The summer is over, and with it an unfortunately temporary respite from the COVID-19 pandemic. Cases have shot through the roof over the last few weeks, and so have hospitalizations, negating the argument that the increase in cases came from broader testing availability. In fact, hospitalizations have hit a new record, breaking the mid-April high in the initial lockdown:

With the number of coronavirus cases in the United States skyrocketing, many health experts warned the total number of people hospitalized in a given day would rise too.

On Tuesday, the number of people with Covid-19 at US hospitals for the first time topped 60,000.

The COVID Tracking Project, a volunteer organization that compiles data on coronavirus cases, said the number as of Tuesday was 61,694. That’s 2,024 more people than were hospitalized on April 15, the previous record.

The United States currently averages about 1,661 new hospitalizations per day, the organization’s data shows.

Fatalities have already begun tracking up, especially in Midwestern states, where the highest transmission rates appear to be. As fatality rates tend to lag the hospitalization curve, this new record on hospitalizations looks like especially bad news:

On Tuesday, the country hit another one-day record, logging more than 135,000 new coronavirus cases, along with 1,403 additional deaths. At least five states, including Missouri and Wisconsin, set single-day highs for fatalities. At least five more, including Illinois and Pennsylvania, set single-day highs for new cases. Almost nowhere in the country are caseloads actually subsiding.

“We’re now seeing widespread community transmission,” said Maryland Gov. Larry Hogan (R). “More people are getting infected with the virus, more people are being hospitalized and going into intensive care, and more people are dying.” …

Nearly 62,000 infected Americans currently lie in hospital beds — a number the nation has not experienced since April. More than a dozen states have hit new highs for hospitalizations this month, with many setting records again on Tuesday, according to figures compiled by The Washington Post.

“I’m not sure it disappoints me as much as it scares the hell out of me,” said Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “This is like one huge coronavirus forest fire, and I don’t think it’s going to spare much human wood out there unless we change our behavior.”

The good news — the only good news — is that we have ramped up production of resources for hospitals, including improved therapeutics. The bad news is that these hospitals are on the verge of being overwhelmed. With that in mind, several states have begun increasing restrictions again on in-person commerce. Governors have taken a less coercive approach to them at the moment, pleading for mask use and a stay-at-home attitude:

Following weeks of rapid climbs in Covid-19 infections and hospitalizations, more state leaders have begun asking residents to stay at home in hopes of helping curb an already rampant spread of the virus. The announcements also come as Texas became the first US state to surpass a million cases.

Nevada Gov. Steve Sisolak is asking people to commit to a voluntary plan he calls “Stay at Home 2.0” in the next two weeks in efforts to push a “significant reversal of the current trends” in the state.

“We have to go back to the basics,” the governor said, encouraging businesses to return to telecommuting as much as possible and asking residents to avoid hosting groups of people over for dinners, parties and other gatherings.

Wisconsin’s governor announced Tuesday he’s signed a new order advising people to “stay home to save lives.”

“It’s not safe to go out, it’s not safe to have others over,” he said. “Please, cancel the happy hours, dinner parties, sleepovers, and playdates at your home. And if a friend or family member invites you over, offer to hang out virtually instead.”

There’s a reason these states are trying a more cooperative approach Governors in some states — Wisconsin included — got out over their skis in March and April with the use of emergency powers to impose mandates. Legislatures fought them in legal battles, eventually winning to curtail their ability to issue mandates. Tony Evers needs to work with the Republican legislature in Wisconsin now to craft any mandatory restrictions, which has been somewhat skeptical of Evers’ previous scope and scale of mandates.

The same conflict occurred here in Minnesota between Gov. Tim Walz and the legislature. Walz rolled out more targeted restrictions last night, hoping to keep businesses from folding in the second wave, but Republicans are criticizing the focus on bars and restaurants:

Walz said the 10 p.m. closing time was justified because Health Department data shows more bar-related outbreaks occur later in the evening when people become less cautious.

“We are seeing at least a doubling in infections after nine o’clock,” Walz said.

The new restrictions take effect Friday, including a ban on social games such as darts and pool. Counter service will not be permitted. Takeout service can continue after 10 p.m., though, and service at cafeteria-­style counters also can continue. Maximum capacity will shrink from 250 to 150 people, or 50% of an establishment’s fire code capacity, whichever number is lower. …

Wedding and funeral reception crowd sizes also will be limited, although the ceremonies will not be affected by the change. Ninety-six weddings have been linked to 851 primary infections — with attendees spreading the virus secondarily to others. That includes 44 weddings in October. Most of the infections spread during the receptions, which will be limited to 50 people on Nov. 27 and then 25 people effective Dec. 11.

Informal group gatherings in backyards and garages have been the source of many outbreaks, though more so in July and August. Those gatherings have been linked to 71 outbreaks and 599 primary COVID-19 infections.

Because of that, indoor and outdoor social gatherings will be limited to 10 people from no more than three households. Walz acknowledged that the new limits largely rely on voluntary compliance.

“Obviously, on this issue, we’re not going into someone’s home and arresting them on Thanksgiving,” he said.

That’s been the dirty little secret all along. No one has the resources to enforce these mandates, especially in Minneapolis, where police are becoming a scarce resource. Compliance has always relied on voluntary action. Governors learned a hard lesson on that point in the shutdown. It’s better to appeal to people than to dictate to them, especially when the dictates have little chance of being enforced.

And the rest of us are learning a hard lesson now. Let me offer a personal testimony, anecdotal though it may be: on Sunday night, I had to call 911 after suffering severe chest pains. (That’s why I wasn’t around on Monday.) The ambulance couldn’t transport me to any hospital in St. Paul, much closer to my house, because they were all at capacity with COVID-19 cases. They transported me instead across town to Minneapolis and the excellent U of M health center. Fortunately, they had isolation areas for non-COVID emergency cases and observation, and enough capacity to deal with my issue. Still, I am lucky that this wasn’t an actual cardiac event (not sure yet what it was, but my heart’s in very good shape). Time matters in heart attacks, and the extra time to get across town could have been bad news.

I am still going to be isolating myself for the next couple of weeks as best I can, just in case I got exposed. The nurses in the isolation area told me that their area tests all personnel every day, and every patient that comes in (myself included: negative), and that the risk is less than going to the grocery store. But they also told me that they’re running low on supplies again and that COVID-19 hospitalizations are stretching the limits of their capacity. It’s not a mirage, and it’s not just an artifact of better testing. It’s a real second wave, and the vaccine can’t come fast enough.