U.S. loses one life every 33 seconds to COVID-19 in deadliest week so far

(Reuters) – In the United States last week, someone died from COVID-19 every 33 seconds.

The disease claimed more than 18,000 lives in the seven days ended Dec. 20, up 6.7% from the prior week to hit another record high, according to a Reuters analysis of state and county reports.

Despite pleas by health officials not to travel during the end-year holiday season, 3.2 million people were screened at U.S. airports on Friday, Saturday and Sunday.

Health officials are worried that a surge in infections from holiday gatherings could overwhelm hospitals, some of which are already at capacity after Thanksgiving celebrations.

And while the country has begun to administer two new vaccines, it may be months before the inoculations put a dent in the coronavirus outbreak.

The number of new COVID-19 cases last week fell 1% to nearly 1.5 million. Tennessee, California and Rhode Island had the highest per capita new cases in the country, according to the Reuters analysis. In terms of deaths per capita, Iowa, South Dakota and Rhode Island were the hardest hit.

Across the United States, 11.3% of tests came back positive for the virus, down from 12% the prior week, according to data from the volunteer-run COVID Tracking Project. Out of 50 states, 31 had a positive test rate of 10% or higher. The highest rates were in Iowa and Idaho at over 40%.

The World Health Organization considers positive test rates above 5% concerning because it suggests there are more cases in the community that have not yet been uncovered.

(Graphic by Chris Canipe, writing by Lisa Shumaker, editing by Tiffany Wu)

U.S. COVID-19 cases cross 11 million as pandemic intensifies

By Roshan Abraham and Seerat Gupta

(Reuters) – The number of coronavirus cases in the United States crossed the 11-million mark on Sunday reaching yet another grim milestone, according to a Reuters tally, as the third wave of COVID-19 infections surged across the country.

Reuters data shows the pace of the pandemic in the United States has quickened, with one million more new cases from just 8 days ago when it hit 10 million, making it the fastest since the pandemic began. This compares with 10 days it took to get from 9 to 10 million and 16 days it took to reach 9 million from 8 million cases.

The United States, hardest-hit by the coronavirus, crossed 10 million COVID-19 cases on November 8 and is reporting over 100,000 daily cases for the past 11 days straight.

The latest 7-day average, shows the United States is reporting more than 144,000 daily cases and 1,120 daily deaths, the highest for any country in the world.

Texas and California have reported the highest number of COVID-19 infections across the United States, together accounting for about 2.1 million cases or about 19% of the total cases since the pandemic began, according to Reuters analysis.

As COVID-19 related hospitalizations continue to rise, crossing 69,000 on Saturday, U.S. President-elect Joe Biden’s top advisers have stressed the need to control the pandemic, warning that local healthcare systems are at a tipping point.

The Midwest remains the hardest-hit region based on the most cases per capita with North Dakota, South Dakota, Wisconsin, Iowa and Nebraska the top five worst-affected U.S. states.

Illinois, which has emerged as the pandemic’s new epicenter in the region as well as across the country, reported a record 15,433 new cases on Friday, the most of any state in a 24-hour period, surpassing the previous all-time high of 15,300 set by Florida in July.

Several states this week re-imposed restrictions to curb the spread of the virus across the nation. North Dakota became the latest state to require that face coverings be worn in public, as it joins 39 other states this month in reporting record daily jumps in new cases.

State governors urged residents to stay home as much as possible, including Nevada Democrat Steve Sisolak, who said late on Friday that he became the fourth governor to become infected with the virus.

The United States accounts for about 20% of more than 54 million global cases and close to 19% of the 1.31 million deaths reported worldwide, according to a Reuters tally.

(Reporting by Roshan Abraham and Seerat Gupta in Bengaluru; editing by Diane Craft)

Chicagoans told to stay home, Detroit moves school online as COVID-19 cases surge

By Brendan O’Brien and Maria Caspani

CHICAGO (Reuters) – Chicago issued a stay-at-home advisory and Detroit stopped in-person schooling on Thursday to staunch the coronavirus outbreak as more than a dozen states reported a doubling of new COVID-19 cases in the last two weeks.

Officials in the Midwestern cities along with New York, California, Iowa and other states were re-imposing this week restrictions that had been eased in recent months. The moves were driven by surging infection rates and concern that the onset of winter, when people are more likely to gather indoors, will worsen the trends.

Chicago Mayor Lori Lightfoot on Thursday issued a 30-day advisory calling upon residents to stay at home and have no visitors, even during Thanksgiving festivities. The third- largest city in the United States could see 1,000 more COVID-19 deaths by the end of 2020 if residents do not change behaviors to stop the spread of the virus, Lightfoot said.

Lightfoot set a 10-person limit on gatherings, including indoor and outdoor events, and said travelers from out of the state needed to quarantine for 14 days or submit a negative coronavirus test.

“None of us can keep maintaining the status quo in the face of this very stark reality,” the mayor told reporters, noting the average number of cases have gone from 500 to 1,900 per day over the last month and the city’s positivity rate shot up to 15% from 5%.

Illinois has emerged as the pandemic’s new epicenter in the region as well as across the country. In the past two weeks, the state reported about 130,000 cases, the highest in the country and more than hard-hit Texas and California.

A Reuters tally showed coronavirus cases more than doubling in 13 states in the past two weeks.

In Michigan, the Detroit public school system – the state’s largest – said on Thursday it would suspend of in-person education until Jan. 11, with the infection rate in the city rising rapidly. The district will hold all classes online starting Monday.

New York City Mayor Bill de Blasio said on Thursday that the country’s largest school system was preparing for a possible shutdown but closure might still be averted.

“We’re not there yet, and let’s pray we don’t get there,” de Blasio told reporters. De Blasio has said schools will close if the percentage of city residents testing positive, now at a seven-day average of 2.6%, surpasses 3%.

Total COVID-19 cases across the United States hit an all-time daily high for a second day in a row on Wednesday at 142,279 and crossed the 100,000 mark for an eighth consecutive day, Reuters data showed.

The number of people hospitalized with the virus surged to at least 64,939 by late Wednesday, the highest ever for a single day during the pandemic, increasing by more than 41% in the past two weeks. The death toll rose by 1,464 to a total of 241,809.

Vaccine developers have offered some good news this week, with Pfizer and BioNTech trumpeting successful early data from a large-scale clinical trial of a coronavirus vaccine.

Health experts are hopeful that a vaccine might become available in the coming months for the most vulnerable populations and for healthcare providers.

But with a more lengthy timeline for the general public, many are urging strict adherence to well-known virus mitigation measures like wearing a face covering, washing hands and maintaining a safe social distance.

“We hope that by the time you get into the second quarter, end of April, early May, May-June – somewhere around that time, the ordinary citizen should be able to get it,” Dr. Anthony Fauci, a top U.S. health official, told the ABC “Good Morning America” program on Thursday.

“What we need to do is what we’ve been talking about for some time now but really doubling down on it.”

(Reporting by Maria Caspani in New York and Anurag Maan in Bengaluru and Brendan O’Brien in Chicago, additional reporting by Peter Szekely in New York and Doina Chiacu in Washington; Editing by Howard Goller and Cynthia Osterman)

New U.S. COVID-19 cases up 34% last week, set fresh records

By Michael Erman and Julie Steenhuysen

(Reuters) – Pfizer Inc’s experimental COVID-19 vaccine is more than 90% effective based on initial trial results, the drugmaker said on Monday, a major victory in the war against a virus that has killed over a million people and battered the world’s economy.

Experts welcomed the first successful interim data from a large-scale clinical test as a watershed moment that showed vaccines could help halt the pandemic, although mass roll-outs, which needs regulatory approval, will not happen this year.

Pfizer and German partner BioNTech SE said they had found no serious safety concerns yet and expected to seek U.S. authorization this month for emergency use of the vaccine, raising the chance of a regulatory decision as soon as December.

If granted, the companies estimate they can roll out up to 50 million doses this year, enough to protect 25 million people, and then produce up to 1.3 billion doses in 2021.

“Today is a great day for science and humanity,” said Pfizer Chief Executive Albert Bourla.

“We are reaching this critical milestone in our vaccine development program at a time when the world needs it most with infection rates setting new records, hospitals nearing over-capacity and economies struggling to reopen,” he said.

Experts said they still wanted to see the full trial data, which have yet to be peer-reviewed or published in a medical journal, but the preliminary results looked encouraging.

“This news made me smile from ear to ear. It is a relief to see such positive results on this vaccine and bodes well for COVID-19 vaccines in general,” said Peter Horby, professor of emerging infectious diseases at the University of Oxford.

There are still many questions, such as how effective the vaccine is by ethnicity or age, and how long it will provide immunity, with the “new normal” of social distancing and face covering set to remain for the foreseeable future.

Pfizer expects to seek U.S. emergency use authorization for people aged 16 to 85. To do so, it will need two months of safety data from about half the study’s 44,000 participants, which is expected in the third week of November.

U.S. Health and Human Services Secretary Alex Azar said it would take several weeks for U.S. regulators to receive and process data on the vaccine before the government could potentially approve it.

MARKETS SURGE

The prospect of a vaccine electrified world markets with the S&P 500 and Dow hitting record highs as shares of banks, oil companies and travel companies soared. Shares in companies that have thrived during lockdowns, such as conferencing platform Zoom Video and online retailers, tumbled.

Pfizer shares jumped more than 11% to their highest since July last year, while BioNTech’s stock hit a record high.

Shares of other vaccine developers in the final stage of testing also rose with Johnson & Johnson up 4% and Moderna Inc, whose vaccine uses a similar technology as the Pfizer shot, up 8%. Britain’s AstraZeneca, however, fell 2%. Moderna is expected to report results from its large-scale trial later this month.

“The efficacy data are really impressive. This is better than most of us anticipated,” said William Schaffner, infectious diseases expert at Vanderbilt University School of Medicine in Nashville, Tennessee. “The study isn’t completed yet, but nonetheless the data look very solid.”

U.S. President Donald Trump welcomed the test results, and the market boost: “STOCK MARKET UP BIG, VACCINE COMING SOON. REPORT 90% EFFECTIVE. SUCH GREAT NEWS!” he tweeted.

President-elect Joe Biden said the news was excellent but did not change the fact that face masks, social distancing and other health measures would be needed well into next year.

The World Health Organization said the results were very positive, but warned there was a funding gap of $4.5 billion that could slow access to tests, medicines and vaccines in low- and middle-income countries.

‘NEAR ECSTATIC’

“I’m near ecstatic,” Bill Gruber, one of Pfizer’s top vaccine scientists, said in an interview. “This is a great day for public health and for the potential to get us all out of the circumstances we’re now in.”

Between 55% and 65% of the population will need to be vaccinated to break the dynamic of the spread of COVID-19, said Germany’s health minister Jens Spahn, adding that he did not expect a shot to be available before the first quarter of 2021.

The European Union said on Monday it would soon sign a contract for up to 300 million doses of the Pfizer and BioNTech COVID-19 vaccine.

The companies have a $1.95 billion contract with the U.S. government to deliver 100 million vaccine doses beginning this year. They did not receive research funding from the Trump administration’s Operation Warp Speed vaccine program.

The drugmakers have also reached supply agreements with the United Kingdom, Canada and Japan.

Pfizer said the interim analysis, conducted after 94 participants in the trial developed COVID-19, examined how many had received the vaccine versus a placebo.

Pfizer did not break down how many of those who fell ill received the vaccine. Still, over 90% effectiveness implies that no more than 8 of the 94 had been given the vaccine, which was administered in two shots about three weeks apart.

The efficacy rate, which could drop once full results are available, is well above the 50% effectiveness required by the U.S. Food and Drug Administration for a coronavirus vaccine.

Shortly after Pfizer’s announcement, Russia said its Sputnik V vaccine was also more than 90% effective, based on data collated from inoculations of the public. Its preliminary Phase III trial data is due to be published this month.

MORE DATA NEEDED

To confirm the efficacy rate, Pfizer said it would continue its trial until there were 164 COVID-19 cases among volunteers. Bourla told CNBC on Monday that based on rising infection rates, the trial could be completed before the end of November.

Pfizer said its data would be peer reviewed once it has results from the entire trial.

“These are interesting first signals, but again they are only communicated in press releases,” said Marylyn Addo, head of tropical medicine at the University Medical Center Hamburg-Eppendorf in Germany.

Dozens of drugmakers and research groups around the globe have been racing to develop vaccines against COVID-19, which on Sunday exceeded 50 million cases since the new coronavirus first emerged late last year in China.

The Pfizer and BioNTech vaccine uses messenger RNA (mRNA) technology, which relies on synthetic genes that can be generated and manufactured in weeks, and produced at scale more rapidly than conventional vaccines. The technology is designed to trigger an immune response without using pathogens, such as actual virus particles.

The Trump administration has said it will have enough vaccine doses for all of the 330 million U.S. residents who want it by the middle of 2021.

(Reporting by Michael Erman and Julie Steenhuysen; Additional reporting by Michele Gershberg in New York, Ludwig Burger and Patricia Weiss in Frankfurt and Kate Kelland in London; Editing by Bill Berkrot, Caroline Humer, Edwina Gibbs and David Clarke)

U.S. crosses 10 million COVID-19 cases as third wave of infections surges

By Anurag Maan and Shaina Ahluwalia

(Reuters) – The United States became the first nation worldwide since the pandemic began to surpass 10 million coronavirus infections, according to a Reuters tally on Sunday, as the third wave of the COVID-19 virus surges across the nation.

The grim milestone came on the same day as global coronavirus cases exceeded 50 million.

The United states has reported about a million cases in the past 10 days, the highest rate of infections since the nation reported its first novel coronavirus case in Washington state 293 days ago.

The country reported a record 131,420 COVID-19 cases on Saturday and has reported over 100,000 infections five times in the past seven days, according to a Reuters tally.

The U.S. latest reported seven-day average of 105,600 daily cases, ramped up by at least 29%, is more than the combined average for India and France, two of the worst affected countries in Asia and Europe.

More than 237,000 Americans have died of COVID-19 since the illness caused by the coronavirus first emerged in China late last year.

The daily average of reported new deaths in the United States account for one in every 11 deaths reported worldwide each day, according to a Reuters analysis.

The number of reported deaths nationwide climbed by more than 1,000 for a fifth consecutive day on Saturday, a trend last seen in mid-August, according to a Reuters tally.

Health experts say deaths tend to increase four to six weeks after a surge in infections.

U.S. President-elect Joe Biden, who spent much of his election campaign criticizing President Donald Trump’s handling of the pandemic, pledged on Saturday to make tackling the pandemic a top priority.

Biden will announce a 12-member task force on Monday to deal with the pandemic that will be led by former surgeon general Vivek Murthy and former Food and Drug Administration commissioner David Kessler. The coronavirus task force will be charged with developing a blueprint for containing the disease once Biden takes office in January.

The Midwest remains the hardest-hit region based on the most cases per capita with North Dakota, South Dakota, Wisconsin, Iowa and Nebraska the top five worst-affected U.S. states.

Illinois emerged as the new epicenter in the Midwest, with the state reporting over 60,000 COVID-19 infections in the last seven days, the highest in the country, according to Reuters data. The state reported more than 12,454 new cases on Saturday, the highest single-day number so far.

Texas, which accounts for 10% of total U.S. cases, is the hardest-hit state and became the first to surpass a million coronavirus cases in the United States on Saturday.

According to a Reuters analysis, the South region comprises nearly 43% of all the cases in the United States since the pandemic began, with nearly 4.3 million cases in the region alone, followed by the Midwest, West and Northeast.

New York, with over 33,000 fatalities, remains the state with highest number of deaths and accounts for about 14% of total U.S. deaths.

The United States performed about 10.5 million coronavirus tests in the first seven days of November, of which 6.22% came back positive, compared with 6.17% the prior seven-days, according to data from The COVID Tracking Project, a volunteer-run effort to track the outbreak.

(Reporting by Anurag Maan and Shaina Ahluwalia in Bengaluru; Editing by Diane Craft and Michael Perry)

New U.S. COVID-19 cases rise 11% last week, Midwest hard hit

(Reuters) – The number of new COVID-19 cases rose 11% in the United States last week compared to the previous seven days, with infections spreading rapidly in the Midwest, which reported some of the highest positive test rates, according to a Reuters analysis.

Deaths fell 3% to about 4,800 people for the week ended Oct. 11, according to the analysis of state and county reports. Since the pandemic started, nearly 215,000 people have died in the United States and over 7.7 million have become infected with the novel coronavirus.

Twenty-nine out of 50 states have seen cases rise for at least two weeks in a row, up from 21 states in the prior week. They include the entire Midwest except Illinois and Missouri, as well as new hot spots in the Northeast, South and West.

In Idaho, 23.5% of more than 17,000 tests came back positive for COVID-19 last week, the highest positive test rate in the country, according to data from The COVID Tracking Project, a volunteer-run effort to track the outbreak. South Dakota, Iowa and Wisconsin also reported positive test rates above 20% last week.

For a third week in a row, testing set a record high in the country, with on average 976,000 tests conducted each day last week. The percentage of tests that came back positive for the virus rose to 5.0% from 4.6% the prior week.

The World Health Organization considers rates above 5% concerning because it suggests there are more cases in the community that have not yet been uncovered.

(Writing by Lisa Shumaker; Graphic by Chris Canipe; Editing by Tiffany Wu)

New U.S. COVID-19 cases rise 17% in past week, deaths up 5%

(Reuters) – The weekly number of new COVID-19 cases in the United States rose last week for the first time after falling for eight straight weeks, an increase that health experts attributed to schools reopening and parties over the Labor Day holiday.

New cases rose 17% to about 287,000 for the week ended Sept. 20, while deaths rose 5.5% to about 5,400 people after falling for the previous four weeks, according to a Reuters analysis of state and county reports.

Thirteen states have seen weekly infections rise for at least two weeks, up from nine states the previous week, according to the Reuters tally. In Arizona, new cases doubled last week.

On average, more than 776 people a day died from COVID-19 last week, with deaths rising in Arkansas, Kansas and Virginia.

After weeks of declining test rates, an average of 812,000 people a day were tested last week. The country set a record of testing over 1 million people on Saturday.

Nationally, the share of all tests that came back positive for COVID-19 fell for a seventh week to 5.0%, well below a recent peak of nearly 9% in mid-July, according to data from The COVID Tracking Project, a volunteer-run effort to track the outbreak.

However, 26 of the 50 states still have positive test rates above the 5% level that the World Health Organization considers concerning. The highest positive test rates are in the Midwest at over 16% in Idaho, Wisconsin, Iowa and South Dakota.

(Writing by Lisa Shumaker; Graphic by Chris Canipe; Editing by Tiffany Wu)

U.S. COVID-19 deaths surpass 190,000; Iowa and South Dakota emerge as new hotspots

By Anurag Maan

(Reuters) – Coronavirus deaths in the United States topped 190,000 on Wednesday along with a spike in new cases in the U.S. Midwest with states like Iowa and South Dakota emerging as the new hotspots in the past few weeks.

Iowa currently has one of the highest rates of infection in the nation, with 15% of tests last week coming back positive. Nearby South Dakota has a positive test rate of 19% and North Dakota is at 18%, according to a Reuters analysis.

The surge in Iowa and South Dakota is being linked to colleges reopening in Iowa and an annual motorcycle rally last month in Sturgis, South Dakota.

Kansas, Idaho and Missouri are also among the top 10 states for positive test rates.

New coronavirus infections have fallen for seven weeks in a row for the United States with a death rate of about 6,100 per week from COVID-19 in the last month.

On a per capita basis, the United States ranks 12th in the world for the number of deaths, with 58 deaths per 100,000 people, and 11th in the world for cases, with 1,933 cases per 100,000 residents, according to a Reuters analysis.

U.S. confirmed cases are highest in the world with now over 6.3 million followed by India with 4.4 million cases and Brazil with 4.2 million. The U.S. death toll is also the highest in the world.

The U.S. Centers for Disease Control and Prevention had forecast last month that the U.S. death toll will reach 200,000 to 211,000 by Sept. 26.

The University of Washington’s health institute last week forecasted that the U.S. deaths from the coronavirus will reach 410,000 by the end of the year.

(Reporting by Anurag Maan in Bengaluru; Editing by Lisa Shumaker)

U.S. disasters cause insurance double whammy for pandemic-hit businesses

By Suzanne Barlyn and Alwyn Scott

(Reuters) – As insurers brace for an expensive natural-disaster season because of storms and wildfires ravaging parts of the United States, the novel coronavirus is giving them an odd financial break.

Many companies that were damaged or evacuated because of natural catastrophes were already generating far less revenue due to the pandemic. That means they will get lower payouts upon filing business-interruption claims, according to analysts, lawyers and industry sources.

It is another hit for small businesses that rebuilt after major disasters in recent years, only to see revenue screech to a halt during the pandemic, and then enter another aggressive disaster season. It could leave some companies unable to survive, said John Ellison, an attorney at Reed Smith LLP who has represented policyholders in cases stemming from hurricanes Katrina, Rita and Sandy.

“There is a reasonable chance that any business in that situation is not going to make it,” he said.

Claims are never simple to file or process, with insurers, lawyers and accountants quibbling over calculations. They rarely cover all losses.

The past several months have been particularly tough for policyholders in states like California, Iowa and Louisiana. They were already battling insurers in court over pandemic claims and then suffered damage from Hurricane Laura, wildfires and a destructive, fast-moving storm that devastated parts of the Midwest.

Most disaster claims are for property damage, but a “significant” amount still comes from business interruption, based on the way insurers have attributed losses after major disasters, said Piper Sandler analyst Paul Newsome.

Insurers do not disclose how much of their total disaster losses are for business interruption.

The amount of payouts for disasters during the pandemic depend on the business, said Loretta Worters, a spokeswoman for the industry-funded Insurance Information Institute. A liquor store whose business is booming might have higher revenues than six months ago, she said.

Many insurers make a 12-month income projection when calculating the claim, Worters said.

Business-interruption policies cover losses based on recent income trends, so payouts will almost certainly be lower for companies whose operations suffered because of the pandemic, said Credit Suisse analyst Mike Zaremski. Government-imposed lockdowns, supply-chain disruptions and weaker customer demand have hurt many businesses.

That is the situation in Guerneville, California, a wine region where many businesses had to evacuate because of wildfires after already being hurt by the pandemic.

For instance, Big Bottom Market, a gourmet deli there, had to close from March to May. When it re-opened, business was initially off by 40% compared with the prior year, said owner Michael Volpatt. Introducing new services like catering stemmed the tide, but July revenue was still down 9%, Volpatt said.

An Aug. 18 mandatory wildfire evacuation forced Big Bottom Market to close for 12 days. The store escaped property damage but lost over $20,000 in revenue, said Volpatt, who is preparing an insurance claim.

Business interruption was already a sore point between insurers and customers, who are battling in court about whether policies cover pandemics. Only a few of nearly 1,000 lawsuits that are pending have produced rulings, with mixed results.

Hair-salon owner Berlin Fisher is a plaintiff in one such case filed in July. A Hiscox Ltd unit denied business interruption claims for Fisher’s two California salons, whose revenue was wiped out by a measure barring indoor haircuts, he said. Fisher’s San Francisco salon went under as the pandemic dragged on.

A Hiscox spokesman declined comment.

In June, Fisher began cutting hair under a tent in Guerneville to make ends meet. He evacuated four weeks later because of the fires and filed another claim, which is pending.

Fisher pays about $100 monthly for the policy, but said it may not be worth the expense.

“There’s a huge discrepancy between what people who sold the insurance told me then and what actually happens,” he said.

(Reporting by Suzanne Barlyn and Alwyn Scott; Editing by Lauren Tara LaCapra and Dan Grebler)

U.S. coronavirus cases top six million as Midwest, schools face outbreaks

By Lisa Shumaker

(Reuters) – U.S. cases of the novel coronavirus surpassed six million on Sunday as many states in the Midwest reported increasing infections, according to a Reuters tally.

Iowa, North Dakota, South Dakota and Minnesota have recently reported record one-day increases in new cases while Montana and Idaho are seeing record numbers of currently hospitalized COVID-19 patients.

Nationally, metrics on new cases, deaths, hospitalizations and the positivity rates of tests are all declining, but there are emerging hotspots in the Midwest.

Many of the new cases in Iowa are in the counties that are home to the University of Iowa and Iowa State University, which are holding some in-person classes. Colleges and universities around the country have seen outbreaks after students returned to campus, forcing some to switch to online-only learning.

New York Governor Andrew Cuomo on Sunday said his state was sending a “SWAT team” to a State University of New York (SUNY) campus in Oneonta in upstate New York to contain a COVID-19 outbreak. Fall classes, which started last week at the college, were suspended for two weeks after more than 100 people tested positive for the virus, about 3% of the total student and faculty population, SUNY Chancellor Jim Malatras said.

“We have had reports of several large parties of our students at Oneonta last week, and unfortunately because of those larger gatherings, there were several students who were symptomatic of COVID,” Malatras said.

Across the Midwest, infections have also risen after an annual motorcycle rally in Sturgis, South Dakota drew more than 365,000 people from across the country from Aug. 7 to 16. The South Dakota health department said 88 cases have been traced to the rally.

More than eight months into the pandemic, the United States continues to struggle with testing. The number of people tested has fallen in recent weeks.

Many health officials and at least 33 states have rejected the new COVID-19 testing guidance issued by the Trump administration last week that said those exposed to the virus and without symptoms may not need testing.

Public health officials believe the United States needs to test more frequently to find asymptomatic COVID-19 carriers to slow the spread of the disease.

While the United States has the most recorded infections in the world, it ranks tenth based on cases per capita, with Brazil, Peru and Chile having higher rates of infection, according to a Reuters tally.

The United States also has the most deaths in the world at nearly 183,000 and ranks 11th for deaths per capita, exceeded by Sweden, Brazil, Italy, Chile, Spain, the United Kingdom, Belgium and Peru.

(Reporting by Lisa Shumaker in Chicago and Maria Caspani in New York; Editing by Daniel Wallis and Paul Simao)