandate should be tried first. Mr Burgum has declined to do that.
In Idaho, Republican governor Brad Little also resisted calls for a statewide mask requirement even as health clinics grappled with dozens of staff absences and thousands of calls from people seeking help.
In other states, officials have tightened restrictions, though not as much as when the virus first hit in the spring.
Chicago mayor Lori Lightfoot called on residents to cancel Thanksgiving gatherings, limit all social gatherings to 10 people, and stay home except for essentials, like work or getting groceries, starting on Monday.
Minnesota joined states including New York in ordering bars and restaurants to close by 10pm while Wisconsin’s governor this week advised people to stay home.
Utah’s governor put in place a statewide mask mandate, while Indiana’s governor extended his state’s mask rule for another month.
New Jersey governor Phil Murphy said on Thursday he will sign an executive order to give towns and cities the option to limit hours at nonessential businesses after 8pm.