“It’s going to get a lot worse,” said Dr. Haseltine, who was at the heart of the U.S response to the HIV/AIDS and anthrax crises. “We’re looking at easily an excess of 100,000 infections a day and overwhelmed hospitals all over the country.”

Haseltine said that prediction was supported by several factors: The weather will only get colder, forcing people indoors. Flu season is approaching. The holidays will tempt people to gather in groups. There are no silver bullets coming. The smaller—but still devastating—peaks in the spring and the summer were largely contained to specific regions of the United States.

“Now it’s just about everywhere across the country,” said Haseltine, noting that cases are impacting more age groups, environments, and facilities. While many states saw clusters originating in meatpacking plants, prisons, and retirement facilities earlier in the year, they’re now being traced more often back to private family gatherings, religious services, bars, athletic events, colleges, high schools, and more…

“What we can hope for,” said Haseltine, “is that this will plateau at 100,000 [new cases per day], and that enough people will get enough scared and that enough hospitals will get overwhelmed” that it convinces the American public to wear masks, social distance, and exercise caution.