Governors and public health officials across the United States are pleading with Americans to change their behaviour as the country shatters record after record for coronavirus cases and hospitalisations.
Both records were broken yet again last Friday, as more than 181,100 new cases were reported nationwide, while Saturday saw at least 121,000 new cases recorded.
The seven-day average of new daily cases is more than 140,000, with upward trends in 49 states. Some 30 states added more cases in the the previous week than in any other seven-day period.
The surge is straining the healthcare system as the number of hospitalised Covid-19 patients rose to an all-time high of 68,141 on Friday.
Governor Andrew Cuomo of New York tweeted on Saturday: "One in every 378 Americans tested positive for Covid over the past week. Wear a mask."
Mr Cuomo's mathematics is on target: In a population of 330 million, 894,819 people, or one in 378, have tested positive since Saturday.
The virus has killed more than 1,000 Americans a day in the past week. Wyoming reported 17 new deaths on Saturday; Oklahoma, 23; Montana, 36; and South Dakota, 53all single-day records.
New Jersey, West Virginia, Maryland, Minnesota, Indiana, Utah, Montana, Alaska and North Dakota all set single-day records for new cases the same day.
A total of 39 American states this month reported record daily jumps in new cases, 17 saw record deaths and 25 registered a record number of Covid-19 patients in hospitals.
In a stark reversal, North Dakota became the 35th US state to require face coverings to be worn in public, after Governor Doug Burgum announced several measures on Friday, including a limit on indoor dining and a suspension of high school winter sports and extracurricular activities until Dec 14.
"Our situation has changed, and we must change with it," Mr Burgum said.
The state has critically understaffed hospitals and the highest rates of new cases and deaths per person in the nation.
In the spring, North Dakota was one of a handful of states that never entered a lockdown, and Mr Burgum had for weeks resisted any new orders, emphasising personal responsibility instead of requirements such as a mask mandate.
But the state's situation has rapidly deteriorated: Over the past week, it's averaged 1,334 cases per day, an increase of 54 per cent from the average two weeks earlier, and deaths are climbing fast.
Hospitals are so overwhelmed that Mr Burgum the previous week angered the state nurses' union by stating that medical workers who test positive could stay on the job to treat Covid-19 patients as long as the workers show no symptoms.
In New Mexico on Friday, Governor Michelle Lujan Grisham announced the nation's most sweeping statewide measure of the autumn season, issuing a two-week "stay at home" order that begins today.
Governor Kate Brown of Oregon also issued orders on Friday to place the state in a partial lockdown for two weeks, shuttering gyms, halting restaurant dining and mandating that social gatherings have no more than six people.
With Thanksgiving and other holidays on the horizon, Ms Brown, along with the governors of California and Washington, urged residents to avoid venturing out of state.
Gathering with family and friends, they warned, can transmit the virus through what New York's Governor Cuomo has called the "living room spread".
Dr Anthony Fauci, the nation's top infectious disease expert, on Friday repeated his pleas to Americans to take the virus seriously.
"If we do the things that are simple public health measures, that soaring will level and start to come down," he said. "You add that to the help of a vaccine, we can turn this around. It's not futile."
Since the pandemic began, the virus has infected more than 10.9 million people in the US, killing over 245,000 of them.
The widely cited model of the University of Washington's Institute for Health Metrics and Evaluation projects nearly 195,000 more fatalities by March 1 next year.
The biggest monthly spike of the pandemic will come in January, when more than 65,000 people are projected to die, the institute said.
NYTIMES, REUTERS