(CNN)On a day his state and others reported staggering coronavirus numbers, one Midwestern governor said he could see through the darkness to better days ahead. But he acknowledged it will remain a difficult journey.
Moderna hours before had announced its Covid-19 vaccine has an astonishingly high success rate -- 94.5% effective -- based on interim clinical trial data. It is the second company to report such high efficacy results.
"There is light at the end of the tunnel," Minnesota Gov. Tim Walz told reporters Monday of the vaccine news, a phrase echoed later in the day by Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.
"But I want to be very clear. We need to get all our neighbors to the end of the tunnel," said Walz.
That tunnel is going to be a long one.
Most Americans probably won't get vaccinated until next year. And the fall surge continues to bring a terrifying jump in cases: Nationwide, for two straight weeks, the US has added more than 100,000 new cases daily. And hospitalizations hit another new high.
For the 11th day in a row, Illinois reported more than 10,000 cases in a single day, according to the state Department of Health website.
Cases in California are up 51.3% in the past week and daily cases have doubled in just 10 days, Gov. Gavin Newsom said. About 70% of the counties in the state are moving back into more restrictive tiers as Newsom used the analogy of "pulling an emergency brake" to deal with the crisis.
As vaccination trials continue, tens of thousands of lives could either be saved or lost, depending on how people act. Traditional Thanksgiving gatherings, for example, are a huge concern among health experts and state leaders.
"We simply can't do that right now," Walz said as his state reported 24,000 new cases in just three days.
All of this comes as one expert says Covid-19 could become the leading daily cause of death in the US.
"It's more than just heading in the wrong direction," said Dr. Peter Hotez, dean of tropical medicine at the Baylor College of Medicine. "We are on the verge of a humanitarian catastrophe."
California considers curfew to limit spread
Last week, California became the second state, behind Texas, to surpass 1 million infections.
Residents got more grim news Monday when Newsom said 41 of the 58 counties, representing 94% of the population, will now fall under the most restrictive of the state's four-tier reopening system.
In this tier, where infections are considered widespread, guests are welcomed only outdoors at restaurants, gyms and places of worship.
The state's face covering mandate is being strengthened to require residents to wear a mask whenever they are outside of their homes, with few exceptions.
Newsom said officials are considering a curfew, but details of such a possible action were not divulged. Los Angeles County officials are specifically considering a curfew "so businesses do not have to close again, but would instead have limited hours for essential activities," according to County Supervisor Mark Ridley-Thomas.
Los Angeles Mayor Eric Garcetti urged residents to stay at home as much as possible during the surge in cases. "Los Angeles is in a very dangerous situation," he said.
"If you don't have essential travel, don't travel," said Garcetti. "If you don't have to take a trip as an essential worker or because of a family emergency, don't travel."
Why the 'war' against Covid-19 is getting worse
Much of the current surge is fueled by people hanging out with friends or family who don't live with them -- and wrongfully assuming they're not infected.
US Surgeon General Jerome Adams said all Americans must mask up and double down on safety precautions, including social distancing, as the next few months are expected to be the worst of the pandemic.
"Hard truths: 49/50 states with increasing cases, 34 in red or orange zones (ie significant rise)," Adams tweeted.
Many hospitals are already running out of health care staff. Major surgeries for non-Covid patients are getting delayed. And some patients are several hours away from the closest available ICU bed.
The winter surge of coronavirus cases could push some hospitals "to the breaking point," said Dr. Dara Kass, an emergency medicine physician at Columbia University Medical Center in New York.
Kass said that some areas being hit hardest by the current surge are the least equipped to handle them.
"When you look at Utah, or Montana or the Dakotas, they just have such a fewer number of ICU beds and specialists, that when they get at capacity, it's going to be a breaking point for them in a way it wasn't for us in the coastal cities and states," Kass said at an online event hosted by Stat.
Nationwide, more than 11 million people in the US have been infected with coronavirus, and more than 247,000 have died, according to data from Johns Hopkins University.
If 95% of Americans wore masks consistently, 68,000 lives could be saved by March 1, according to the University of Washington's Institute for Health Metrics and Evaluation.
Still, disagreements remain over social distancing and gatherings.
In Oregon, Democratic Gov. Kate Brown announced a two-week "social freeze," which includes limiting social gatherings, suspending indoor restaurant dining, and limiting the number of people who can gather for faith-based organizations. Social gatherings are limited to six people.
Tootie Smith, who will start her term as chairwoman of the Clackamas Board of County Commissioners in January, said in a Facebook post that Brown's order is wrong and her family "will celebrate Thanksgiving with as many family and friends as I can find."
Another Facebook post said Smith's constituents understand Centers for Disease Control and Prevention guidelines and "can make their own informed decisions and maintain their personal rights."
Brown on Monday did not address Smith's comment but said her household will keep its gathering small. "We want to make sure that we don't accidentally kill someone," Brown said.
CNN has been unable to reach Smith for comment.
The hospitalization record is shattered, again
A record-high 73,014 Covid-19 patients were hospitalized Monday, according to the Covid Tracking Project. That's more than 3,000 above Sunday's tally.
Both far exceed the spring peak of 59,940, on April 15, and the summer peak of 59,718 on July 23.
Hospitalizations will likely keep rising as new infections keep soaring. And the increased case numbers aren't just due to more testing.
About 1,000 people on average are dying every day, Fauci said Monday at an American Medical Informatics Association virtual symposium.
"This is really an extraordinarily difficult situation," he said, referring to the big surge of infections, "the likes of which we have not seen, including what was going on in the spring."
"We are now, as we get deeper into the cooler weather of the fall and the upcoming winter weather that's cold, people are going to be doing more things indoors rather than outdoors, which means we really need to double down on the fundamental things that we do to prevent infection," he said.
Bipartisan officials enact new restrictions
A growing number of Republican and Democratic governors and city leaders have issued new mandates to try to stop the crisis from getting worse.
On Monday, Republican Gov. Mike DeWine of Ohio announced new limits on social gatherings, weddings and funerals.
"Despite the health order that limited mass gatherings to 10 people that was signed in April remaining in effect, we have seen rampant spread of the virus as a result of banquets, wedding receptions, and social gatherings following funerals," the governor said.
The revised order prohibits dancing or socializing in open, congregate areas. Guests must be seated, and food should be served to them at their seats. No more than 10 people can sit at a table, and those people must be from the same household.
Philadelphia announced new outdoor restrictions. As a result, the Eagles will not be able to host fans at Lincoln Financial Field, the NFL team said in a tweet. The Archdiocese of Philadelphia Schools announced it will comply with the citywide measures and have all high schools do remote learning from November 23 through the end of the year.
Starting Thursday, all bars and restaurants in Oklahoma must close by 11 p.m. and restaurant tables must be 6 feet apart.
"We need to slow the spread of this virus," said Republican Gov. Kevin Stitt. "Data shows that social distancing is harder to maintain as it gets later at night, especially in bars."
Beginning Tuesday, state employees must wear masks in common areas or when they are close to other workers, Stitt said.
Washington Gov. Jay Inslee, a Democrat, has banned indoor social gatherings with people from different households, unless they take appropriate precautions.
Those precautions include everyone quarantining for 14 days before the gathering, or quarantining for seven days before the gathering and getting a negative Covid-19 test result no more than 48 hours beforehand.
'This winter will be hard'
Yes, there's great news with two vaccine trials -- one from Moderna, and one from Pfizer/BioNTech.
But let's be clear: There will be no return to normal this year, BioNTech CEO Ugur Sahin said.
"This winter will be hard. We will not have a big impact on the infection numbers with our vaccine this winter," Sahin told the BBC.
Last week, Pfizer CEO Albert Bourla said "we believe that we are in good situation to have up to 50 million doses this year, globally, and I believe we are in a very, very good situation to have 1.3 billion doses globally next year."
But just like the Moderna vaccine, the Pfizer/BioNTech vaccine requires two doses for each person.
So if 50 million doses are available worldwide by the end of this year, that would mean 25 million people could get vaccinated.
Moderna, Pfizer and other companies making vaccines must first ask for and then receive emergency use authorization from the US Food and Drug Administration before they can start distributing their vaccines.
Fauci said the efficacy of the Moderna vaccine is more than he would have predicted. "For me, that was aspirational to get to that level. I would have been comfortable with a 70 to 75% effective vaccine," he said.
Still, Fauci said, Americans should do risk assessments before holiday gatherings.
"The cavalry is coming, but the cavalry is not here yet," he said at the American Medical Informatics Association event.
