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Earlier in the week, Dr. Scott Atlas, a scientific adviser to President Trump, mocked the idea that older relatives would be put at risk over the holiday weekend, although there is ample medical evidence that seniors are much more likely to become ill if they are exposed to the virus and to die if they become sick.

An estimated 55 million Americans had planned to travel for the holiday, according to AAA Travel. But rising coronavirus infections, new quarantine rules and increased unemployment have combined to deter travelers in the past few weeks, and that number will be at least 10 percent lower now, the largest year-over-year decrease since 2008.

The C.D.C.’s warning runs counter to messages from administration officials, who have denounced concerns that Thanksgiving celebrations will speed the virus’s spread.

Officials in California on Thursday announced a curfew aimed at trying to quickly curb a surge of new coronavirus infections. Nearly all of the residents of the nation’s most populous state will be barred from leaving their homes to do nonessential work or to gather from 10 p.m. to 5 a.m.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of Mr. Biden’s Covid-19 advisory board, warned that a Thanksgiving feast was the perfect setting for spreading the virus.

Colleges have encouraged students — many returning home for the remainder of the semester — to take a coronavirus test before they depart, but C.D.C. officials do not endorse testing before gathering for Thanksgiving.

The C.D.C.’s advice went so far as to urge people to speak in low voices, because shouting — or singing — can spread the virus. Only one person should serve the food, federal officials said.

“I’ve seen a growing awareness, a wake-up, to the systemic oppression of people of color,” said Ms. LaDuke, an enrolled member of the White Earth Ojibwe Nation. “There is a movement toward justice for Native people. People want to listen.”

“There was an event that happened in 1621,” Ms. Coombs said. “But the whole story about what occurred on that first Thanksgiving was a myth created to make white people feel comfortable.”

In the period between Indigenous People’s Day and Thanksgiving, she said she is “inundated with people who might have some awareness with the pain over the characterizations that comes with this time.”

Hiʻilei Julia Hobart, an assistant professor of anthropology at the University of Texas at Austin, said current events allow students to see more clearly the shared legacies of African-Americans, many of whose enslaved ancestors were forced to work land stolen from Native Americans, whose agricultural know-how was also co-opted.

Unfortunately, this development doesn’t mean we can all relax and start doing more things. It means we need to tighten up even further until the vaccine becomes available.

The goal is now no longer to learn to live indefinitely with the virus. It’s to get as many people through the winter as possible without getting sick.

It’s always been hard to convince people to make good choices when considering sacrifices. Uncertainty around when we’d get an effective vaccine made it even harder. Cutting off in-person interactions for an uncertain stretch of time was excruciating. But it may be more palatable to hunker down if it’s only for a defined period.

And the costs are not just financial; mental health is at risk as well as physical health as people forgo care, including self-care, to remain free from infection. All of that becomes easier to swallow if it’s for a shorter period of time.

To make the situation concrete, let’s consider the upcoming Thanksgiving holiday. With cases growing rapidly around the country, especially in the northern Midwest, indoor social gatherings are more dangerous than at any point since the spring. Thanksgiving dinners are ideal settings for “superspreader” events: They crowd people from all over around a table to talk, laugh and drink, often in poorly ventilated rooms. Many families stuff themselves into houses for an entire long weekend.

The calculus is very different, however, if a vaccine is around the corner. While Pfizer’s still needs to be approved, manufactured and distributed, the company estimates that 50 million doses could be distributed before the end of the year. Another 1.3 billion would come in 2021. If other vaccines also show success, relief could come as soon as the spring.

While Pfizer’s still needs to be approved, manufactured and distributed, the company estimates that 50 million doses could be distributed before the end of the year. Another 1.3 billion would come in 2021. If other vaccines also show success, relief could come as soon as the spring.

The point generalizes. Without question, the sacrifices required to keep us safe from Covid-19 are costly. And the costs are not just financial; mental health is at risk as well as physical health as people forgo care, including self-care, to remain free from infection. All of that becomes easier to swallow if it’s for a shorter period of time.

Cutting off in-person interactions for an uncertain stretch of time was excruciating. But it may be more palatable to hunker down if it’s only for a defined period.

Pfizer’s announcement strengthens the case for federal financial support. Covid-19 is still going to hurt some businesses disproportionately, either because they’ll be forced to close again or because people have stopped going out as much. But Congress no longer needs to write a blank check to support them. It just needs to provide a lifeline for a number of months, a much more palatable prospect.

It’s a bad idea for restaurants and bars to be open for indoor dining this winter. Temporarily closing them down would be easier to stomach if these establishments are given the wherewithal to reopen next year.

The Pfizer announcement is unmitigated good news. But it would be a tragic mistake to relax our vigilance. Instead, continue to mask up, stay home and consider canceling or limiting your Thanksgiving plans. This is still a marathon, but the end is much closer than before.

For weeks, Canadian political leaders in virus hotspots have barred dine-in eating, closed gyms and theaters, and restricted large gatherings.

With a surge in cases ongoing and more holidays to come on the calendar, many hospitals in Canada are now activating surge capacity plans, adding temporary Covid-19 units and more acute care beds.

"Clearly, even though we haven't, in Canada, experienced one of the catastrophic scenarios we fretted over in April, we shouldn't feel too safe," Dr. Francois Lamontagne, a clinician and scientist at the University of Sherbrooke in Quebec, told CNN.

But Lamontagne said he's also concerned about how some people now distrust authorities and the medical advice they dispense about the virus.

The United States has recorded more than 9.1 million infections and 230,548 deaths during the pandemic, according to data from Johns Hopkins University (JHU).

The US Centers for Disease Control and Prevention also recently released guidance on holiday gatherings and what Americans need to be aware of before traveling, hosting or attending parties -- or just gathering with family and friends over the Thanksgiving holiday.

The lowest risk for contracting the highly infectious virus or spreading it is simply celebrating Thanksgiving in your own home with members of your household and/or virtually with extended family, the CDC said.

Traveling during the holidays, on planes or public transportation, increases the chances of catching and spreading Covid-19 because it increases exposure to the virus, the CDC said in its holiday guidelines.

The primary reason for lower gasoline prices is the recent weakness of oil prices, which have fallen by more than $15 a barrel, or nearly 20 percent, since early Septembe

Demand for fuel has been weak in China and parts of Europe, while production has been strong in Brazil, Canada and the United States.

“Reaching a new agreement to cut production will prove to be challenging,”

Saudi Arabia had been expected to extend its cuts in production, while cajoling other countries to show restraint as well to bolster prices. But Nigeria and Angola are resisting, and lobbying for higher production quotas

He said that although Russia and eight other members of the cartel agreed to cuts in June, “it would be difficult for these countries to accept even lower production quotas.”

The uncertainty has served as a signal to traders to bail out of crude.

Airfares will be slightly more expensive than last year, the motor club said, but otherwise holiday travel should be cheaper. It said the average price for a domestic hotel stay is down 12 percent from last year, while rental car costs are 20 percent lower.

“Talents for low intrigue, and the little arts of popularity,” might suffice for someone to be elected to the governorship of a state, but not the presidency. Election would “require other talents, and a different kind of merit,” to gain “the esteem and confidence of the whole Union,” or enough of it to win the presidency. As a result, there would be “a constant probability of seeing the station filled by characters pre-eminent for ability and virtue.” This was the Framers’ goal in designing the system that would make “the choice of the person to whom so important a trust was to be confided.”

In a nutshell, while carrying out his official duties, a president has to put the country, not himself, first; he must faithfully follow and enforce the law; and he must act with the utmost care in doing all that.

can Trump do all that? Does his personality allow him to? Answering those questions doesn’t require mental-health expertise, nor does it really require a diagnosis. You can make the argument for Trump’s unfitness without assessing his mental health: Like James Fallows, for example, you could just ask whether Trump would have been allowed to retain any other job in light of his bizarre conduct

More than a diagnosis, what truly matters, as Lincoln’s case shows, is the president’s behavioral characteristics and personality traits. And understanding how people behave and think is not the sole province of professionals; we all do it every day, with family members, co-workers, and others.

its criteria for personality disorders—they don’t require a person to lie on a couch and confess his or her innermost thoughts. They turn on how a person behaves in the wild, so to speak.

Donald Trump, as president of the United States, is probably the most observable and observed person in the world. I’ve personally met and spoken with him only a few times, but anyone who knows him will tell you that Trump, in a way, has no facade: What you see of him publicly is what you get all the time, although you may get more of it in private

accounts of a person’s behavior from laypeople who observe him might be more accurate than information from a clinical interview, and that this is especially true when considering two personality disorders in particular—what the DSM calls narcissistic personality disorder and antisocial personality disorde

These two disorders just happen to be the ones that have most commonly been ascribed to Trump by mental-health professionals over the past four years. Of these two disorders, the more commonly discussed when it comes to Trump is narcissistic personality disorder, or NPD—pathological narcissism

it touches directly upon whether Trump has the capacity to put anyone’s interests—including the country’s and the Constitution’s—above his own.

A certain amount of narcissism is healthy, and helpful—it brings with it confidence, optimism, and boldness. Someone with more than an average amount of narcissism may be called a narcissist. Many politicians, and many celebrities, could be considered narcissists

“Pathological narcissism begins when people become so addicted to feeling special that, just like with any drug, they’ll do anything to get their ‘high,’ including lie, steal, cheat, betray, and even hurt those closest to them,”

The “fundamental life goal” of an extreme narcissist “is to promote the greatness of the self, for all to see,

To many mental-health professionals, Donald Trump provides a perfect example of such extreme, pathological narcissism: One clinical psychologist told Vanity Fair that he considers Trump such a “classic” pathological narcissist that he is actually “archiving video clips of him to use in workshops because there’s no better example”

The goal of a diagnosis is to help a clinician guide treatment. The question facing the public is very different: Does the president of the United States exhibit a consistent pattern of behavior that suggests he is incapable of properly discharging the duties of his office?

Even Trump’s own allies recognize the degree of his narcissism. When he launched racist attacks on four congresswomen of color, Senator Lindsey Graham explained, “That’s just the way he is. It’s more narcissism than anything else.” So, too, do skeptics of assigning a clinical diagnosis. “No one is denying,” Frances told Rolling Stone, “that he is as narcissistic an individual as one is ever likely to encounter.” The president’s exceptional narcissism is his defining characteristic—and understanding that is crucial to evaluating his fitness for office

The DSM-5 describes its conception of pathological narcissism this way: “The essential feature of narcissistic personality disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts.”

The diagnostic criteria offer a useful framework for understanding the most remarkable features of Donald Trump’s personality, and of his presidency. (1) Exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements?

(2) Preoccupied with fantasies of unlimited success, power, brilliance

(3) Believes that he or she is “special” and unique and should only associate with other special or high-status people?

Trump claims to be an expert—the world’s greatest—in anything and everything. As one video mash-up shows, Trump has at various times claimed—in all seriousness—that no one knows more than he does about: taxes, income, construction, campaign finance, drones, technology, infrastructure, work visas, the Islamic State, “things” generally, environmental-impact statements, Facebook, renewable energy, polls, courts, steelworkers, golf, banks, trade, nuclear weapons, tax law, lawsuits, currency devaluation, money, “the system,” debt, and politicians.

(4) Requires excessive admiration? Last Thanksgiving, Trump was asked what he was most thankful for. His answer: himself, of course. A number of years ago, he made a video for Forbes in which he interviewed two of his children. The interview topic: how great they thought Donald Trump wa

(5) A sense of entitlement? (9) Arrogant, haughty behaviors? Trump is the man who, on the infamous Access Hollywood tape, said, “When you’re a star, they let you do it. You can do anything you want”—including grabbing women by their genitals. He’s the man who also once said, “I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters.”

(8) Envious of others? Here’s a man so unable to stand the praise received by a respected war hero and statesman, Senator John McCain, that he has continued to attack McCain months after McCain’s death;

(6) Interpersonally exploitative? Just watch the Access Hollywood tape, or ask any of the hundreds of contractors and employees Trump the businessman allegedly stiffed, or speak with any of the two dozen women who have accused Trump of sexual misconduct, sexual assault, or rape.

Finally, (7) Lacks empathy: is unwilling to recognize or identify with the feelings or needs of others? One of the most striking aspects of Trump’s personality is his utter and complete lack of empathy

The notorious lawyer and fixer Roy Cohn, who once counseled Trump, said that “Donald pisses ice water,” and indeed, examples of Trump’s utter lack of normal human empathy abound.

“It made no sense, Priebus realized, unless you understood … ‘The president has zero psychological ability to recognize empathy or pity in any way.’

What kind of human being, let alone politician, would engage in such unempathetic, self-centered behavior while memorializing such horrible tragedies? Only the most narcissistic person imaginable—or a person whose narcissism would be difficult to imagine if we hadn’t seen it ourselves. The evidence of Trump’s narcissism is overwhelming—indeed, it would be a gargantuan task to try to marshal all of it, especially as it mounts each and every day.

A second disorder also frequently ascribed to Trump by professionals is sociopathy—what the DSM-5 calls antisocial personality disorder

Central to sociopathy is a complete lack of empathy—along with “an absence of guilt.” Sociopaths engage in “intentional manipulation, and controlling or even sadistically harming others for personal power or gratification. People with sociopathic traits have a flaw in the basic nature of human beings … They are lacking an essential part of being human.” For its part, the DSM-5 states that the “essential feature of antisocial personality disorder is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.”

Trump’s sociopathic characteristics sufficiently intertwine with his narcissistic ones that they deserve mention here. These include, to quote the DSM-5, “deceitfulness, as indicated by repeated lying, use of aliases, or conning others.” Trump’s deceitfulness—his lying—has become the stuff of legend; journalists track his “false and misleading claims” as president by the thousands upon thousands.

Other criteria for antisocial personality disorder include “failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest”; “impulsivity or failure to plan ahead”; and “lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

As for impulsivity, that essentially describes what gets him into trouble most: It was his “impulsiveness—actually, total recklessness”—that came close to destroying him in the 1980s

And lack of remorse? That’s a hallmark of sociopathy, and goes hand in hand with a lack of human conscience. In a narcissistic sociopath, it’s intertwined with a lack of empathy. Trump hardly ever shows remorse, or apologizes, for anything. The one exception: With his presidential candidacy on the line in early October

In a way, Trump’s sociopathic tendencies are simply an extension of his extreme narcissism

articular, “They change reality to suit themselves in their own mind.” Although Trump “lies because of his sociopathic tendencies,” telling falsehoods to fool others, Dodes argues, he also lies to himself, to protect himself from narcissistic injury. And so Donald Trump has lied about his net worth, the size of the crowd at his inauguration, and supposed voter fraud in the 2016 election.

The latter kind of lying, Dodes says, “is in a way more serious,” because it can indicate “a loose grip on reality”—and it may well tell us where Trump is headed in the face of impeachment hearings. Lying to prevent narcissistic injury can metastasize to a more significant loss of touch with reality

Experts haven’t suggested that Trump is psychotic, but many have contended that his narcissism and sociopathy are so inordinate that he fits the bill for “malignant narcissism.” Malignant narcissism isn’t recognized as an official diagnosis; it’s a descriptive term coined by the psychoanalyst Erich Fromm, and expanded upon by another psychoanalyst, Otto Kernberg, to refer to an extreme mix of narcissism and sociopathy, with a degree of paranoia and sadism mixed in

In the view of some in the mental-health community, such as John Gartner, Trump “exhibits all four” components of malignant narcissism: “narcissism, paranoia, antisocial personality and sadism.”

Mental-health professionals have raised a variety of other concerns about Trump’s mental state; the last worth specifically mentioning here is the possibility that, apart from any personality disorder, he may be suffering cognitive decline.

His “mental state,” according to Justin A. Frank, a former clinical professor of psychiatry and physician who wrote a book about Trump’s psychology, “include[s] so many psychic afflictions” that a “working knowledge of psychiatric disorders is essential to understanding Trump.” Indeed, as Gartner puts it: “There are a lot of things wrong with him—and, together, they are a scary witch’s brew.”

when you line up what the Framers expected of a president with all that we know about Donald Trump, his unfitness becomes obvious. The question is whether he can possibly act as a public fiduciary for the nation’s highest public trust. To borrow from the Harvard Law Review article, can he follow the “proscriptions against profit, bad faith, and self-dealing,” manifest “a strong concern about avoiding ultra vires action” (that is, action exceeding the president’s legal authority), and maintain “a duty of diligence and carefulness”? Given that Trump displays the extreme behavioral characteristics of a pathological narcissist, a sociopath, or a malignant narcissist—take your pick—it’s clear that he can’t.

To act as a fiduciary requires you to put someone else’s interests above your own, and Trump’s personality makes it impossible for him to do that. No president before him, at least in recent memory, has ever displayed such obsessive self-regard

Indeed, Trump’s view of his presidential powers can only be described as profoundly narcissistic, and his narcissism has compelled him to disregard the Framers’ vision of his constitutional duties in every respect

Trump’s incapacity affects all manner of subjects addressed by the presidency, but can be seen most acutely in foreign affairs and national security.

All in all, Trump sought to impede and end a significant counterintelligence and criminal investigation—one of crucial importance to the nation—and did so for his own personal reasons. He did precisely the opposite of what his duties require. Indeed, he has shown utter contempt for his duties to the nation

hat constitutional mechanisms exist for dealing with a president who cannot or does not comply with his duties, and how should they take the president’s mental and behavioral characteristics into account?

it turns out that impeachment is a more practical mechanism

In short, now that the House of Representatives has embarked on an impeachment inquiry, one of the most important judgments it must make is whether any identified breaches of duty are likely to be repeated. And if a Senate trial comes to pass, that issue would become central as well to the decision to remove the president from office. That’s when Trump’s behavioral and psychological characteristics should—must—come into pla

One of the most compelling arguments about the meaning of those words is that the Framers, in Article II’s command that a president faithfully execute his office, imposed upon him fiduciary obligations. As the constitutional historian Robert Natelson explained in the Federalist Society Review, the “founding generation [understood] ‘high … Misdemeanors’ to mean ‘breach of fiduciary duty.’

Eighteenth-century lawyers instead used terms such as breach of trust—which describes the same thing. “Parliamentary articles of impeachment explicitly and repetitively described the accused conduct as a breach of trust,” Natelson argues, and 18th-century British legal commentators explained how impeachment for “high Crimes and Misdemeanors” was warranted for all sorts of noncriminal violations that were, in essence, fiduciary breaches.

why the discussion of Morris’s suggestion was so brief—the drafters knew what the words historically meant, because, as a House Judiciary Committee report noted in 1974, “at the time of the Constitutional Convention the phrase ‘high Crimes and Misdemeanors’ had been in use for over 400 years in impeachment proceedings in Parliament

Certainly Alexander Hamilton knew by the time he penned “Federalist No. 65,” in which he explained that impeachment was for “those offenses which proceed from the misconduct of public men, or, in other words, from the abuse or violation of some public trust.

What constitutes such an abuse or violation of trust is up to Congress to decide: First the House decides to bring impeachment charges, and then the Senate decides whether to convict on those charges. The process of impeachment by the House and removal by trial in the Senate is thus, in some ways, akin to indictment by a grand jury and trial by a petit jury

As Laurence Tribe and Joshua Matz explain in their recent book on impeachment, “the Constitution explicitly states that Congress may not end a presidency unless the president has committed an impeachable offense. But nowhere does the Constitution state or otherwise imply that Congress must remove a president whenever that standard is met … In other words, it allows Congress to exercise judgment.”

As Tribe and Matz argue, that judgment presents a “heavy burden,” and demands that Congress be “context-sensitive,” and achieve “an understanding of all relevant facts.” A president might breach his trust to the nation once in some small, inconsequential way and never repeat the misbehavior, and Congress could reasonably decide that the game is not worth the candle.

It’s also an appropriate mechanism, because the constitutional magic words (other than Treason and Bribery) that form the basis of an impeachment charge—high Crimes and Misdemeanors, found in Article II, Section 4 of the Constitution—mean something other than, and more than, offenses in the criminal-statute books. High Crimes and Misdemeanors is a legal term of art, one that historically referred to breaches of duties—fiduciary duties—by public officeholders. In other words, the question of what constitutes an impeachable offense for a president coincides precisely with whether the president can execute his office in the faithful manner that the Constitution requires.

there’s another reason as well. The people have a right to know, and a need to see. Many people have watched all of Trump’s behavior, and they’ve drawn the obvious conclusion. They know something’s wrong, just as football fans knew that the downed quarterback had shattered his leg. Others have changed the channel, or looked away, or chosen to deny what they’ve seen. But if Congress does its job and presents the evidence, those who are in denial won’t be able to ignore the problem any longer.

For years, conservative justices have said the court disfavors the Second Amendment. Justice Amy Coney Barrett is likely to shift the balance, and a case to help her do so may be knocking.

ThanksgivingWelcome to Homeownership

In dissent, Judge Stephanos Bibas, a former law professor appointed to the court by President Trump (and the author of a scathing decision on Friday rejecting the president’s challenge to the election results in Pennsylvania), wrote that the framers of the Constitution would not have allowed lawmakers to bar felons convicted of nonviolent crimes from owning guns.

That dissent was written by Justice Barrett when she was a judge on the federal appeals court in Chicago. The law forbidding people with felony convictions from owning guns, she wrote, should not apply when the crimes in question were nonviolent.

Before Justice Barrett’s arrival, the court’s four most conservative justices had repeatedly written that the court should return to the subject of the Second Amendment

It's a grim reality reflected in the latest numbers.

The US had its highest day of new cases -- 217,664 -- and deaths -- 2,879 -- on Thursday,

There were a record-setting, 100,667 hospitalizations

The US has been adding 1 million new cases every six days for three weeks.

Covid-19 was the leading cause of death this week, with 11,820, an average of 1,660 a day,

"Scaling up mask use to 95% can save 66,000 lives by April 1," the team said.

"We are now up to roughly 2,100 positive cases in our hospitals. That's an increase of almost 70% since November 11," O'Quinn said. "We're seeing about 70 to 100 new cases every day."

In Pennsylvania, just under 5,000 people are hospitalized with Covid-19, and two parts of the state are inching closer to staffing shortages, Secretary of Health Dr. Rachel Levine said Thursday.

"It is so important to remember that all of us have to be mindful, that we all have a role to play in what is happening in the hospitals right now," Levine said. "You might not need hospital care right now; you might not have a loved one in the hospital right now. But what is happening in our hospitals has a direct impact on you."

California hospitals are treating about 2,066 Covid-19 patients in intensive care units

"We'll see more of the surge as we get two to three weeks past (and) it butts right up on the Christmas holiday, as people start to travel and shop and congregate," Fauci said.

Fauci said he supports as a "good idea" Biden's plan to suggest all Americans wear a mask for the first 100 days of his presidency.

"Shutdowns, or lockdowns, are really not on the table, at least not from the Biden-Harris team. We really view this as restrictions that you dial up or dial down based on the local epidemiology," Gounder said.

And hospitals nationwide have yet to see the impacts that Thanksgiving gatherings and travel could bring, with another surge projected in coming weeks. On NBC's "Today" on Friday, Dr. Anthony Fauci said the "full brunt" of Thanksgiving coronavirus cases won't be clear for another week or two.

The figure comes as Gov. Gavin Newsom announced a strict regional stay-at-home order.

Delaware Gov. John Carney announced Thursday a stay-at-home advisory, telling residents to avoid indoor gatherings with anyone outside their households from December 14 through January 11.

A vaccine is on the way but, make no mistake, we are facing the most difficult few months of this crisis," the governor said in a statement. "I know we're all tired of COVID-19 -- but it's not tired of us."

Meanwhile, local and state leaders have begun giving updates on when they expect their first batches of vaccines. No vaccine has received emergency use authorization from the Food and Drug Administration.

New York City Mayor Bill de Blasio said Thursday he expects the first round in about 12 days from Pfizer. About a week later, the city will get vaccines from Moderna.

"Over time, there will be enough vaccines for everyone," de Blasio said.

Massachusetts Gov. Charlie Baker said he expects about 300,000 doses of a Covid-19 vaccine by the end of the month. Health care workers and long-term care facility residents and staff are "absolutely going to be up near the top of the list" for the first doses, Baker said.

President TrumpDonald John TrumpBiden says GOP senators have called to congratulate him Biden: Trump attending inauguration is 'of consequence' to the country Biden says family will avoid business conflicts MORE has been largely silent when it comes to warning the public about the need for precautions or announcing major new steps aimed at curbing the spread of the virus before a vaccine is widely available.

Centers for Disease Control and Prevention (CDC) Director Robert Redfield warned on Wednesday that December, January and February are “going to be the most difficult time in the public health history of this nation.”

Even though some of those warnings were aimed at the public, the White House did not release the report and instead sent it privately to states. The document came to light only after it was leaked to the press.

The U.S. is already being hit with 150,000 new cases a day, as well as a record 100,000-plus coronavirus patients in hospitals and more than 2,500 deaths from the virus on Wednesday alone. Those numbers are expected to worsen as more people test positive after a surge of Thanksgiving travel and gatherings.

The White House coronavirus task force sent a report, dated Sunday, to states sounding the alarm on several fronts, including that “a further post-Thanksgiving surge will compromise COVID patient care, as well as medical care overall” as hospitals are overwhelmed.

state responses “remain inadequate” in “many areas” and called for measures like limiting or closing indoor dining, which many states have not done.

Trump administration health officials are issuing increasingly dire warnings about the coronavirus and its rapid spread across the country, drawing a sharp contrast to the president’s reluctance to acknowledge the severity of the crisis head-on.

Some health experts said that given Trump’s history of making skeptical and at times misleading remarks about the coronavirus, his relative silence on the topic might be better than having him undercut the messaging from public health agencies.

“I’d rather he be quiet than step on the message of the CDC, which appears to be waking back up and providing useful guidance.”

“He's been hard at work,” she added. “He's done I don't know how many coronavirus task force briefings from this podium. But the work he's done speaks for itself.”

When Trump has spoken about coronavirus recently, it has been to tout progress on the vaccine, which has indeed progressed at record speed and shown very promising safety and efficacy results. But the vaccine will not be widely available for several months, highlighting the need for other measures in the short term to get through the brutal winter months.

“If you can loot businesses, burn down buildings, engage in protest, you can also go to a Christmas party, you can celebrate the holiday of Christmas, and you can do it responsibly.

it would probably be many years until it was safe enough to “return to approximately the lifestyle we had.” She said, “We have to settle to live with the virus.”

Epidemiologists are worried about many unknowns, including how long immunity lasts; how the virus may mutate; the challenges of vaccine distribution; and the possible reluctance to accept the vaccine among some groups.

the epidemiologists are living with stringent precautions and new workarounds in place, far stricter than those of many ordinary Americans

Most scientists say around 70 percent of the population will need to be immune for the United States to reach herd immunity, when the virus slows down significantly or stops

Three-quarters of respondents said they planned to spend Christmas, Hanukkah or other winter holidays only with members of their household, or not celebrate at all, similar to how they spent Thanksgiving.

most epidemiologists agreed on these general principles: They are less worried about outdoor activities and about touching surfaces, and more worried about indoor activities and those with large groups.

“Indoor venues with lots of people is the riskiest situation,” said Leland Ackerson of the University of Massachusetts. “Outdoors with few people, social distancing and precautions is the least risky.” He said that during the last month, he had hiked with friends, opened mail without precautions and run errands.

“It’s funny: When you asked this before, I was so optimistic about the U.S. being able to lead and address this in a timely fashion,” said Rachel Widome, associate professor at the University of Minnesota. “I told you I thought things would be better by now. I was very wrong. They are dramatically worse.”

Of 23 activities of daily life that the survey asked about, there were only three that the majority of respondents had done in the last month: gathering outdoors with friends; bringing in mail without precautions; and running errands, like going to the grocery store or pharmacy.

Nearly a third of respondents said they would be comfortable returning to more activities of daily life once they were vaccinated. Some said they would feel comfortable doing only certain things, like socializing with people who had also been vaccinated

A few said they would wait until the country had reached the herd immunity threshold and they had received a vaccine themselves.

“I would do some minimal travel, small indoor gatherings with other close relatives when I am vaccinated, but maintain safety precautions such as wearing a mask and social distance.”

Some said they were less worried than last spring about socializing outdoors, touching surfaces or sending young children to school. They were more worried about indoor air transmission and the dangers of not wearing masks.

“It entirely depends upon what we do as a nation to address the pandemic,” said Emeli Anderson, a doctoral student of epidemiology at Emory. “Right now, we are not nearly doing enough.”

Many epidemiologists expressed disappointment and frustration that public health messaging had not been more effective, and that a growing share of Americans seemed to distrust science. They feared that the politicization of measures like wearing masks and staying home would have long-term consequences.

“This virus has humbled me as a professional and a person,” said Michelle Odden, associate professor of epidemiology at Stanford. “I did not think this level of failure in a federal response was possible in the United States. We have a lot of work to do.”

assuming a highly effective therapeutic drug isn’t developed, a significant number said it would be at least a year before they felt it would be safe to do many of the things they used to.

“I expect that wearing a mask will become part of my daily life, moving forward, even after a vaccine is deployed,”

Many said they planned to keep working from home at least part of the time. Some said they would always be more hesitant about greeting people with a handshake or a hug, being in crowded places or traveling internationally.

“I think it will be a few years before gathering with large groups of people in crowded public places and being on airplanes and other public transportation will feel safe to me,”

Others cautioned that even when the physical dangers of the pandemic recede, other consequences are likely to be long-lasting. They mentioned the effects of isolation on children’s developing brains; the exposure of deep inequities in health care and in safety nets; and the fear and sadness of so much illness and death.

Being in close proximity to people I don’t know will always feel less safe than it used to,” said Ellicott Matthay, a postdoctoral scholar at the University of California, San Francisco.

Three-quarters of respondents said they planned to spend Christmas, Hanukkah or other winter holidays only with members of their household, or not celebrate at all, similar to how they spent Thanksgiving.

Most scientists say around 70 percent of the population will need to be immune for the United States to reach herd immunity, when the virus slows down significantly or stops.

Nearly a third of respondents said they would be comfortable returning to more activities of daily life once they were vaccinated.

Since the spring, 79 percent of the epidemiologists said their assessment of various risks had changed, and that they had adjusted their behaviors accordingly. Science is a process, they said, and the virus is new, so even those studying it most closely have learned things along the way.

“It entirely depends upon what we do as a nation to address the pandemic,” said Emeli Anderson, a doctoral student of epidemiology at Emory. “Right now, we are not nearly doing enough.”

Many epidemiologists expressed disappointment and frustration that public health messaging had not been more effective, and that a growing share of Americans seemed to distrust science.

“This virus has humbled me as a professional and a person,” said Michelle Odden, associate professor of epidemiology at Stanford. “I did not think this level of failure in a federal response was possible in the United States. We have a lot of work to do.”

As for the future, some said that parts of life could begin to return to normal sometime in the summer, thanks to vaccines. B

ut assuming a highly effective therapeutic drug isn’t developed, a significant number said it would be at least a year before they felt it would be safe to do many of the things they used to.

Many said they planned to keep working from home at least part of the time. Some said they would always be more hesitant about greeting people with a handshake or a hug, being in crowded places or traveling internationally.

South Korea, for example, has much higher compliance with masking and other social distancing guidelines. But that is not all; testing, contact-tracing and other public health infrastructure have proved to be just as important.

Americans need to start thinking about how to control the pandemic under the assumption that people are not necessarily going to listen. Testing is a key component of this. What if, for Thanksgiving, in addition to telling people not to see their families, we also emphasized getting a test before and after traveling and isolating until results were available?

Our testing capacity makes this strategy difficult in many places. But in some states, testing on either end of travel is possible. Public health officials may worry that testing should be presented only as a last resort, out of fear that it will encourage people to travel and let their guard down. But the fact is, their guard is already down.

As with so many other health behaviors, we cannot expect solutions based solely on individual behavior change. Pandemic fatigue is real, and we need to find more realistic solutions.

But he suggested that a statewide mask mandate would not help halt the surge, adding that it is nearly impossible to participate in the Arizona economy without wearing a mask due to various local restrictions.

She said cases were increasing in many states with mandates, adding that communities were free to establish local regulations. 

The U.S. has reported more than 11.5 million cases and more than 250,000 deaths, according to Johns Hopkins University data. The global totals: 56.4 million cases and 1.35 million deaths.

As state officials and lawmakers urged the shutdown of a Tyson Foods pork processing plant in Iowa, managers at the plant reportedly placed bets on how many would end up getting sick.

As COVID-19 cases pile up at a staggering rate, Republicans and Democrats remain in stark disagreement over the threat of the virus and the steps necessary to mitigate its spread.

That has surprised political scientists and public health experts who thought that, if the pandemic worsened, the partisan gap would begin to close

European officials announced a modest gain in the continent's battle against the virus.

Still, an average of 4500 lives are lost to COVID-19 in Europe every day, Kluge said.

He described further lockdowns as a last resort and said that if mask use reached 95%, lockdowns would not be needed.

Almost 100,000 long-term care U.S. residents have died in the coronavirus pandemic, and advocates for the elderly say tens of thousands more are succumbing to neglect by overwhelmed staffs and slow declines from isolation imposed as protection from COVID.

The U.S. has become the first country to have 250,000 people die from COVID-19, nearly 19% of the global total of 1.35 million fatalities.

That means we can begin inoculating health care and other essential workers even before we’re done with the Thanksgiving leftovers,

The vaccine being developed Oxford researchers and U.K.-based AstraZeneca appears to trigger a "robust immune response" in healthy adults, including those aged 56 and older, the university said in a release.

Although the COVID-19 outbreak is looking worse than ever, news from vaccine makers is fueling optimism

The death toll the virus has inflicted among Americans is more than twice as large as the number of U.S. service members who died in World War I.

Colleges are scrambling to prevent a massive spread, with some urging or requiring students to quarantine or receive a negative coronavirus test before traveling home. Without those precautions, college leaders say, students should consider abstaining from their holiday plans and instead opt for a celebration closer to campus.

Boston University's recommendation is that students either stay in Boston for the holiday or go home and not come back. Kenneth Elmore, dean of students, says the school is urging students to think of the greater good. 

As Arizona's COVID-19 trends spike, the state is giving hospitals $25 million to bolster staffing, but Gov. Doug Ducey said Wednesday that he won't impose a statewide mask mandate.

Ducey suggested that a statewide mask mandate would not effectively curb the spread of the virus, and emphasized that about 90% of the state is under a local mask mandate. He also said it is nearly impossible to participate in the Arizona economy without wearing a mask.

More than 90,000 students in the state's largest school district will return to virtual learning starting Nov. 30 through the end of the semester.

The district reported about 13 cases per week when it first opened early childhood education centers. Cases have now surpassed 300 per week.

There are some reasons for this. The U.S. Centers for Disease Control and Prevention, acknowledging the nation's pandemic-related rodent problem, points out restaurants have reduced service, which means fewer food scraps are ending up in the dumpsters on which rats and mice often feed.

Dr. Anthony Fauci is urging Americans to "think twice" about traveling and having indoor gatherings for the holidays.

"As we get into the colder weather, we should really think twice about these kind of dinner parties where you're not sure of whether the people that are in your bubble (are safe)," he said. "Then you're going to start seeing these unanticipated infections related to innocent home gatherings, particularly as we head into the holiday season."