As U.S. awaits a president-elect, coronavirus escalates to 6-figure daily case total

New confirmed cases of the coronavirus in the United States have climbed to an all-time high seven-day average of more than 86,000 per day, in a glimpse of the worsening crisis that lies ahead for the winner of the presidential election.

Cases and hospitalizations are setting records all around the country just as the holidays and winter approach, demonstrating the challenge that either President Donald Trump or former vice-president Joe Biden will face in the coming months.

Daily new confirmed coronavirus cases in the U.S. have surged 45 per cent over the past two weeks, to a record seven-day average of 86,352, according to data compiled by Johns Hopkins University. Deaths are also on the rise, up 15 per cent to an average of 846 deaths every day.

The New York Times, Washington Post and Covid Tracking Project from The Atlantic magazine on Wednesday all tracked more than 100,000 cases in the most recent 24-hour period, the first time that threshold has been reached.

The total U.S. death toll is already more than 232,000, and total confirmed U.S. cases have surpassed nine million. Those are the highest totals in the world — though many countries lack the testing capacity to accurately gauge their true caseload — and new infections are increasing in nearly every state.

Several states on Wednesday reported grim numbers that are fuelling the national trends. Texas reported 9,048 new cases and 126 deaths, and the number of coronavirus patients in Missouri, Nebraska and Oklahoma hospitals set records. About a third of the new cases in Texas happened in hard-hit El Paso, where a top health official said hospitals are at a "breaking point."

In Missouri, St. Charles County spokesperson Mary Enger said in a news release Thursday that a person who worked at a polling place on Tuesday as an election judge supervisor despite a positive coronavirus test has died.

Enger said the county's health department recently learned that the poll worker tested positive Oct. 30 for COVID-19 and was advised to quarantine for 14 days.

The cause of death was not immediately clear. No details about the worker at the Blanchette Park Memorial Hall were released.

Nine election workers at the site were advised to be tested for the virus, Enger said.

St. Charles County Director of Elections Kurt Bahr said election workers were required to wear masks or face shields.

The poll worker's duties did not usually involve close contact with the more than 1,800 voters who visited the site, she said, but people there are being advised to monitor for symptoms and call a hotline number if they have questions.

The state reported 3,553 new cases and 18 deaths on Thursday. All told, Missouri has reported 196,576 confirmed case and 3,106 deaths. The positivity rate of 15.2 per cent is triple the benchmark recommended by the World Health Organization.

'An extremely dire place'

Trump's current term doesn't end until Jan. 20. In the 86 days until then, 100,000 more Americans will likely die from the virus if the nation doesn't shift course, said Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University's Feinberg School of Medicine, echoing estimates from other public health experts.

"Where we are is in an extremely dire place as a country. Every metric that we have is trending in the wrong direction. This is a virus that will continue to escalate at an accelerated speed and that is not going to stop on its own," said Dr. Leana Wen, a public health expert at George Washington University.

Polls showed the public health crisis and the economy were top concerns for many Americans.

They are competing issues that Trump and Biden view through drastically different lenses.

Trump has ignored the advice of his top health advisers, who have issued increasingly urgent warnings in recent days about the need for preventive measures, instead holding rallies where face coverings were rare and falsely suggesting that the pandemic is waning.

"President Trump has already made clear what his strategy is for COVID-19, which is to pretend that there is not a contagious virus all around us," Wen said. Trump has been touting treatments and vaccines, which won't be widely available to all Americans until at least mid-2021, she said.

"There's a lot of suffering that is going to happen before then, which could have been prevented," Wen said.

By contrast, Biden has rarely been seen in public without a mask and made public health a key issue. Even if he prevails, he will likely be operating with a Republican-controlled Senate as well as a conservative media landscape that has often followed Trump's lead in downplaying the virus.

Health experts sidelined

Federal health officials have said they believe a vaccine could get emergency use authorization before the end of the year. The first limited supplies of doses would then be immediately distributed to the most vulnerable populations, which is likely to include front-line health-care workers. Doses would then gradually become more widely available.

The timeline hinges on having a vaccine that's shown to be safe and effective, which experts note is not yet a certainty.

"The vaccine has to move at the speed of science," said Dr. Joshua Sharfstein, vice-dean for public health practice at Johns Hopkins and former Maryland state health department chief.

So far, the FDA has granted full approval to only one drug — the antiviral remdesivir — for hospitalized patients. Dexamethasone or similar steroids are recommended for certain severely ill patients under federal treatment guidelines.

Trump's recent addition to the White House advisory team, Scott Atlas, has sought to emphasize that for most people, the coronavirus causes mild or moderate symptoms, and some don't feel sick at all.

Absent a national pandemic strategy, curbing virus spread in the U.S. will depend on more Americans taking necessary precautions with Thanksgiving and Christmas approaching. 

Health officials in San Francisco said Wednesday that residents who travel outside the area during the upcoming holiday season should adhere to a two-week quarantine.

In San Diego County, the second most-populous county in California, county supervisor Greg Cox said people were being less diligent about wearing masks and keeping distant from others as time wore on.

"The truth is people are tired of this pandemic and unfortunately they're letting down their guard," he said.