NEW YORK (BLOOMBERG) - Covid-19 is spreading again across most of the US, hammering rural America and smaller cities and raising anxiety in New York, as experts warn that school reopenings and colder weather may cause the situation to rapidly deteriorate.
In 34 states, the seven-day average of new cases is higher now than it was a month ago.
Although the virus has waned in populous states including California and Florida, it is wreaking unprecedented havoc in the Midwest and making an incipient return in parts of the Northeast.
"The weather report is darkly cloudy with further storms on the horizon," said infectious disease professor William Schaffner of Vanderbilt University in Nashville, Tennessee.
Medical professionals have long warned about a resurgence of the novel coronavirus as colder temperatures in North America drive people inside and many jurisdictions reopen schools.
Knowing that, scientists have been racing to prepare a vaccine. But even if it is approved, it's unlikely to reach most of the public for many months.
Meanwhile, most attention has turned to President Donald Trump, who returned to the White House on Monday evening (Oct 5) after being treated at Walter Reed National Military Medical Centre for the disease that has killed about 210,000 Americans so far.
Prof Schaffner said the lack of adequate social distancing and masking in rural areas may combine with the coming cold weather and influenza, possibly resulting in a "twindemic" that further strains the healthcare system.
In Nebraska, the seven-day average of cases hit a record on Saturday, joining Midwestern and Western states including Wisconsin, Montana and the Dakotas in confronting a virus that had eluded them until recently.
In New York City, schools in virus hot spots will close down on Tuesday.
Across the country, there were 41,075 new cases reported on Sunday, bringing the total to 7,420,921, according to Johns Hopkins University.
"We're in very bad shape, never having achieved any sense of containment, never gotten below 20,000 new confirmed cases per day," said Dr Eric Topol, director of Scripps Research Translational Institute. "Things can only get worse on this course."
Similar concerns are emerging in Canada. The country has reported 1,861 new daily cases on average over the past seven days, compared with 456 cases during the first week of September.
The province of Quebec, which shut down restaurant dining rooms and other indoor venues last week, has seen a 46 per cent rise in hospitalisations since Sept 28.
Elsewhere in the US: Kentucky posted record cases on Saturday, while in Arkansas, current Covid-19 hospitalisations reached 499 on Sunday, the most since early August. Separately, Texas Governor Greg Abbott plans to announce additional relaxation of anti-virus rules just weeks after he first began easing restrictions.