/The C.D.C. director warns of an the impending doom of a potential 4th surge in virus cases. – The New York Times

The C.D.C. director warns of an the impending doom of a potential 4th surge in virus cases. – The New York Times

President Biden on Monday called on governors and mayors to maintain or reinstate mask-wearing orders, saying that because of “reckless behavior,” the coronavirus was again spreading fast, threatening the progress the nation has made so far against the pandemic.

“People are letting up on precautions, which is a very bad thing,” he said. “We are giving up hard-fought, hard-won gains.”

Mr. Biden asked the nation to persevere, saying that he had directed his coronavirus team to ensure that there was a vaccination site within five miles of 90 percent of Americans within three weeks.

He said doses are now plentiful enough that nine of ten adults in the nation — or more — will be eligible for a shot by April 19. Previously, he had only called on states to broaden eligibility to all adults by May 1.

While it will take time for everyone to get an appointment, Mr. Biden said, “you won’t have to wait till May to be eligible for your shot.”

Buoyed by promises of bigger shipments of doses in coming weeks, many states have already moved quickly to allow more people to sign up for shots. On Monday, New York said all adults would be eligible starting April 6, joining at least 37 other states that will make all adult residents eligible for vaccinations by mid-April.

Asked if states should pause their reopening efforts, the president replied simply, “Yes.” He said that governors, mayors, local officials and businesses should demand mask-wearing, calling it a “patriotic duty” that is crucial to the nation’s fight against the virus.

“Please, this is politics,” he said. “Reinstate the mandate if you let it down.”

Mr. Biden spoke a few hours after Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, issued perhaps her most impassioned warning to date about a possible fourth surge of the coronavirus, saying she felt a recurring sense of “impending doom.”

The nation has “so much reason for hope,” she said, her voice trembling with emotion. “But right now I’m scared.”

“I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends,” she said at a White House briefing.

According to a New York Times database, the seven-day average of new virus cases as of Sunday was about 63,000, a level comparable to late October, and up from 54,000 a day two weeks earlier, an increase of more than 16 percent. Similar upticks in the past over the summer and winter led to major surges in the spread of disease, Dr. Walensky said. Still, new cases and deaths have declined from the early January peak, though the seven-day average of new deaths remains near 1,000 a day.

The wave of new cases comes as the nation rapidly broadens eligibility for vaccines, the average number of daily shots continues to rise, and a new C.D.C. report released Monday confirmed the findings of last year’s clinical trials that vaccines developed by Moderna and Pfizer are highly effective against Covid-19 disease. The report documented that the vaccines work to prevent symptomatic and asymptomatic infections under real-world conditions.

The seven-day average of vaccines administered hit 2.7 million on Sunday, a slight increase over the pace the previous week, according to data reported by the C.D.C. But worrisome hot spots continue popping up.

In nine states over the past two weeks, virus cases have risen more than 40 percent, the Times database shows. Michigan led the way with a 133 percent increase. The Northeast has also seen a troubling rise in virus cases. Connecticut reported a 62 percent jump in cases over the past two weeks, and New York and Pennsylvania both reported increases of more than 40 percent.

Michigan’s spike has not been traced to any one event, but epidemiologists have noted that cases started to jump after the state eased restrictions for indoor dining on Feb. 1 and lifted other restrictions in January. Other hot spots included North Dakota, where cases rose by nearly 60 percent and Minnesota, where cases have jumped 47 percent. Of those states, North Dakota is the only one without a current mask mandate.

Dr. Walensky on Monday described “a feeling of nausea” she would experience last year when, as a doctor at a Boston hospital, she saw the corpses of Covid-19 patients piled up, overflowing from the morgue; and when she stood, “gowned and shielded,” as the last one in a patient’s room before they died alone, without family.

At the time, she said, there were so many unknowns about the virus. But now, with the vaccination program rapidly gaining speed, she said, she is hopeful the pandemic can be beat.

Dr. Walensky, who has issued several warnings in recent weeks about the need to keep up mask-wearing and social distancing, said she planned to talk to governors about the risks of prematurely lifting restrictions on Tuesday during a weekly call about the pandemic and vaccine rollout.

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