(HealthDay)—On the heels of days of staggering coronavirus case counts, more than 90,000 new infections were reported among Americans on Election Day.

All of the country’s five highest days of new COVID-19 cases have been recorded since Oct. 29, confirming fears that another surge has taken hold and will only worsen, CNN reported.

The nationwide seven-day average of new cases now stands at about 86,363—more than double what it was on Sept. 4, CNN reported.

Not only cases are spiking: the number of people hospitalized with COVID-19 has reached record highs in a growing number of states.

Missouri, Oklahoma, Iowa, Indiana, Nebraska, North Dakota and New Mexico all reported record high hospitalizations this week, the Associated Press reported. Nebraska’s largest hospitals started limiting elective surgeries and looked to bring in nurses from other states to cope with the surge. Hospital officials in Iowa and Missouri warned bed capacity could soon be overwhelmed.

Though these surges are concentrated largely in the Midwest and Upper Midwest, troubling signs are also emerging in the Northeast, The New York Times reported.

A second wave of infections has started to surface in states that had brought the virus under control last spring: Connecticut has been averaging over 800 new cases per day, approaching its April peak of over 1,000, the newspaper said. Maine is well above its May peak with a seven-day average of 88 new cases per day as of Tuesday, when the state set a record with 127 new cases, the Times reported. Rhode Island, with fewer people than Maine, has been averaging over 400 new cases per day, well above its spring peak.

In Massachusetts, additional restrictions on businesses and public gatherings have gone into effect to fight rising coronavirus infections, the Times reported.

In New York, Gov. Andrew M. Cuomo has ordered that incoming travelers from non-neighboring states must be tested for the coronavirus before and after entry. Those from New Jersey, Massachusetts, Connecticut, Vermont and Pennsylvania will be exempt, as will essential workers. The requirement took effect on Wednesday, the Times reported.

Top COVID Advisor Birx warns the pandemic is about to get much worse

White House coronavirus response coordinator Dr. Deborah Birx warned Monday that the pandemic is entering a new and “deadly” phase and the United States needs to adopt a more aggressive approach to curbing its spread.

The warning, expressed in a private memo to White House officials, was a direct contradiction to President Donald Trump’s repeated claims that the pandemic is “rounding the corner,” the Washington Post reported.

Birx’s memo painted a grim picture: “Cases are rapidly rising in nearly 30 percent of all U.S. counties, the highest number of county hotspots we have seen with this pandemic,” it said. “Half of the United States is in the red or orange zone for cases despite flat or declining testing.”

The memo went further, and suggested that Trump and his advisers were spending too much time focusing on preventing lockdowns and not enough time on controlling the virus.

“We are entering the most concerning and most deadly phase of this pandemic,” Birx wrote. “This is not about lockdowns—it hasn’t been about lockdowns since March or April. It’s about an aggressive balanced approach that is not being implemented.”

Until now, Birx has not criticized Trump or his administration in public, the Post reported. But her sharp critique mirrors a growing dread among government scientists and public health experts that the worst of the pandemic is yet to come.

Birx now contradicts Trump on numerous points, the Post reported:

—While he holds large campaign rallies, she warns against them.

—While the president blames rising cases on more testing, Birx says testing is “flat or declining” in many areas where cases are rising.

—While Trump says the country is “rounding the turn,” Birx notes the country is entering its most dangerous period yet and will see more than 100,000 new cases a day this week.

States say they don’t have enough money to distribute a COVID vaccine

Meanwhile, state health officials say they are frustrated about a lack of financial support from the federal government as they face orders to prepare to receive and distribute the first doses of a coronavirus vaccine by the unlikely target date of Nov. 15, the Washington Post reported. And these officials stress that they don’t have enough money to pay for the massive undertaking.

State officials say they have been planning distribution efforts even though no one knows which vaccine will be authorized, what special storage and handling may be required, and how many doses each state will receive.

Even so, the U.S. Centers for Disease Control and Prevention sent a letter last week asking states to provide critical information, including a list of each jurisdiction’s top five sites capable of receiving and administering a vaccine that must be stored at extremely cold temperatures of minus-94 Fahrenheit, the Post reported. The letter refers to the vaccine only as Vaccine A, but industry and health officials say it is the Pfizer vaccine.

“We acknowledge that you are being asked to do unprecedented work,” wrote Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, which is leading the CDC’s role in vaccine distribution. She added: “This is a new planning ask,” the Post reported.

State officials say they have been trying to raise the issue with federal officials but have received little response.

“It is absolutely ridiculous that the administration, after spending $10 billion for a Warp Speed effort to develop a vaccine, has no interest in a similar investment in a Warp Speed campaign to get the vaccine to every American as quickly as possible after it is approved,” said Michael Fraser, executive director of the Association of State and Territorial Health Officials.

“The now accelerated timeline underscores the need to address the issue of funding for state and territorial health agencies to make this all work,” Fraser said. “There are many other costs that have no clear way to be paid for at this point.”

States and territories have received $200 million from the CDC to do planning, the Post reported.

Recruiting and training workers for coronavirus vaccination campaigns will cost at least $3 billion. Another $1.2 billion will be needed for cold supply chain management, $1 billion for arranging additional vaccination sites and $500 million for data information system upgrades, the Post reported.

COVID-19 continues to spread around the globe

By Wednesday, the U.S. coronavirus case count passed 9.4 million while the death toll passed 232,600, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Wednesday were: Texas with over 973,000; California with over 949,000; Florida with over 816,600; New York with over 518,000; and Illinois with nearly 438,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

Many European countries are tightening restrictions, the AP reported. France began a nationwide lockdown Friday, Germany began a partial lockdown on Monday and Austria started one Tuesday as government officials across the continent scramble to slow a sharp rise in infections that threatens to overwhelm their health care systems.

England will follow suit on Thursday, while Italy, Greece and Kosovo also announced new measures, the AP reported.

Things are no better in India, where the coronavirus case count has passed 8.3 million, a Johns Hopkins tally showed.

More than 123,600 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India’s younger and leaner population.

Still, the country’s public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil passed 5.5 million cases and had over 160,400 deaths as of Wednesday, the Hopkins tally showed.

Cases are also spiking in Russia: The country’s coronavirus case count has passed 1.6 million. As of Wednesday, the reported death toll in Russia was nearly 29,000, the Hopkins tally showed.

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