US governors from the coastal states of New Jersey and California and the heartland of Iowa and Ohio have acted to restrict gatherings and boost face coverings in confronting a coronavirus surge that they warned is out of control.
Each of the four governors, representing both ends of America's political divide and a mix of urban and rural regions, on Monday cited health data showing the pandemic reaching its most perilous point yet in the United States, threatening to overwhelm hospitals and claim thousands more lives in the weeks ahead.
They acknowledged that tighter limits on social interactions would prove especially difficult through the winter holidays. But without efforts to immediately tamp down the spread of the virus, they warned, more drastic action would be necessary in the near future.
Health experts have projected that the coming holiday travel season and the onset of colder weather, with more people tending to congregate indoors, are likely to worsen the situation.
More than 70,000 Americans were hospitalised for treatment of Covid-19 as of Monday, the most at any time since the pandemic began, according to a Reuters tally of public health figures.
The number of US cases documented to date surpassed 11 million on Monday, a little more than a week after crossing the 10-million markthe fastest time it's taken for the national tally to grow by a million cases. The country has averaged more than 148,000 new cases a day, and 1,120 daily deaths, over the past week.
The spike in cases and hospitalisations has been especially striking in places like Iowa, a largely rural, Midwestern state spared the worst ravages of the pandemic when it began eight months ago.
Iowa recorded over 52,000 new infections in the past two weeks, concerning the same number documented from March to mid-August, with Covid-19 accounting for one in every four patients now hospitalised in the state.
"No one wants to do this," Iowa Governor Kim Reynolds, a Republican, said in announcing that all indoor gatherings for social, leisure and community events will be limited to 15 people, with outdoor gatherings limited to 30, weddings and funerals included.
In addition, Iowa's restaurants and bars will be ordered to close by 10pm, and masks will be required for anyone spending at least 15 minutes in an indoor public space without being able to socially distance, the governor said.
Ms Reynolds said success hinged on public cooperation rather than enforcement. "If Iowans don't buy into this, we lose," she said at a news conference. "Businesses will close once again. More schools will be forced to go online, our healthcare system will fail, and the cost in human life will be high."
Similar messages were delivered on Monday by the Democratic governors of California and New Jersey and their Republican counterpart in Ohio.
But the new curbs are meeting with resistance, and it's been especially fierce in Michigan, where Governor Gretchen Whitmer, a Democrat, on Sunday said she would stop indoor dining, close casinos and cinemas, and halt in-person learning at high schools and colleges for three weeks.
A Republican state legislator quickly called for her to be impeached, and Dr Scott Atlas, President Donald Trump's coronavirus adviser, went on Twitter to urge people in the state to "rise up" in protest. He afterwards said he did not mean to incite violence.
REUTERS, NYTIMES