As the United States continues to shatter coronavirus records, governors and mayors from California to Pennsylvania are ramping up COVID-19 restrictions ahead of the Thanksgiving holiday.

A record-breaking nearly 70,000 people were hospitalized with the coronavirus in the U.S. as of Sunday, 13,000 more than a week earlier, according to the COVID Tracking Project. Deaths in the U.S. are running at more than 1,100 per day on average, an increase of over 50% from early October.

The virus is blamed for more than 246,000 deaths and over 11 million confirmed infections in the United States.

Last week, a flurry of states imposed new coronavirus restrictions – this week, even more tightened restrictions as the current wave appears bigger and more widespread than the surges that happened in the spring and summer. 

Many of the new guidelines come as people prepare for Thanksgiving, a holiday sure to further increase the surge in cases as Americans travel to celebrate with friends and family. The CDC recommends small or virtual Turkey Day gatherings to mitigate the spread of the virus, but many local politicians are taking their guidance a step further. 

“We don’t really want to see mamaw at Thanksgiving and bury her by Christmas,” said Dr. Mark Horne, president of the Mississippi State Medical Association. “It’s going to happen. You’re going to say ‘Hi’ at Thanksgiving, ‘It was so great to see you,’ and you’re going to either be visiting by FaceTime in the ICU or planning a small funeral before Christmas.”

Here are the states that imposed restrictions last week, and below are some more cities and states imposing COVID guidelines as the holidays grow near: 

California

Gov. Gavin Newsom says the state is pulling the "emergency brake" on economic activity in light of what he calls an unprecedented spike in COVID-19 cases statewide. 

"Daily cases in the State of California have doubled just in the last 10 days," Newsom said. "California is experiencing the fastest increase in cases we have seen yet – faster than what we experienced at the outset of the pandemic or even this summer.”

The move means counties with spiking virus metrics can move backward in the state's four-tier reopening matrix after one week, rather than the previous two-week requirement. Counties can also move back multiple tiers when called for, and counties that move backward must require industry restrictions immediately, not three days. 

While last week there were 12 counties in the state's most restrictive purple tier, Newsom announced that this week that number had jumped to 41 counties. That increase will see some 94% of the state's residents falling under the purple tier, leaving 11 counties in red, four in orange, and just two in the least restrictive yellow tier.

"We are seeing community spread broadly throughout the state of California," Newsom said. 

"We have been preparing for this moment. While the governor sounded the alarm on what he defined as California moving "backwards, not forwards," he also cited progress the state had made in amassing critical PPE. 

"The inventory we’ve been able to accrue, our inventory is substantially greater than it's ever been with 180 million N95 masks, over 522 million masks total, you can get a sense of the preparation you can get a sense of the PPE," said Newsom.

Illinois

Chicago Mayor Lori Lightfoot called on residents in the nation’s third-largest city to restrict social gatherings to 10 people starting Monday. 

In instructions that were advisory, not mandatory, she urged residents to stay home except for essential activities, like going to work or grocery shopping.

Lightfoot also imposed restrictions on social gatherings, adding a 10-person limit to events like weddings, birthday parties, and funerals.

Michigan

Over the weekend, Governor Gretchen Whitmer announced that Michigan high schools and colleges must halt in-person classes, restaurants must stop indoor dining and entertainment businesses must close for three weeks. Gathering sizes also will be tightened.

The new rules, set to last three weeks, are extensive but not as sweeping the Democratic governor’s stay-at-home order this past spring, when she faced criticism from a Republican-led Legislature that refused to extend the state’s coronavirus emergency declaration and authorized a lawsuit challenging Whitmer’s authority to combat the pandemic.

“The situation has never been more dire,” Whitmer said at a Sunday evening news conference. “We are at the precipice and we need to take some action.”

There was a quick backlash to Whitmer's order. Scott Atlas, one of President Donald Trump's top coronavirus advisers, tweeted in response to Whitmer's restrictions: "The only way this stops is if people rise up. You get what you accept."

Soon after Atlas’ remarks, Whitmer condemned his words as “incredibly reckless” and warned she has the authority to issue a second stay-at-home order to curb the spiking coronavirus if necessary. 

Fourteen men were charged earlier this fall in an alleged plot to kidnap the governor in anger over her COVID-19 restrictions.

Atlas later tweeted that he “NEVER” would endorse or incite violence.

New Mexico

New Mexico Gov. Michelle Lujan Grisham’s stay-at-home order went into effect Monday.

Only essential businesses, including grocery stores and pharmacies, will be open.

North Dakota

After months of resisting ordering the people of North Dakota to wear masks and limit the size of gatherings, the state’s Republican governor relented in an effort to stem a coronavirus surge that is among the worst in the U.S. and that threatens to overwhelm the state’s hospitals.

Gov. Doug Burgum’s executive order Friday night came as a surprise and only hours before the state recorded new daily records for hospitalizations and infections. Throughout the pandemic, the former software executive had been leaving it to individuals to take personal responsibility for slowing the spread of the virus, beseeching the public during his weekly press briefings to wear masks but emphasizing a “light touch” by government.

But in a video message announcing his new restrictions, which took effect Saturday and will remain in effect until Dec. 13, a somber Burgum said, “Our situation has changed, and we must change with it.”

“Our doctors and nurses heroically working on the front lines need our help, and they need it now. Since the beginning, we’ve taken a data-driven approach to our pandemic response, focusing on saving lives and livelihoods,” Burgum said in his news release. “Right now, the data demands a higher level of mitigation efforts to reverse these dangerous trends, to slow the spread of this virus and to avoid the need for economic shutdowns.”

After a spring in which North Dakota had relatively few COVID-19 cases, the disease spread rapidly over the summer and has only picked up steam since. As of Saturday, there were only 18 free Intensive Care Unit beds and 178 non-ICU beds in hospitals throughout the state.

In neighboring South Dakota, which is also being hit hard by the coronavirus, Gov. Kristi Noem continued her hands-off approach and resisted a mask mandate or other restrictions. 

 

Ohio

 

Ohio will be under a curfew starting Thursday that will run from 10 p.m. to 5 a.m. and last for three weeks, Gov. Mike DeWine announced Tuesday.

DeWine said he will not close any businesses today. His current approach to the surging coronavirus cases in Ohio is a "slowdown" not a shutdown.

DeWine said he hopes the curfew will reduce some of the human to human contacts that are contributing to the spread of the virus.

There will be exeptions for going to work and the grocery store. 

More details about the curfew have not been released. This story will be updated as more information becomes available.

Ohio reported 7,079 new cases Tuesday. The report showed 30 new deaths and an increase of 368 COVID-19 positive hospital inpatients. There are now 3,648 COVID-19 patients hoospitalized, 897 ICU patients, and 441 patients on ventilators. The seven-day positivity rate has risen to 12.8%. 

DeWine's announcement that he would not close businesses followed an announcement last week that he was considering shutting down indoor dining and would make a decision on the matter this week. The governor said he is encouraged by early conversations he has had about his new mask order, which went into effect Monday. Businesses are now inspected by state officials who can issue warnings and close a business for a day upon a second offense. 

Pennsylvania

Philadelphia, the nation’s 6th-largest city, banned all indoor dining at restaurants and indoor gatherings of any size, public or private, of people from different households, starting this Friday.

“We need to keep this virus from jumping from one household to another,” the city’s Health Commissioner Dr. Thomas Farley said.

Farley also announced Monday that they will begin shuttering gyms, casinos, libraries, and museums, limit occupancy at stores and houses of worship, and pause in-person learning at universities and high schools. 

Texas

As Texas continues to see a surge in new coronavirus cases, hospitalizations and deaths, one of Gov. Greg Abbott’s medical advisers says it’s time for the state to enact more restrictions. 

“This is going to be the worst surge of the entire pandemic. We’ve known this is coming for a while,” Dr. Mark McClellan, who’s also a former FDA Commissioner, said in an interview with Spectrum News.  “It’s winter. People are tired of it. This is going to be a tough couple of months ahead and we need to be thinking about some further steps.” 

Gov. Abbott recently said there would not be any new lockdowns. But McClellan said it doesn’t have to be everywhere and encouraged a regional approach. He also says he thinks the shutdown order in hard-hit El Paso should be in place. 

“More focused efforts in local areas can help bring down the rates in those places and still have flexibility to have a bit more openings in areas where the cases aren’t quite so dangerous.” 

The shutdown order in El Paso is currently halted. 

A state appeals court stopped the order late last week after Attorney General Ken Paxton and a group of business owners sued.

Washington State

Washington Gov. Jay Inslee announced the state would enforce new restrictions on businesses and social gatherings for the next month on Monday.

Starting Tuesday, gyms and some entertainment centers in Washington will be required to close their indoor services. Retail stores, including grocery stores, will be ordered to limit indoor capacity and multiple-household, indoor social gatherings will be prohibited unless attendees have quarantined for 14 days or tested negative for COVID-19 and quarantined for a week. 

By Wednesday, restaurants and bars will again be limited to outdoor dining and to-go service.

Across Washington — which was among the first states to report a COVID-19 case and death in early 2020 — all 39 of its counties have been paused in either the second or third phase of a four-stage reopening plan that started in early May after a lockdown that began in March.

The restrictions announced by Inslee, a Democrat, temporarily rolls back all counties and places them under the same guidelines. The advisories say people should avoid non-essential out-of-state travel and quarantine for 14 days after arriving from another state or country.

The Associated Press contributed to this report.