Coronavirus outbreaks in the United States were once traced back to their origins, whether at busy restaurants or crowded meatpacking plants. But now that the virus is spreading rapidly in much of the country — more than 2,200 U.S. deaths from Covid-19 were reported on Tuesday alone, making it the deadliest day in more than six months — state and local health officials are giving up on contact tracing.
Revealing the trail of transmission from one person to another is a key tool for containing the spread of the coronavirus. Within 48 hours of testing positive, patients receive a phone call from a trained contact tracer, who conducts a detailed interview before hunting down each new person who may have been exposed.
That, at least, is how it’s supposed to work.
Now, with the United States recording a staggering two million new cases in less two weeks and 42 states recording sustained caseload increases, overwhelmed public health agencies are making hard choices about how much they can still realistically learn, while acknowledging that contact tracing can no longer be expected to contain the virus’s spread.
On Monday, the Centers for Disease Control and Prevention released new guidance that called on health departments to focus contact tracing efforts on people who had tested positive within the past six days and especially those who were at the greatest risk of infecting others. Patients infected more than 14 days ago should not be traced.
States like Pennsylvania, which had already been revising its tracing protocols, have announced that they will follow the C.D.C.’s new guidance.
Dr. Nirav Shah, who heads Maine’s coronavirus response, explained how his state would scale back its ambitions: Contact tracers would touch base with each new patient only once, and not through the course of their illness, to make sure they were well and quarantining.
“Unfortunately, going forward, we have had to make a difficult decision, and I wanted you to hear about that difficult decision from me,” he said when announcing the change.
“Sadly, in Maine and throughout the country, the virus is moving faster and spreading faster than the ability of states to train and deploy new public health investigators.”
Similar decisions were being made all over the country.
New Hampshire last week said that it would only trace cases of people connected to outbreaks or in specific at-risk age or racial groups.
Minnesota’s Itasca County this month said that it was abandoning contact tracing, advising the public that, “if you are in a group setting, just assume that someone has Covid.”
In North Dakota, state officials said last month that they could no longer have one-on-one conversations with everyone who may have been exposed. Aside from situations involving schools and health care facilities, people who test positive were advised to notify their own contacts, leaving residents largely on their own to follow the trail of the outbreak.
Public health experts remain hopeful that contact tracing remains useful in identifying clusters and determining the broad contours of how and where infections are spreading.
“There are diminishing returns when the outbreak is out of control, like it is currently, but the returns aren’t zero,” said Dr. Thomas Tsai, a health policy researcher at Harvard T.H. Chan School of Public Health. “The discourse around our treatments tends to be all or nothing.”
Contact tracing capacity in the United States has been weak since the pandemic began, so it is no surprise that it can’t keep up now, said Rich DiPentima, New Hampshire’s former chief of communicable disease and epidemiology. He argued that it should be expanded rather than scaled back, though he placed more faith in the promise of vaccines.
“We have a situation where we missed the boat in the beginning,” he said. “Then you throw up your hands, saying you can’t do this anymore.”
Americans have agonized over Thanksgiving this year, weighing skyrocketing coronavirus numbers and blunt warnings from the Centers for Disease Control and Prevention against gathering with family for a traditional, carbohydrate-laden ritual.
The United States reported more than 2,200 virus-related deaths on Tuesday alone, the highest daily total since May 6. The country’s seven-day average for new cases has also exceeded 175,000 for the first time.
Around 27 percent of Americans plan to dine with people outside their household, according to interviews conducted by the global data-and-survey firm Dynata at the request of The New York Times.
Views on whether to risk Thanksgiving gatherings appear to track closely with political views, with respondents identifying as Democrats far less likely to be planning a multihousehold holiday.
Megan Baldwin, 42, had planned to drive from New York to Montana to be with her parents, but last week, she canceled her plans.
“I thought I would get tested and take all the precautions to be safe, but how could I risk giving it to my parents, who are in their 70s?” she said, adding that they were not happy with the decision.
“All they want is to see their grandkids,” she said, “but I couldn’t forgive myself if we got them sick. It’s not worth it.”
Others decided to take the plunge, concluding that the emotional boost of being together outweighed the risk of becoming infected, after a grim and worrying year.
“We all agreed that we need this — we need to be together during this crazy, lonely time, and we are just going to be careful and hope that we will all be OK,” said Martha Dillon, who will converge with relatives from four different states on her childhood home in Kentucky.
The AAA has forecast a 10 percent overall decline in Thanksgiving travel compared with last year, the largest year-on-year drop since the recession of 2008. But the change is far smaller, around 4.3 percent, for those traveling by car, who make up a huge majority of those who plan to travel — roughly 47.8 million people.
About 917,000 people were screened by the Transportation Security Administration on Monday, less than half of the number seen on the same day in 2019, according to federal data published on Tuesday.
Airlines are struggling from a dramatic decline in demand that has forced them to drop flights and make big capacity cuts, said Katherine Estep, a spokeswoman for Airlines for America, an industry trade group. “Currently, cancellations are spiking, and carriers are burning $180 million in cash every day just to stay operating,” she said. “The economic impact on U.S. airlines, their employees, travelers and the shipping public is staggering.”
Demand for travel by train is down more sharply, at about 20 percent of what it was last year, said Jason Abrams, a spokesman for Amtrak.
Susan Katz, 73, said she canceled plans to spend Thanksgiving with her daughter last Friday, after watching a monologue by Rachel Maddow, the MSNBC host, describing her partner’s bout of coronavirus and her fear that it would prove fatal.
“Her emotion, Rachel Maddow’s emotion, made it so real, it just moved us,” Ms. Katz said. “I probably called her within a few hours of seeing that.”
Ms. Katz, who lives in Raleigh, N.C., said she would spend the holiday alone with her husband. She is trying to decide whether to bother thawing a turkey breast.
Warnings from experts swayed Laura Bult, 33, to cancel her Sunday flight to St. Louis two days before she was scheduled to leave.
“Doing the small part of being one less person circulating through an airport felt important enough to me,” she said.
A Chinese state-owned vaccine maker has filed an application with the country’s Food and Drug Administration to market coronavirus vaccines before the completion of late-stage trials that will determine their safety and efficacy.
Vaccines made by CNBG, a subsidiary of the state-owned pharmaceutical company Sinopharm, is in late-stage trials with more than 50,000 volunteers in 10 countries, including Argentina, Bahrain, Egypt, Jordan, Morocco, Peru and the United Arab Emirates.
The announcement was made by Sinopharm’s deputy general manager, Shi Shengyi, the state-run Xinhua news agency reported on Wednesday. The article, by the agency’s finance arm, gave no further details and did not specify whether the application was for one or both of the coronavirus vaccines that CNBG manufactures. The company did not respond to requests for comment.
The Chinese government has approved three coronavirus vaccines for emergency use, including two made by CNBG.
Even before the completion of the late-stage trials, Chinese officials had considered those vaccines and one by a rival firm so effective that they allowed tens of thousands of people to be injected. That prompted criticism from scientists that the government was ignoring the risks posed to public health.
Last week, Sinopharm’s chairman, Liu Jingzhen, said the company had injected nearly a million people and that none had reported adverse reactions, with “only a few having some mild symptoms.”
Mr. Liu said those people included construction workers, diplomats and students who took the vaccines before traveling to more than 150 countries. None were infected during their trips, he added.
Many scientists have said that such data is anecdotal and should not be used as evidence that the Sinopharm vaccines are effective.
A Malaysian company that makes disposable gloves used around the world for protection against the coronavirus has been hit by a major outbreak among its workers, many of them foreign laborers who live in overcrowded dormitories.
The outbreak at 28 factories operated by the company, Top Glove Corporation, has infected more than 2,400 workers this month and driven one of Malaysia’s biggest spikes in coronavirus cases since the pandemic began.
Until now, Malaysia has been relatively successful in containing the virus, reporting 58,847 total cases and 341 deaths as of Wednesday, according to a New York Times database. But the country of 32.5 million people reported a new daily high of 2,188 cases on Tuesday, topping the previous record of 1,884 set a day earlier.
Top Glove announced on Monday that it had temporarily closed 16 factories and significantly reduced production at the other 12 in the hope of stemming the outbreak without shutting down production.
The company makes disposable gloves and face masks, and has ramped up production because of the pandemic. The United States and Europe are among its biggest customers.
Most of Top Glove’s workers come from developing countries in Asia — including Bangladesh, Myanmar and Nepal — and live and work in crowded conditions where the virus can easily spread. Malaysia’s minister of human resources, M. Saravanan, toured workers’ quarters after the outbreak was reported and said the living conditions were “terrible.”
“We have started investigations and will spare no one if they were found to have flouted labor laws,” he told The Star, a Malaysian newspaper.
Andy Hall, a labor activist who has long criticized Top Glove, said its workers live in unsanitary and overcrowded dormitories, sometimes packed more than 30 to a room.
“It was obvious it would happen,” Mr. Hall said. “This company has never focused on the welfare of its staff.”
Top Glove did not immediately respond to a request for comment. The United States sanctioned the company in July, citing evidence that it had engaged in forced labor practices, and banned the import of some of its products. Top Glove has begun paying restitution to affected workers.
In other news from around the world:
Japan and China, its largest trading partner, have agreed to restart business travel between the countries later this month, the Japanese foreign minister said on Wednesday. Business travelers will be exempt from quarantine if they test negative for the coronavirus and submit an itinerary of their activities. The arrangement does not apply to tourists and follows similar ones that Japan has begun with Singapore, South Korea and Vietnam.
President Emmanuel Macron of France said on Tuesday that the country was past the peak of its second wave and that shops could reopen on Saturday. Bars and restaurants are unlikely to reopen until mid-January, he said.
Bars and restaurants in Pennsylvania have been ordered by the state to stop selling alcohol at 5 p.m. on Wednesday, in an effort to head off uninhibited pre-Thanksgiving gatherings where the virus could spread rapidly.
“It turns out, the biggest day for drinking is the day before Thanksgiving,” Gov. Tom Wolf said at a news conference on Monday. “I don’t like addressing that more than anyone else does, but it’s a fact. And when people get together in that situation, it leads to the exchange of the fluids that leads to the increased infection.”
“We’re going to defeat this virus,” the governor added. “That should be what we’re focused on, not whether we want to get a transitory benefit from going out with friends the day after tomorrow and having some drinks. Let’s forgo that, this one time.”
The regulation, which allows alcohol sales to resume at 8 a.m. on Thanksgiving Day, was immediately slammed by restaurant and bar owners, who said it put further strain on businesses that are already struggling to survive.
Mr. Wolf said he was fully aware of the ill will the decision had engendered. “The virus is what’s doing this — it’s not me, and it’s not the administration, it’s not the government,” he said. “The more we learn about it, the more we know that this is the kind of place that speeds the transmission of the disease.”
Facing the same concerns in neighboring Maryland, Gov. Larry Hogan announced that the state police and local authorities would step up enforcement of pandemic restrictions on bars, restaurants, nightclubs and catering halls starting on Wednesday, including cutting off alcohol sales at 10 p.m. and other measures the governor imposed last week.
In Utah, on the other hand, Gov. Gary Herbert on Monday partly relaxed the state’s restrictions on casual private gatherings this week for the holiday. The governor said that he was not extending an earlier order that banned indoor gatherings of people from more than one household.
Those We’ve Lost
This obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.
Honestie Hodges, who was handcuffed by the police outside her home in Grand Rapids, Mich., when she was 11, a frightening incident that drew outrage and national headlines in 2017, died on Sunday. She was 14.
Her death, at the Helen DeVos Children’s Hospital in Grand Rapids, was caused by Covid-19, her grandmother Alisa Niemeyer wrote in a post on the website GoFundMe.
On Dec. 6, 2017, Honestie and her family were confronted outside their home by police officers with their guns drawn.
The police, who said they had been searching for a 40-year-old woman in connection with a stabbing, briefly handcuffed the 11-year-old, an incident that caused a widespread uproar and led to a soul-searching within the Grand Rapids Police Department.
This year, Honestie developed severe stomach pains on Nov. 9, her 14th birthday. Taken to the hospital, she tested positive for the coronavirus, and she was placed on a ventilator a few days later.
Then, on Sunday, Ms. Niemeyer wrote: “It is with an extremely heavy heart that I have to tell you that my beautiful, sassy, smart, loving granddaughter has gone home to be with Jesus.”
Lynn Sutfin, a spokeswoman for the Michigan Department of Health and Human Services, said Honestie was not the youngest person to die of Covid-19 in Michigan.
The federal Centers for Disease Control and Prevention has said that Covid-19 deaths among children were rare over all, but that Hispanic and Black children were more likely than their white peers to be hospitalized or admitted to an I.C.U.
Ms. Niemeyer told WOOD-TV that Honestie had been “healthy and happy” with no underlying health issues.
“She could have been the vice president one day, or maybe the president,” Ms. Niemeyer said. “The world was open to her.”
Though her mother lives in Arizona, Cecily Smith typically spends Thanksgiving in New York City with friends who feel like family.
Some years, they shared holiday meals at restaurants. Other times, they held potlucks in cramped apartments.
But with the country in the grip of a surging pandemic, Ms. Smith will spend Thanksgiving this year alone in her Harlem apartment, making herself cocktails and binge-watching Netflix. Her friends, she said, plan to do the same.
“I know I’m going to be lonely,” said Ms. Smith, 46, who has lived in the city for about 20 years. “It is lonely. This is a whole lonely experience.”
The pandemic has altered holiday plans all over the United States this year. But in a bustling city where traditions often extend beyond family to bring friends, acquaintances, castoffs and transplants around the table, the loneliness can especially gnaw.
With a second wave bearing down, officials have urged Americans not to travel, Gov. Andrew M. Cuomo limited private gatherings to 10 people for the foreseeable future and Mayor Bill de Blasio implored people to skip the crowded feasts that generally mark the holiday.
The city’s holiday staples will also be missing. The Macy’s Thanksgiving Day Parade has cut its route to one block, and movie theaters, long an antidote for holiday loneliness, remain closed. Restaurants have limited capacity, a rainy forecast does not favor outdoor dining and many people remain uncomfortable eating indoors.
Amid numerous game cancellations and players and coaches alike testing positive for the coronavirus, the men’s college basketball season will start Wednesday with more than 100 games being played nationwide. This burst of games and the travel — some of which will happen on commercial flights — come at a time when universities are urging their non-basketball-playing students to exercise great caution as they head home for Thanksgiving.
Some coaches are wondering how long a season can go on like this.
Rick Pitino, head coach at Iona College, believes that with vaccines being readied and flu season just arriving, the best way to rescue college basketball’s moneymaker — the N.C.A.A. tournament — may be to move the season back. He suggests starting the season in March and ending it with May Madness.
Dedrique Taylor, the coach at Cal State Fullerton, said one of his players test positive last Thursday, prompting his team to quarantine for two weeks. The next day, the University of Washington tournament they had entered was canceled. Mr. Taylor said that in the normal rhythms of a season, coaches want their teams to build toward playing at their best in March, just as the Titans did when they reached the N.C.A.A. tournament in 2018.
Now, though, instability will be baked in — along with many questions. Mr. Taylor wonders about injury risks when players return from quarantine, about whether the country will loosen up or lock down and how he can support his players and assistants.
“I don’t understand why we’re playing or why we’re opening up when we’re trying to do away with the virus,” he said. “We’re almost encouraging the virus by bringing people together.”