The number of Americans in hospital hit a grim new high on Monday as 96,039 people were confirmed to be admitted - an almost 12 per cent increase on the week before.
The total number of coronavirus cases in the United States for November surpassed four million on Saturday - more than double the 1.9 million record for October.
The U.S. now has 13.5 million confirmed cases, and 268,000 deaths.
On Monday Scott Atlas, Donald Trump's favorite member of the White House coronavirus task force - who angered many with his skepticism over lockdowns and face masks - resigned.
A source close to the task force told CNN on Monday that Atlas' departure comes as welcome news, as his discredited theories will no longer have a seat at the table.
Unlike in the spring, when the epicenter was New York and the heartlands were relatively spared, now the pandemic is nationwide. Cases are rising in 41 states: North and South Dakota, Minnesota, Wyoming and Nebraska were among the hardest-hit.
And public health experts are warning that Americans who ignored advice and traveled over Thanksgiving will now make the situation worse: Dr Anthony Fauci described it as 'a surge, superimposed on a surge'.
Hospitals across the United States were at full capacity and sending patients to field clinics
Doctors in Houston, Texas, tend to a patient who has died from the virus
Medical staff members put tags on a deceased person in Houston, Texas
Hospitals in many regions were at breaking point.
In Rhode Island, residents have been informed that their hospitals are full, and COVID patients will be treated at an emergency field hospital.
On Monday morning, the Emergency Alert System was used and Rhode Islanders were sent a message reading: 'RIGOV COVID ALERT: Hospitals at capacity due to COVID. Help the frontline by staying home as much as possible for the next two weeks. Work remotely if you can, avoid social gatherings, get tested. If we all decrease our mobility, we will save lives. Learn more about RI on Pause at reopeningRI.com/pause'.
The Providence Journal reported that two field hospitals began operating on Monday afternoon.
Care New England is in charge of the 353-bed field hospital on Sockanosset Cross Road in Cranston.
The site is for COVID patients who are not critically ill: those with more severe ailments will still be treated at existing hospitals.
A second field hospital, inside the Rhode Island Convention Center, has been set up in Providence, with 594 beds.
A field hospital has been set up inside the Rhode Island Convention Center
The Cranston facility (pictured) accepted its first COVID patients on Monday
In Alabama, hospitals are already seeing a spike in cases, post-Thanksgiving, and COVID wards are full in Decatur Morgan Hospital, meaning that patients are being cared for in ER - taking space from others in need.
Kelli Powers, president of the hospital, told WZDX that exhaustion among staff was setting in.
'That's the major thing,' she said. 'It is having enough staff to take care of these patients.
'I think I share with y'all every week how tired the doctors, the staff, everybody is - the nurses taking care of patients.'
Despite the new coronavirus unit at Decatur hospital's Parkway Campus, they have had to resort to using the ER, causing longer wait times for the emergency room.
The COVID unit at the Parkway Campus was opened specifically to bring more beds to the area.
The hospital currently has 273 beds, and 69 patients admitted there have covid-19.
Cars line up in Los Angeles on Monday for drive-in COVID testing at the Dodger Stadium
A healthcare worker wears protective gear at a coronavirus testing site in Los Angeles
In Montana, plans are being made to put COVID patients in assisted-living facilities, because the hospitals cannot cope.
Dr. Scott Ellner, the chief executive of a Montana health system, Billings Clinics, said his network was 'at or beyond capacity'.
On Monday he told CNBC that the situation in the state was critical.
'We're making every possible infrastructure change, including more airflow rooms,' he said.
'We've added over 90 rooms that have negative airflow.
'We've expanded offices to create ICU capacity, and we've created double occupancy so that we can allow patients to be together in one room to meet the needs.'
The intensifying outbreak of Covid-19 also has taken a personal toll on the staff of the health system, Ellner said.
'The most sobering thing that we saw, actually this past weekend, was unfortunately that we lost one of our physicians to COVID, so this is really hitting our workforce, our Billings Clinic family pretty hard.'
In West Nyack, New York, nurses on Monday check the results of a rapid test at a drive-through
Brendan Hurley, a junior in high school, is tested at a drive-through site in West Nyack Monday
Nurse Carolina Garcia, 36, takes care of her father, Jose Garcia, 67, in New Mexico on Sunday
New Mexico, which two weeks ago imposed a lockdown, said that its hospitals are operating in the 'contingency' level of care, but are getting closer to reaching the 'crisis' level, which would impact the level of care people would receive.
Jim Justice, the governor of West Virginia, said hospitals across the state will reduce elective surgeries to ensure there is room for coronavirus patients.
The number of people hospitalized with COVID-19 jumped 29 per cent in the past week, he said.
In Kansas City, Kansas, hospital and nursing officials said they fear there will not be enough nurses to staff new hospital beds in the metro area if COVID-19 cases continue unchecked.
Health officials on Monday added 4,425 confirmed infections and 87 hospitalizations to the state's pandemic tally since Friday.
Scott Atlas, Trump's favorite health official, resigned from the COVID task force on Monday
Experts say that Thanksgiving travel and shopping will make matters worse.
In suburban St. Louis, a hospital official warned that hospitalizations could double in two to three weeks if people don't quarantine after Thanksgiving gatherings.
SSM Health DePaul Hospital in Bridgeton, Missouri, last week brought in a morgue trailer to store the dead, canceled elective surgeries and doubled up patients in rooms.
'We will be absolutely overwhelmed,' said Shelly Cordum, vice president of patient care services and chief nursing officer.
'I can't even imagine what we are going to be facing in three weeks if we stay on this path.'
Dr. Anthony Fauci, the government's foremost infectious-disease expert, warned on ABC over the weekend that the country could see a 'surge upon surge' of infections tied to Thanksgiving.
And White House corononavirus task force coordinator Dr. Deborah Birx told CBS that people who traveled should 'assume that you were exposed and you became infected,' and get tested if they experience symptoms.
The Mayor of El Paso, Texas, which is reeling from a staggering surge in coronavirus cases, says 'COVID fatigue' and shopping at large retailers are to blame for the spike.
El Paso's hospitals have become overwhelmed with a troubling increase in coronavirus patients and deaths, prompting the city to bring in at least 10 mobile morgues earlier this month, pay inmates $2 an hour to carry dead bodies away, and deploy the Texas National Guard to help.
'About almost six weeks ago, we started spiking significantly. I think people just… the consensus is people just had COVID fatigue and they let down,' Mayor Dee Margo said on CBS' Face the Nation on Sunday.
'As Dr. [Deborah] Birx said, you got to wear the mask and you've got to maintain the distancing and you've got to avoid crowds,' he added.
El Paso has recorded more than 86,000 COVID-19 cases and more than 920 deaths with a seven day rolling average positivity rate of 13.59 percent.
Mayor Dee Margo of El Paso, Texas says his city's surge in coronavirus cases is due to 'COVID fatigue'. 'About almost six weeks ago, we started spiking significantly. I think people just… the consensus is people just had COVID fatigue and they let down,' Margo said on CBS' Face the Nation on Sunday
He said contact tracers have found that 55 percent of positive cases came from shopping at big box stores for the week of November 10 to 16. A view of a shopper at Academy Sports and Outdoors in El Paso on Black Friday above
Jacqueline Fuentes and her brother Michael Fuentes pictured purchasing a sound bar from Best Buy on Black Friday in El Paso, Texas. As a result Margo said he asked big stores like Walmart to enact 'voluntary limitations' to lower occupancy in the stores to prevent further spread of COVID-19
A view of a Costco store in El Paso, Texas on November 18 above. Residents have been urged to stay home except for essential trips due to the staggering surge of cases and deaths in the state that prompted the border town to bring in 10 mobile morgues to handle the pile-up of bodies
On Monday, 461 new COVID-19 cases were reported and one new death. There are 905 people currently hospitalized with 317 patients in the ICU and 214 patients on ventilators.
In Texas, more than one million people have tested positive for the virus and more than 21,000 have died.
Margo revealed that contact tracers have connected a wave of positive infections from big box stores.
'We did a deep dive in our contact tracing for the week of November the 10th through the 16th and found that 55 per cent of the positives were coming from shopping at large retailers, what we'd term as the big box stores,' Margo said.
'And those are considered essential under CISA guidelines under Homeland Security. And we don't really have - I don't have any control over any limitations there,' he said.
El Paso County detention inmates pictured helping moving bodies to refrigerated trailers outside the Medical Examiner's Office on November 14. The mobile morgues were brought in to help with the surge of coronavirus deaths in the state
The El Paso Sheriff's Office said that the city began to use inmates on November 9 on a volunteer basis to help move the dead into morgues. By November 16 there were at least 10 mobile morgues in the city
County officials said the inmates were paid $2 an hour and were tested and provided with PPE by the Medical Examiner's office and would face a two-week quarantine once the program was over
El Paso County Judge Ricardo Samaniego said the inmates were only used temporarily until the Texas National Guard came in as a last resort. A view of a low-level inmate helping load bodies wrapped in plastic into a refrigerated temporary morgue trailer in a parking lot at the El Paso County Medical Examiner's office on November 17
A view of El Paso County detention inmates helping move bodies to the mobile morgues outside the Medical Examiner's Office on November 14 above
As a result Margo said he asked big stores like Walmart to enact 'voluntary limitations' to lower occupancy in the stores.
Nearly one month ago the El Paso area reached capacity at hospitals and additional medics and the National Guard was deployed to aid in the situation.
'On Thanksgiving Day, we had 406 positives. The next day was 678,' Margo said.
Earlier this month hospitals in the El Paso area were looking dire.
The El Paso Sheriff's Office said that the city began to use inmates on November 9 on a volunteer basis to help move the dead into morgues.
County officials said the inmates were paid $2 an hour and were tested and provided with PPE by the medical examiner's office and would face a two-week quarantine once the program was over.
El Paso County Judge Ricardo Samaniego said the inmates were only used temporarily until the Texas National Guard came in as a last resort.
'If there's no personnel, no one to help out, and there's volunteers, even if they are inmates, then that's what we're left with,' he told KFOX14. 'It was just a temporary focus, and we're waiting for the Texas National Guard to help us out with that.'
On Thanksgiving eve El Paso initiated a new curfew running from 10pm to 5am through Monday November 30.
'We need to do everything possible to avoid the perfect storm. I will use every tool that I have such as issuing a curfew to slow the spread of this virus,' said Judge Ricardo Samaniego.
'We're now cautiously anticipating the outcome of Thanksgiving. Black Friday, Christmas, New Year's, and the terrifying effects of the flu season.'
Last week Samaniego encouraged big box stores to distribute their Black Friday sales throughout the day to avoid amassing large crowds that can't social distance.
He also urged locals against gathering for the shopping event and urged them to stay home except for essential needs.
Officials in Los Angeles went further.
Protesters against a vaccine and against lockdown in New York City on Sunday
In West Virginia, protesters against the lockdown took to the streets of Charleston Monday
Frontline healthcare workers demand more PPE in Los Angeles on Monday
The Plaza Mexico shopping center in Los Angeles' Lynwood district was almost deserted
Los Angeles County imposed a stay-at-home order for its 10 million residents, and Santa Clara County, in the heart of Silicon Valley, banned high school, college and professional sports and decreed a quarantine for those who have traveled more than 150 miles outside the county.
The directive allows for church services and protests, noting that both are constitutionally-protected rights.
It sets maximum occupancy rates for various businesses, including nonessential retail, libraries, and recreational activities, and leaves in place a countywide prohibition on in-person dining at restaurants and bars because patrons cannot wear face masks while eating or drinking.
In Hawaii, the mayor of Hawaii County said trans-Pacific travelers arriving without a negative COVID-19 test must quarantine for 14 days, and even those who have tested virus-free may be randomly selected for another test upon arrival.
New Jersey is suspending all youth sports.
'The red flags are flying in terms of the trajectory in our projections of growth,' said Gavin Newsom, governor of California.
'If these trends continue, we're going to have to take much more dramatic, arguably drastic, action.'
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