Covid-19 Is Resurging, and This Time It’s Everywhere

Pervasive spread in smaller communities fuels nationwide case record, though mortality rates are lower than in the spring

With a third surge of the Covid-19 pandemic hitting the U.S., many public-health authorities are warning the coronavirus is now so widespread that it will take pervasive new measures to contain it.

New infections surpassed 177,224 on Friday, setting a daily record that eclipsed the highest daily case counts of previous peaks in the spring and summer. The number of new infections was lower Saturday at 166,555, while new deaths numbered nearly 1,300, according to data compiled by Johns Hopkins University. The number of people hospitalized with Covid-19, meanwhile, reached 69,455 on Saturday, according to the Covid Tracking Project.

In earlier surges, infections were concentrated in cities such as New York and Chicago, or populous states like Florida and Texas. Many of the outbreaks then were linked to travelers returning from overseas or so-called superspreading events such as conferences, weddings and rallies.

Now, it is everywhere. People are becoming infected not just at big gatherings, but when they let their guard down, such as by not wearing a mask, while going about their daily routines or in smaller social settings that they thought of as safe—often among their own families or trusted friends.

The number of confirmed cases is rising significantly in all but a few states, according to a Wall Street Journal analysis of data from Johns Hopkins University. Most of the new cases are in the Midwest, which is experiencing a major surge. But even states and cities that had successfully beaten the virus down to low levels are struggling with rising numbers of illnesses.

“This is clearly a nationwide event,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who is a member of President-elect Joe Biden’s Covid-19 advisory board for the transition. “We have many mini-epidemics.”

The number of hospitalizations has reached a new high, though hospital stays are shorter and fewer people are dying than in the spring, likely due to more medical knowledge and better treatment. The seven-day average of new daily Covid-19 deaths in the U.S. was above 1,000 last week. But that average was still well below the highs seen in April when the seven-day average briefly topped 2,200 daily deaths.

Disease modelers predict a difficult winter ahead, as families and friends gather; just how difficult will depend on the measures that authorities, businesses and individuals take now to slow the virus, public-health experts say.

Some state officials took new steps last week, including stricter mask mandates and tighter restrictions on gatherings. In Wisconsin and Chicago, officials issued stay-at-home advisories, while Vermont’s governor prohibited all public and private social gatherings outside of members of the same household.

A worker directs vehicles waiting in line to enter a drive-through Covid-19 testing site in Milwaukee.

Photo: Bing Guan/Bloomberg News

Total shutdowns may not be necessary, said Celine Gounder, an infectious-diseases specialist and epidemiologist at NYU Grossman School of Medicine and Bellevue Hospital. Enough has been learned about the virus over the past many months that interventions can be more targeted to certain ZIP Codes or types of gathering places, more like a dimmer than an on-off light switch, she said. “I think at this point we actually know enough—we’ve learned a lot—that we’re not going to have to be quite so draconian in our measures,” said Dr. Gounder, who is also on the Covid-19 transition advisory board.

Many state and local leaders have been reluctant to return to the broad lockdowns imposed in the spring, in large part because of the severe economic and financial consequences for businesses and the public. The pandemic has already cost millions of jobs in the U.S. alone and dented global output.

Epidemiologists cite several factors behind the current surge: colder weather driving people indoors, including into bars and restaurants; the return of students to college campuses; public-health measures such as mask-wearing that are recommended but not required in some states; mixed messages about the dangers of the virus; and pandemic fatigue.

On Halloween, Zachary Mathes and Sarah Katz invited two friends from their “social bubble” over to watch trick-or-treaters, sitting socially distanced outside their Pittsburgh home. Vigilant for months about protecting themselves from the virus, they thought the small gathering was low-risk.

When it got cold outside, the four went to warm up and eat some snacks in the kitchen, leaving masks off after discussing the move first. “We kind of decided we’re all OK; that is our friend group that we are a part of,” said Ms. Katz.

Sarah Katz and Zachary Mathes of Pittsburgh say they were infected at a Halloween get-together with two friends.

Photo: Sarah Katz

Days later, they learned the guests had tested positive for Covid-19. By then Ms. Katz, a 27-year-old communications specialist, and Mr. Mathes, a 29-year-old musician, had symptoms too.

“We thought we were doing everything right, but we still got sick,” said Ms. Katz, who is riding out the illness at home with her husband.

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The virus, having spread for months, is now more entrenched in communities, epidemiologists say.

“When you have so many cases in the community, it is very easy to get infected inadvertently as you go about your daily business,” said Ali Khan, a veteran epidemiologist who is dean of the College of Public Health at the University of Nebraska Medical Center. “You don’t need to go to hot spots anymore.”

That has made it harder for people to tell where and how they got infected and for public-health authorities to track down and stop outbreaks.

Geoffrey Wardle, a lawyer in Boise, Idaho, suspects he got the virus while accompanying his parents to a funeral for a relative who died in a car accident. But he said it also could have been during a weekend birthday trip with his wife to California in mid-October.

Mr. Wardle says he has been careful to wear a mask, wash his hands and stay away from people, so when he and his wife first began to feel congested, they figured they had whatever cold their 16-year-old son had just gotten over. Then a client’s exposure prompted Mr. Wardle to get tested.

“I tried to be careful, but clearly was not careful enough,” Mr. Wardle would write to employees after receiving his positive results. Days later his wife’s test confirmed she was also infected. Their son was not.

Geoffrey Wardle and his wife, Kristin Edvalson Wardle, believe they may have been infected either at a relative’s funeral or on a trip to California.

Photo: Geoffrey Wardle

Bruce Dennis, an internist with a private practice in rural Ada, Okla., said when the pandemic first started it seemed far removed from the community of roughly 17,000 about 85 miles southeast of Oklahoma City. Gradually, many people grew skeptical that the virus was as bad as health officials warned, he said.

“People stayed in and they were cautious but they looked around and they didn’t see anybody actually sick and nobody knew anybody who had been sick, and so that skepticism grew,” Dr. Dennis said.

Now that infected patients are turning up in earnest—Dr. Dennis said he’s gone from seeing a case a week this summer to a case a day now—pandemic fatigue has set in.

“A lot of people just feel like I’m through with Covid, I’ve done all I can,” said Dr. Dennis, who recently suffered his own bout of the virus, along with his wife, daughter, son-in-law, and 6-month-old grandchild. “It’s now just really time to start.”

For months after the pandemic began, Shawna Sero stayed cooped up at home in Cedar Rapids, Iowa, refusing to go out with friends. With asthma and a weak immune system, the 40-year-old was terrified about getting infected, she said.

But after watching the Iowa Hawkeyes’ first football game of the season with her parents and siblings at home a few weekends ago, she let her guard down and decided to go to a bar with a friend.

“I just wanted to keep having fun,” she said. “It had been so long.”

Last week, Ms. Sero lay in a bed in a converted pediatric unit of Mercy Medical Center texting with her sister several floors down. She had been admitted to the hospital a couple of days earlier, struggling to breathe after testing positive for Covid-19. Her 42-year-old sister, also Covid-19 positive, was now in the emergency room, seeking relief from a cough so intense it sometimes made her vomit.

The rest of the family was showing symptoms too: her 37-year-old brother, Bobby Sero, who had tested positive and was texting the sisters from the master bedroom of his home where he was holed up to prevent his wife and five children from infection; their father, a 60-year-old diabetic, who hasn’t wanted to go to the hospital despite feeling sick; and their 59-year-old mother, who moved out at the end of October after a divorce and was awaiting test results at her new Illinois home.

Ms. Sero doesn’t know whether she passed the disease on to her family members, or the other way around.

Her sister is a security guard manager whose boyfriend is a cook at a bar. Her brother lives elsewhere and believes he got infected at work. “I don’t know if I brought it into the house,” she said. “It’s so rampant here that we just don’t even know.”

Ms. Sero is also concerned she might have spread the illness beyond her family when, not knowing she had the virus, she visited her neighborhood polling site to cast a ballot on Election Day. “I had to go vote,” she said. “And now I feel miserable because I went and voted and I had Covid.”

Iowa currently has one of the sharpest recent increases in cases in the nation—ranking third highest, per capita, over the past week after the Dakotas. Cases are rising exponentially, said Eli Perencevich, an infectious-disease doctor and epidemiologist at the University of Iowa Carver College of Medicine. “Everyone is overwhelmed—they are exhausted already,” he said.

Mercy Medical Center has dedicated two of its nine floors to Covid-19 patients and has put off elective surgeries. On one recent day, the hospital was boarding 12 patients in its emergency department until beds for them opened up, said Tony Myers, the hospital’s vice president of system quality, risk and medical affairs.

The hospital is so busy that it is allowing staff who have been exposed to Covid-19 to work if they haven’t tested positive, and they have to self-monitor and isolate at home, Dr. Myers said.

An Iowa Air National Guard member directs cars through a testing site.

Photo: Olivia Sun/The Register/Reuters

Other hospitals in the region are also full of patients and can’t absorb overflow, he said. “Everybody is in the same position,” he said. “For the most part, we all just have to survive on our own.”

Gov. Kim Reynolds, who has resisted a statewide mask mandate, last week banned gatherings of more than 25 people indoors or 100 people outdoors, unless participants are wearing masks. Critics say that isn’t enough.

“We’re kind of killing the economy with the lack of these simple measures,” said Dr. Perencevich.

But Ms. Reynolds has been hesitant to impose tougher restrictions, saying she’s heard from residents and small-business owners who have told her they “can’t afford another shutdown.”

Cedar Rapids Mayor Brad Hart said he spoke to Ms. Reynolds about a statewide mask mandate early in the pandemic but recognizes that she represents the whole state and that what might work for his community won’t work for smaller ones. Still, he decided to issue a mask mandate for the city in early September.

“I got thanked by a lot of people and I got a lot of people who said, ‘You’re going to try to take my guns next, you can’t tell me how to live,’ ” Mr. Hart said. “But more people are clearly wearing masks.”

Now he worries about how many people will choose to gather over the holidays despite the risks—a prospect he called “really scary” given the number of sick people in the state currently.

“So let’s just do the right thing now,” he said. “Do the right thing now and the sooner this will be gone, the sooner we’ll be able to open stuff back up, and the sooner we’ll be able to hug our family and friends again.”

A significant number of Covid-19 patients are dealing with symptoms long after the initial infection. The Wall Street Journal asked four patients to share their stories about how lingering effects are affecting their lives.

Write to Betsy McKay at and Erin Ailworth at

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Appeared in the November 16, 2020, print edition as 'Covid-19’s Spread Covers All Of Nation.'