Coronavirus updates: Fauci says spring could bring return to normal; hospitalizations hit record level

The nation could "start getting things back to relative normal" as soon as the spring if early testing on vaccines holds up and people agree to be vaccinated, the nations top infectious disease expert said Sunday.

"If we get the overwhelming majority of people taking the vaccine... people can start thinking about doing things that were too dangerous just months ago," Dr. Anthony Fauci told CNN's "State of the Union."

The encouraging words come as hospitals across the nation are strained by a record number of coronavirus patients and new infections have surpassed 100,000 each day for almost two weeks straight.

The U.S. remains the global hotspot. Eleven countries have reported more than 1 million coronavirus cases since the pandemic began at the start of the year. The United States has reported more than 1 million coronavirus cases in the last week.

Some major developments:

The Navajo Nation on Monday will reinstate a stay-at-home lockdown for the entire reservation while closing tribal offices and requiring new closures and safety measures for businesses due to rising COVID-19 cases.
Hospitals are getting better at treating COVID-19 patients, according to University of Washington's influential Institute for Health Metrics and Evaluation model. Better treatments have helped decrease the disease's fatality rate by 30% since April, according to a model briefing.

📈 Today's numbers: The U.S. has reported almost 11 million cases and more than 245,000 deaths, according to Johns Hopkins University data. The global totals: 54 million cases and 1.3 million deaths.

🗺️ Mapping coronavirus: Track the U.S. outbreak in your state.

📰 What we're reading: COVID-19 infections are soaring. Lockdowns could be coming. A list of restrictions in your state.

This file will be updated throughout the day. For updates in your inbox, subscribe to The Daily Briefing newsletter.

Washington Gov. Jay Inslee announces sweeping restrictions
Gov. Jay Inslee unveiled new restrictions including a ban on indoor seating at restaurants and indoor social gatherings, a shutdown of gyms, bowling alleys and movie theaters and cutbacks in numbers at other businesses. Most of the restrictions begin Tuesday, including a limit of 25% of capacity at grocery stores and a ban on indoor social gatherings with people from more than one household unless attendees have either quarantined for 14 days before the gathering or tested negative for COVID-19 and have quarantined for seven days. Starting Wednesday, restaurants and bars will be limited to to-go service and outdoor dining with tables seating no more than five people.

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“Today... is the most dangerous public health day in the last 100 years of our state’s history,” Inslee said at an online announcement. “A pandemic is raging (that) left unchecked will assuredly result in grossly overburdened hospitals and morgues."

Fauci: 'We're not going to get a national lockdown'
A national lockdown is not on the table but "very surgical type restrictions" are required to tame the coronavirus outbreak, Fauci said. He told "State of the Union" that governors and mayors must continue to order restrictions to help the nation cope as numbers rise. Fauci also urged President Donald Trump to begin collaborating with President-elect Joe Biden, comparing the coronavirus effort to a relay race where runners don't stop to hand off the baton. The head of the General Services Administration, Emily Murphy, has thus far not signed paperwork required for the transition process to begin.

Fauci said public health fundamentals must "uniform, not spotty."

"Everybody's got to do it," he says. "There's no excuse not to do that right now, because we know that can turn things around. We have good news with regard to the vaccine.

Ex-CDC chief warns death totals are barreling toward 2,000 per day
Tom Frieden, a former director of the Centers for Disease Control and Prevention, warns that "simple, depressing math" indicates hospitalizations will pass 100,000 within a month, placing a perilous strain on the health care system. Almost 70,000 Americans were in hospitals Saturday due to the virus. There were 166,555 new cases and 1,266 reported deaths, which could reach 2,000 daily by the end of the year without a unified effort to halt the surge, Frieden warned.

"Let's stay safe, keep in touch with friends and family, and have a happy and socially connected but physically distant Thanksgiving!" Frieden tweeted Sunday.

Small-town hospitals overwhelmed by COVID patients, deaths
Last spring, the coronavirus attacked major metro areas like New York City and Houston. This summer, it spread to suburban communities and ravaged the Sunbelt. The current wave, which has surpassed 2,000 deaths a day, frightens public health officials because it's tearing into the frayed health care safety net of rural America. Many of the nation’s nearly 1,800 rural hospitals lack the equipment, workforce and expertise to handle a surge of COVID-19 patients. Nurses and doctors are getting sick, leaving already short-staffed hospitals more desperate for workers.

“These rural hospitals are designed for primary care, general surgery,” said Alan Morgan, CEO of the National Rural Health Association. “They were never designed for a global pandemic response.”

– Ken Alltucker

Mexico reaches 1 million virus cases, nears 100,000 deaths
Mexico on Saturday reached 1 million confirmed coronavirus cases and nearly 100,000 test-confirmed deaths, though officials agree the number is probably much higher. Health Director General Ricardo Cortés Alcalá announced that the number of confirmed cases had reached 1,003,253, with at least 98,259 deaths from COVID-19. How did Mexico get here? By marching resolutely, even defiantly, against many internationally accepted practices in pandemic management, from face mask wearing, to lockdowns, testing and contact tracing.

President Andres Manuel López Obrador almost never wears a mask, and Assistant Health Secretary Hugo López-Gatell only occasionally does. Except science does not appear to be on their side: International experts have recommended mass testing, and say face masks protect both the wearer and other people.

West Virginia, North Dakota mandate masks, capacity limits
The Republican governors of North Dakota and West Virginia have mandated the wearing of masks in businesses and indoor spaces in their states. “It’s just silly to be in a public building with strangers walking around without a mask on,” West Virginia Gov. Jim Justice said Friday. “Even if you have this macho belief or whatever it may be, it’s silly.”

Justice's first indoor mask order in July did not require masks if social distancing was possible. The new order, effective Friday, requires masks at all times except when eating or drinking. The state's 11 new deaths caused by COVID-19 brings the death toll to at least 565.

North Dakota Gov. Doug Burgum's order followed increased pressure from doctors, nurses and other health care professionals. The directive goes into effect Saturday and will last until Dec. 13. Burgum said in a statement that doctors and nurses “need our help, and they need it now.” The state's COVID-19 death toll has risen to 707, according to state health data. Burgum also directed all bars and restaurants to limit capacity to 50%, and closed all in-person service between 10 p.m. and 4 a.m. Large-scale venues are limited to 25% capacity.

More:The Dakotas are 'as bad as it gets anywhere in the world' for COVID-19

Coronavirus spike is sending more kids back to online learning
The nation's new COVID-19 spike is poised to send hundreds of thousands of students who were in school at least part-time back to 100% remote learning. A quick look around the country:

County officials in Indianapolis on Thursday ordered all public and private schools to close and return to online learning by Nov. 30 for safety reasons, a move that affects around 200,000 students.
A number of urban districts that have operated fully online since the start of the year, such as San Diego, Atlanta, Philadelphia, Detroit, Anchorage and several big, suburban districts outside of Washington, D.C., are further delaying plans for in-class learning because of rising infections.

Before the most recent surge, districts were facing pressure to get more children back into classrooms. Mounting evidence shows schools that carefully reopened with safety protocols have not had major outbreaks. Most of the virus spread, experts have said, appears to be happening in the community, not schools. Read more here.

— Erin Richards

Want to gather with family for Thanksgiving? Start quarantining now
The holiday season is upon us and so is another surge of the coronavirus pandemic. So what's a family to do? While some state and city officials have advised against large family gatherings, folks may still be trying to find a way to spend time with loved ones this fall and welcoming students back into the fold.

Dr. Adam Jarrett, who serves as the chief medical officer at Holy Name Medical Center in New Jersey, said that the safest way to try to gather would be to get tested and then “truly self-quarantine for 10 days to two weeks.” With Thanksgiving falling on Nov. 26, that means quarantine should begin now.

“That’s the only way that we can be pretty close to 100% safe,” Jarrett said.

– Katie Sobko, The Bergen Record

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