Everything to Know About the Coronavirus in the United States

A drive-through COVID-19 screening site in Yorba Linda, California. Photo: MediaNews Group via Getty Images

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In February, the Centers for Disease Control and Prevention warned that the United States should brace for a domestic coronavirus outbreak. Just one month later, the World Health Organization officially declared COVID-19 a pandemic, and President Trump announced a national state of emergency. Over the past nine months, the number of confirmed cases of COVID-19 has risen dramatically, with more than 58 million across the globe. But the U.S. has suffered the largest outbreak in the world. As of November 22, more than 12.1 million people across every state, Washington, D.C., and four territories have tested positive for the disease, and more than 255,000 people with the virus have died.

It is hard to overstate the severity of the national trajectory: Across the U.S., coronavirus cases are surging to terrifying, unprecedented levels, with nearly every state suffering what one trusted tracker has characterized as “uncontrolled spread.” In mid-November, for the first time ever, the country added more than 1,017,000 cases over a single week — a period in which roughly one in every 323 people in the U.S. would have tested positive. Per the New York Times, there are “almost no hopeful signs in the data.”

Here’s everything to know about the spread of the virus in the U.S.

How many new coronavirus cases have been confirmed in the U.S.?

As of November 22, there have been at least 12,172,000 confirmed cases of COVID-19 in the U.S., and the death toll is now at least 255,753.

Back in May, President Trump predicted that the U.S. would see “anywhere from 75,000, 80,000, to 100,000” fatalities from the virus. Now, the U.S. has reported more deaths from COVID-19 than any other country, and is seeing the highest single-day increases of any country in the world. Though the U.S. accounts for 4 percent of the world’s population, it has had around 20 percent of the world’s coronavirus deaths — by far the largest gap of any affluent country. Still, many public-health experts believe that the official numbers significantly underestimate the pandemic’s true toll.

Though cases had been on a downward trajectory after the widespread lockdowns in March and April, the virus spread rapidly throughout the summer — especially in regions of the country that were early to reopen, including the South and West. Now, with cooler weather pushing people indoors, we are seeing drastic surges in cases nationwide. Over the past week, the country has reported an average of 170,539 new cases per day, a 59 percent increase from the average just two weeks earlier. Throughout late October and early November, the nation also broke new records for daily cases almost as soon as it set them: Just one day after the daily tally surpassed 90,000, on October 30, the country reported more than 99,000 new cases. On November 4, the country clocked over 100,000 new cases for the first time since the pandemic began. On November 10, the tally was 139,855. On November 13, more than 181,000 new cases were reported in a 24-hour timespan. So far, November has seen over 3 million new infections added to the caseload nationwide, or approximately 25 percent of the total.

Texas, which has had the largest outbreak in the country, has broken a grim milestone: On November 10, it became the first state to surpass 1 million total cases. (The current count is 1,164,130.) California has now passed the 1 million-mark, too, with 1,109,844 cases as of November 22. In comparison, New York, the early epicenter of the pandemic, has recorded a total of 595,581 cases. Now, the worst outbreaks are occurring in rural areas within the Upper Midwest, the Great Plains, and the Mountain West, although the situation is dire across the country. With numbers rising in all but a small handful of states — numbers in Hawaii and Maine remained relatively low as of November 22 — many officials are considering stay-at-home and other precautionary measures to mitigate the spread, which shows no sign of abating. In New York City, for example, Mayor Bill de Blasio closed public schools on November 19, eight weeks after partially reopening them for in-person instruction. After tamping down its infection rate over the summer, de Blasio explained that the city had exceeded 3 percent positivity over seven days of testing, triggering school (but not full restaurant or gym) closures.

Public-health experts expected a situation like this. On October 18, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told NBC that “the next six to 12 weeks are going to be the darkest of the entire pandemic.” Of particular concern right now is Thanksgiving and the holiday season, as public-health experts say that small indoor gatherings are driving new COVID-19 outbreaks. “You get one person who’s asymptomatic and infected and then all of a sudden, four or five people in that gathering are infected,” Fauci said during a recent livestreamed interview. “To me, that’s the exact scenario that you’re going to see on Thanksgiving.” On November 19, CDC officials gave the agency’s first public briefing since August, advising the country against Thanksgiving travel, and gatherings outside their immediate households.

The largest COVID-19 outbreaks have been in nursing homes, correctional facilities, and meat-processing plants. Additionally, federal data shows that Black and Latino people in the U.S. have been three times as likely to contract the virus as white people and that they have been nearly twice as likely to die from it. While elderly and immunocompromised people accounted for a large share of COVID-19 infections at the start of the pandemic, in recent months, younger people have been testing positive more than any other age group, and many outbreaks have been linked to schools and universities that have resumed in-person classes. Recently, more than 61,000 children across the country tested positive for COVID-19, more than any other week during the pandemic, the American Academy of Pediatrics reported.

How has the Trump administration responded to the pandemic?

In March, President Trump declared a national emergency over the coronavirus pandemic, effectively freeing up to $50 billion in federal funds to help states and territories fight the spread of the virus. He also signed a $2 trillion stimulus plan, the largest in modern American history, which sent direct payments of around $1,200 to millions of Americans who earn less than $99,000, along with an additional $500 per child. Negotiations on a second, scaled-back aid proposal bill were ongoing until, in early October, the president ordered Treasury Secretary Steven Mnuchin to put everything on hold until after the election. Meanwhile, the Trump administration has asked the Supreme Court to overturn the Affordable Care Act, which could take away health-insurance access from as many as 23 million Americans.

President Trump has repeatedly downplayed the seriousness of the current outbreaks and told his supporters at a rally in Ohio in September that the virus “affects virtually nobody.” He has previously, falsely, claimed that “99 percent” of cases are “totally harmless” — despite the fact that he told journalist Bob Woodward in early February that he knew the virus was airborne and “more deadly than even your strenuous flus.” On October 1, Trump announced that he and Melania had tested positive for coronavirus. Although he reportedly worried he “could be one of the diers,” after being treated with several different drugs, Trump was back to holding large public events one week later, repeating his claim that coronavirus is “disappearing.” (Meanwhile, infections within the president’s orbit still continue to climb.)

What is Biden’s coronavirus-response plan?

Days after winning enough electoral votes to secure the presidency, President-elect Joe Biden announced his coronavirus task force, which was met with widespread praise — namely because, unlike Trump’s task force, Biden’s includes an impressive slate of epidemiologists and infectious-disease experts. Whereas Trump’s team was led by Vice-President Mike Pence, who fueled an HIV outbreak in Indiana while he was governor, Biden’s will be led by Vivek Murthy, surgeon general under Obama. Additionally, the president-elect has pledged to reverse Trump’s withdrawal from the World Health Organization, and spoken about his plans to enforce mask mandates and expand testing infrastructure.

But none of this will be simple. Biden has inherited a public-health crisis that is all but certain to get much, much worse before he is inaugurated. And, if Republicans maintain control of the Senate, he’ll likely meet resistance in implementing all of his plans.

When will we get a coronavirus vaccine?

Researchers around the world have been working around the clock to develop a safe and effective vaccine and get it on the market as soon as possible, a process that can sometimes take up to a decade. On November 9, we received a much-needed bit of promising news: Pfizer, one of the four U.S. drug companies with a vaccine in late-stage trials, announced that its two-dose vaccine was more than 90 percent effective in preventing COVID-19 in an ongoing trial, according to an early analysis. Now, the company believes its product to be 95 percent effective. Shortly thereafter, Moderna announced that late-stage trials of its vaccine also showed a 95 percent efficacy rate.

While many questions remain unanswered, and the FDA still has to approve the vaccine, the development was met with cautious enthusiasm from public-health experts. However, as epidemiologists have long warned, distributing a vaccine to the public is logistically challenging, so it’s unlikely we’ll have widespread distribution until early-to-mid-2021. Meaning, we won’t be abandoning masks or social-distancing precautions anytime soon. Still, on Sunday, Moncef Slaoui — head of the government vaccine development push — told CNN that the first vaccinations could begin as soon as mid-December. Pfizer applied to the FDA for emergency use authorization on Friday, and the vaccine advisory board meets December 10. “Our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval, so I would expect maybe on day two after approval, on the 11th or on the 12th of December, hopefully, the first people will be immunized across the United States,” Slaoui said.

Meanwhile, other potential coronavirus treatments are undergoing clinical studies to determine their efficacy. On October 22, the Food and Drug Administration formally approved the country’s first treatment for COVID-19, the anti-viral drug remdesivir, which the FDA commissioner called “an important scientific milestone in the COVID-19 pandemic.” The FDA also recently issued emergency authorization to an antibody therapy called bamlanivimab. And on November 21, the FDA granted emergency authorization for the experimental antibody cocktail made by Regeneron, which Trump touted as a miracle cure, for treating COVID patients.

What should I do to minimize my coronavirus risk?

The two best ways to protect yourself and others from the coronavirus, according to public-health experts, is to wear a face mask and practice social distancing. (Thirty-three states plus Washington, D.C. require residents to wear masks in public settings when social distancing is not possible.) Also, maybe consider lowering the decibel of your voice, as some research shows that speaking quietly instead of yelling — which sends an abundance of respiratory droplets and aerosols out into the air — can lower the rate of virus transmission.

If you have symptoms associated with coronavirus — particularly coughing, fever, respiratory issues — call your doctor before showing up at their office: The virus is highly contagious and you want to limit the possibility of spreading it. If you are sick, the CDC recommends that you stay home and self-isolate, confining yourself to one room as much as possible and wearing a mask when you have to interact with others. Wash your hands frequently — soap and water and at least 20 seconds of scrubbing — and avoid touching shared household items, cleaning “high touch” surfaces (like your phone) regularly.

Regardless of whether or not you have symptoms, though, keep your hands clean, and seriously, stop touching your face and just stay home.

This post is being updated daily with new developments.

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