Hospitals on the brink of capacity as the virus continues its surge across the U.S.

New reported cases by day in the United States

60,000 cases

March

April

May

June

July

Aug.

Sept.

Oct.

New cases

7-day average

Source: New York Times database of reports from state and local health agencies

See maps and charts showing Covid-19 cases around the country »

The latest coronavirus surge is raging across the American heartland, most acutely in the Midwest and Mountain West.

This harrowing third surge, which led to a U.S. single-day record of 79,196 new cases Friday, is happening less than two weeks from Election Day, which will mark the end of a campaign dominated by the pandemic and President Trump’s much-criticized response to it.

As of Friday evening, 12 states have added more cases in the past week than in any other seven-day stretch of the pandemic: Wisconsin, a battleground in the presidential election, Wyoming, Idaho, Utah, South Dakota, Montana, Arkansas, Alaska, Tennessee, Ohio, Indiana, and North Dakota. And four states have added more deaths this week than in previous weeks: Wisconsin, Kentucky, South Dakota and Oklahoma.

North Dakota leads the nation in coronavirus cases per capita. Illinois is averaging more than 4,100 new cases per day, up 85 percent from the average two weeks ago. And Pennsylvania, another battleground state, is regularly seeing single-day case counts near those set in the earliest days of the pandemic, on Thursday the state reached a new record of 2,054 cases.

The virus will be front of mind for voters in several key states, especially Wisconsin, home to seven of the country’s 10 metro areas with the highest numbers of recent cases. And in Ohio, where more people are hospitalized with the coronavirus than at any other time during the pandemic.

Experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount, especially in rural areas where medical facilities could be quickly overwhelmed.

Credit…Hannah Mckay/Reuters

Citing a rise in hospitalizations across the state, the Colorado Department of Public Health and Environment announced a strengthening of coronavirus restrictions in certain counties, capping gatherings at 10 people from no more than two separate households.

Overnight, nearly 2,500 people were hospitalized in Illinois, the state’s top public health official, Dr. Ngozi Ezike, said in a news conference Friday afternoon. The mayor of Chicago, Lori E. Lightfoot, announced a curfew on nonessential businesses beginning at 10 p.m. on Friday.

In the latest presidential debate on Thursday night, President Trump asserted that the virus was “going away” as he defended his management of the pandemic. Former Vice President Joseph R. Biden Jr., the Democratic nominee, attacked Mr. Trump’s handling, calling for much more aggressive federal action for the “dark winter” ahead.

President Trump and many supporters blame restrictions on business activity, often imposed by Democratic governors and mayors, for prolonging the economic crisis initially caused by the virus. But the experience of states like Iowa, which recently set a record for patients hospitalized with Covid-19, shows the economy is far from back to normal even in Republican-led states that have imposed few business restrictions.

Iowa was one of only a handful of states that never imposed a full stay-at-home order. Restaurants, movie theaters, hair salons and bars were allowed to reopen starting in May, earlier than in most states. Many businesses worry they won’t be able to make it through the winter without more help from Congress. Others have already failed.

Defying the guidance of infectious disease experts, who say that universal masking and social distancing are essential to limiting the virus’s spread, has eroded support for both Mr. Trump and Gov. Kim Reynolds in Iowa, especially among voters over 65, normally a solid Republican constituency, according to public and private polls. Mr. Trump and Senator Joni Ernst — whose seat could play a decisive role in determining control of the Senate — are both in tight races in a state that the president easily won four years ago.

Dr. Anthony S. Fauci, the nation’s leading expert on infectious diseases, again stressed the importance of wearing masks, socially distancing, avoiding crowds and regular hand washing Friday evening in an appearance on CNN.

“It’s not going to spontaneously turn around unless we do something about it,” he said, adding “I plead with the American public to please take these things seriously.”

A field hospital that was opened in Milwaukee to accommodate the surge in Covid-19 patients in Wisconsin.
Credit…Gabriela Bhaskar for The New York Times

The number of people hospitalized with the coronavirus in the United States has risen 40 percent in the past month and 41,485 people are now hospitalized across the country, according to the Covid Tracking Project.

While the nation has seen more people hospitalized at earlier points in the pandemic — during an onslaught of cases in New York City in April and in the Sun Belt in July — patients are now spread out much more broadly, raising concern for critically ill patients in rural areas with limited medical resources.

In Utah, where one out of five patients in intensive care units are Covid-19 patients, Gov. Gary Herbert said the state was preparing to open a field hospital at an exposition center south of Salt Lake City.

In Idaho, a hospital in Twin Falls said it will no longer be admitting children because of the increase in virus patients. Instead, they will be sent over a hundred miles to another hospital in Boise.

Medical centers in Kansas City, Mo., turned away ambulances on a recent day because they had no room for more patients.

According to the Times database, eight states — Wyoming, Utah, South Dakota, Tennessee, Oregon, Pennsylvania, Alaska and Ohio — set single-day state records for new cases on Friday. And twelve states have added more cases in the past week than in any other seven-day stretch of the pandemic.

Experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount.

“I don’t really see any signs that things are slowing down and that concerns me a lot,” Caitlin M. Rivers, an epidemiologist at Johns Hopkins University, said. “It has to be our starting premise that it’s not going to slow down unless we force it to slow down.”

The Food and Drug Administration said on Thursday that it had formally approved remdesivir as the first drug to treat Covid-19. The antiviral drug had been approved for adults and patients 12 years of age and older, and weighing at least 40 kilograms, for Covid-19 treatments requiring hospitalization, the F.D.A. said.

Across the Atlantic, hospitals in parts of Europe that have been hit with a second wave of the virus are also scrambling to prepare for an onrush of Covid-19 patients. Poland has turned its largest stadium into an emergency field hospital. In Belgium and Britain, the numbers of Covid-19 patients have doubled in two weeks. And in the Czech Republic, doctors and nurses are falling ill at an alarming rate.

The number of Covid-19 patients in hospitals across the continent is still less than half of the peak in March and April, but it is rising steadily each week, according to data from the European Centre for Disease Prevention and Control. People across much of Europe — including larger countries like France, Italy, Poland and Spain — are now more likely to be hospitalized with Covid-19 than those in the United States.

The U.S. headquarters of AstraZeneca in Gaithersburg, Md.
Credit…Ting Shen for The New York Times

Late-stage coronavirus vaccine trials run by AstraZeneca and Johnson & Johnson have resumed in the United States after the companies said Friday that serious illnesses in a few volunteers appeared not to be related to the vaccines.

Federal health regulators gave AstraZeneca the green light after a six-week pause, concluding there was no evidence the experimental vaccine had directly caused neurological side effects reported in two participants. The AstraZeneca news was first reported by The Wall Street Journal.

Johnson & Johnson said that its trial, which had been on pause for 11 days, would restart after a company investigation determined that a “serious medical event” in one study volunteer had “no clear cause.” To maintain the integrity of the trial, the company said, it did not check whether the volunteer received the vaccine or the placebo.

Dr. Luciana Borio, a former acting chief scientist at the Food and Drug Administration, welcomed the announcements, citing the urgent need for multiple vaccines to remain in the race for a product that could protect the global population from the coronavirus, which has already killed more than a million people worldwide.

“The demand for safe and effective Covid vaccines exceeds any single manufacturer’s production capacity,” Dr. Borio said. “We really need several in the field.”

An F.D.A. spokesperson declined to comment on Friday afternoon.

AstraZeneca and Johnson & Johnson are two of the four companies now in late-stage clinical trials in the U.S. for experimental coronavirus vaccines. Both companies are using adenoviruses, which typically cause harmless colds. The adenovirus is engineered so that it can chauffeur a coronavirus gene into human cells.

Their two high-profile competitors, Moderna and Pfizer, also in advanced trials, are instead using a technology based on genetic material known as mRNA. Delivered into human cells, the mRNA prompts the production of coronavirus proteins, triggering an immune response.

AstraZeneca moved swiftly into clinical trials, enrolling thousands of volunteers for its vaccine trials around the world in countries including Brazil, India, South Africa and Britain. A large, late-stage trial kicked off in the United States at the end of August. But all the trials were halted days later, on Sept. 6. A volunteer who had received the vaccine in the United Kingdom reportedly experienced symptoms of transverse myelitis, or inflammation of the spinal cord, triggering a global pause to the company’s efforts.

The incident sparked some concern among experts, who noted that a similar adverse neurological event, reported months ago, had occurred in another vaccinated volunteer. While this earlier event prompted its own pause in AstraZeneca’s trials, an independent safety board ultimately determined it was unrelated to the vaccine, allowing studies to resume.

Following the second AstraZeneca halt in September, trials abroad rapidly resumed in most countries. But the American hiatus persisted, with few details released as to why.

According to two vaccine experts familiar with the situation who were not authorized to discuss it publicly, the F.D.A. did not directly tie the vaccine to the two neurological illnesses, although it could not be ruled out. The agency has advised the company to alert study volunteers about related symptoms like weakness and numbness that might point to a milder case of transverse myelitis, the experts said.

Johnson & Johnson launched their Phase 3 trial on 60,000 volunteers in September. On October 12, the company announced its own trial pause, citing concerns that an illness had happened in one of its volunteers as well. The company has kept mostly quiet about the details of the incident.

“There are many possible factors that could have caused the event,” the company said. “Based on the information gathered to date and the input of independent experts, the Company has found no evidence that the vaccine candidate caused the event.”

Adverse events are not uncommon in large-scale vaccine trials. In some cases, they are caused by a vaccine. But investigations usually reveal that they’re coincidental — a simple matter of chance.

Before the pauses, both companies had indicated they would likely submit their vaccines for emergency authorization from the Food and Drug Administration within a few month’s time — perhaps even by year’s end. It remains unclear how much these plans have now been thrown into flux in the wake of trial delays. Results from AstraZeneca’s late-stage trials are still expected later this year, according to the statement. Johnson & Johnson did not provide an updated estimate in their statement.

A student in the bookstore at the University of New Mexico at the beginning of the school year.
Credit…Sam Wasson/Getty Images

More than 200,000 coronavirus cases have been identified at U.S. colleges this year, according to a New York Times survey that showed universities continuing to struggle to control major outbreaks. More than 35,000 cases of those cases have been identified since early October.

At least 75 virus-related deaths have also been reported from the time the pandemic began.

The University of Dayton in Ohio announced on Friday that Michael Lang, 18, of LaGrange, Ill., had died the previous day after a lengthy hospitalization. Mr. Lang was a first-year student in the College of Arts and Sciences and had left campus on Sept. 13 to return home for remote study, college officials wrote in a letter to students and staff members.

Though some colleges have moved all their fall classes online, many campuses have remained open even as positive tests have accumulated by the hundreds or thousands. Of the more than 1,700 institutions surveyed by The Times, more than 50 reported at least 1,000 cases over the course of the pandemic. More than 375 colleges have reported at least 100 cases.

The 214,000 cases at colleges account for 2.5 percent of all known cases in the United States. And that figure is an undercount because some colleges have refused to provide any case data or have stopped giving updates.

Large public institutions in the South and Midwest reported the highest case totals, including seven campuses where there have been more than 3,000 cases.

The virus has disrupted every sector of higher education, forcing quarantines and canceling plans at schools large and small, public and private.

In Ohio, the College of Wooster moved all classes online for the rest of the fall after dozens of cases had emerged, including several tied to social events. The University of New Mexico canceled its season-opening football game with Colorado State because of spiking case numbers in the Albuquerque area. And at the University of Michigan, where more than 600 people have tested positive, undergraduates were told to remain in their homes for two weeks except when attending class, eating or working.

“The situation locally has become critical, and this order is necessary to reverse the current increase in cases,” Jimena Loveluck, the Washtenaw County health officer, said in announcing the stay-in-place order at the University of Michigan.

A spokeswoman for the Department of Health and Human Services declined to answer detailed questions about why the vaccine office was closed.
Credit…Stefani Reynolds for The New York Times

As the first coronavirus vaccines arrive in the coming year, government researchers will face a monumental challenge: monitoring the health of hundreds of millions of Americans to ensure the vaccines don’t cause harm.

Purely by chance, thousands of vaccinated people will have heart attacks, strokes and other illnesses shortly after the injections. Sorting out whether the vaccines had anything to do with their ailments will be a thorny problem, requiring a vast, coordinated effort by state and federal agencies, hospitals, drug makers and insurers to discern patterns in a flood of data. Findings will need to be clearly communicated to a distrustful public swamped with disinformation.

For now, Operation Warp Speed, created by the Trump administration to spearhead development of coronavirus vaccines and treatments, is focused on getting vaccines through clinical trials in record time and manufacturing them quickly.

The next job will be to monitor the safety of vaccines once they’re in widespread use. But the administration last year quietly disbanded the office with the expertise for exactly this job. Its elimination has left that long-term safety effort for coronavirus vaccines fragmented among federal agencies, with no central leadership, experts say.

“We’re behind the eight ball,” said Daniel Salmon, who served as the director of vaccine safety in that office from 2007 to 2012, overseeing coordination during the H1N1 flu pandemic in 2009. “We don’t even know who’s in charge.”

An H.H.S. spokeswoman declined to answer detailed questions about why the vaccine office, set up in 1987, was closed or how the health agencies were planning to track the safety of vaccines once they are injected into millions of people. In a brief statement, she said that Operation Warp Speed was working closely with the Centers for Disease Control and Prevention “to synchronize the IT systems” involved in monitoring vaccine safety data.

At a hospital in Warsaw, a tent at the entrance to test for the virus.
Credit…Czarek Sokolowski/Associated Press

Poland, which has reported 64,783 cases of the coronavirus in the past seven days, will enact a number of new restrictions starting on Saturday, Prime Minister Mateusz Morawiecki announced at a news conference on Friday.

The country reported 13,632 new cases on Friday. The country has recorded 214,686 cases of the virus and more than 4,000 deaths. Thirty percent of the total cases have come in the past week. Poland, which the prime minister designated as a “red zone” on Friday, largely avoided the first wave of the pandemic by imposing an early lockdown in March.

As of Saturday, all cafes, bars and restaurants will be closed — except for carry out — and remote teaching will become a norm for older children in primary schools, as well as in high schools and at universities. Residents are required to use face coverings outside their homes.

Young people up to 16 years old will not be allowed outside between 8 a.m. and 4 p.m. without the supervision of an adult, and socializing in groups of more than five will be forbidden. Additionally, gyms and swimming pools will close. The government also asked that people over 70 stay home.

“We are far away from the comfort zone,” said Adam Niedzielski, the health minister during the news conference.

There are concerns about how the country’s underfunded health care system will cope with the growing number of virus patients. Earlier this week the government announced that it was transforming the national stadium in Warsaw into a field hospital, and constructing new temporary virus hospitals in major cities.

Monika Pronczuk and

Global Roundup

Body Tech Fitness gym in Liverpool, England, kept a discreet side door open for members during a shutdown.
Credit…Mary Turner for The New York Times

The first time the police came to the Body Tech Fitness gym in Liverpool, England, it was with a polite warning. But four hours later they were back, and this time in force.

As lunchtime gymgoers worked out, about half a dozen officers, some with Tasers, ordered the closure of the fitness center, which had been deemed in breach of England’s toughest coronavirus restrictions.

But even a show of strength like that doesn’t always work — particularly not in a city like Liverpool. While the main entrance was closed, the gym kept a discreet side door open for members to come in and work out.

But on Friday, in a head-snapping turn of events, the gym will operate legally for the first time in nine days, having forced the authorities into an unlikely retreat.

The Body Tech Fitness saga, with its combination of opaque rule-making, inconsistent enforcement and, ultimately, reversal, is in many ways emblematic of the British government’s overall performance since the outbreak of the coronavirus. Its handling of the pandemic has been in turns hesitant, halting, confused, secretive and contradictory.

That has generated confusion and distrust, along with growing resistance, to the diktats from Westminster. And if there was one place that was not going to suffer quietly, local people say, it was Liverpool, which finds itself in the highest tier of restrictions.

“Historically, we have shown that we are not going to lie down when something is unfair,” said Nick Whitcombe, 29, the owner of the gym, as he celebrated a victory achieved through concerted lobbying of politicians and slick outreach to the media.

The city has not been an easy testing ground for a new system of rules that divides England into three tiers, depending on the seriousness of coronavirus infection rates.

The system has left many frustrated and confused, even as they acknowledge the gravity of the worsening health situation in Liverpool.

In other developments around the world:

  • More than 170 Australians stranded in Britain will return home on Friday on a government-chartered repatriation flight. Upon arrival, they will be transferred to an isolation facility to quarantine for 14 days. The flight is the first of eight that will bring back up to 1,315 Australians from Britain, India and South Africa. More than 30,000 Australians are stranded abroad. Many have been trying to return for months but have faced difficulties because of caps on international arrivals imposed by the government.

  • In Spain, the regional authorities in Madrid will reintroduce lockdowns on Monday around 32 specific areas of the city where the rate of infections has been spiraling. As of Saturday, people in Madrid will be prohibited from gathering between midnight and 6 a.m. with people who do not live under the same roof. These rules replace a travel ban for Madrid residents. In the eastern region of Valencia, the authorities have ordered a curfew from midnight to 6 a.m., which will remain in force at least until Dec. 9. The central government is studying whether to reintroduce a nationwide state of emergency, which would supersede the mosaic of regional and local rules that have recently come into force.

  • Two senior Palestine Liberation Organization officials tested positive for the coronavirus on Thursday, as the virus spread among the Ramallah-based Palestinian leadership. Azzam al-Ahmad and Ahmad Majdalani, members of the P.L.O. Executive Committee, tested positive before a meeting with Mahmoud Abbas, the president of the Palestinian Authority, who is in his 80s, Mr. Majdalani said. Mr. al-Ahmad, in his 70s, and Mr. Majdalani, in his 60s, entered isolation after receiving the results and did not attend the meeting with Mr. Abbas. Saeb Erekat and Hanan Ashrawi, two other members of the executive committee, also tested positive for the virus this month. Mr. Erekat, who was hospitalized in Jerusalem on Sunday, is on a ventilator and is in critical but stable condition, according to the hospital.

  • Residents of Belgium will not be able to attend sporting events, theme parks will be closed, and cultural events will be limited to 200 people, the prime minister, Alexander de Croo, announced at a news conference on Friday. The measures will be re-examined Nov. 19. The restrictions come a week after Belgium shut all restaurants, bars, and cafes, and limited close social contacts to one person outside a household.

Mules carried empty gas cylinders on a path earlier this year near Namche Bazar, in the Everest region.
Credit…Prakash Mathema/Agence France-Presse — Getty Images

The Nepali government has temporarily suspended trekking and access to Mount Everest, the world’s highest mountain, and other mountains in Solukhumbu District after an 80-year-old local man tested positive for the coronavirus.

“Trekking and mountaineering in Everest region have been suspended for now to prevent the spread of virus,” Laxman Adhikari, a village chief of the Everest region, said in a telephone interview. “We cannot say how long it will be suspended.” The infected man is a politician from Namche Bazaar, a town in the Solukhumbu District.

For decades tourists and adventurers from around the world have been visiting Everest — even at the relatively low base camp — to fulfill an intensely personal, and expensive, quest to test extremes. In March, Nepal suspended trekking and mountaineering when the pandemic hit. After six months the country started welcoming back foreign and domestic tourists willing to climb Mount Everest, a significant source of revenue for Nepal.

Mr. Adhikari said that, after the news of the man’s infection, locals started denying accommodation to trekkers and that the authorities had collected swabs of 100 people in the area, fearing the virus had already spread. Flights to the area have also been suspended for now.

The broader route which was shut by authorities takes trekkers and mountaineers to the Everest base camp. Mr. Adhikari said fewer than 100 foreign tourists, including a 19-member team from Bahrain, had reached the Everest region in recent weeks.

Nepal, a country of 30 million people sandwiched between India and China, is enmeshed in a public health crisis over the virus. As of Friday, Nepal has more than 153,800 infections and 829 deaths, according to health authorities. Health experts have been warning that the Nepali government isn’t conducting enough high-quality testing to allow for measures to keep the virus from spreading.

Evetta Applewhite was laid off from two jobs when the Covid-19 pandemic arrived
Credit…Derek Gee/Buffalo News

The New York Times partnered with 11 newsrooms across the country to bring readers the stories of Americans laid off amid the pandemic. Among them: Evetta Applewhite, 39, a former legal assistant trainer from Buffalo, who shares her experience below.

The day I got laid off, in March, I was supposed to have an 11 a.m. training. All of a sudden an 11 a.m. conference call popped up on my calendar instead. I knew a bunch of people were on this call because as I was dialing in, the line kept chiming: boop, boop, boop. And then the HR manager said that, due to everything that’s going on, everyone on the call was being laid off.

I sat back and I cried. I was 39 years old, working as a trainer at a law firm, training legal secretaries and paralegals. I was finally where I wanted to be. Then I was torn right back down again. I felt the law firm threw me away this spring.

Rent still needed to be paid. But who wants to go back to working two or three jobs when you have a child at home? So my path forward was to figure something else out. And I never want to be laid off from another job. Going back to a company is not for me, period.

I’m going to school to be a small business consultant. I’m also taking evening classes to get my real estate license. And I started working with a real estate office for a few hours each day, but I’ve been driving for Uber, too.

Losing my job at the law firm did something to my ego. I started to feel like I was done. But then I imagined my child having to tell someone that his mom “was.” And I couldn’t be a past tense in his life.

I’m not struggling to pay my bills. I saved when I was on unemployment, and there are other things I can do if I need to. Believe me when I tell you I have plans “B” through “Z.”

— Interview by Caitlin Dewey, Buffalo News

The president’s unpopularity in New York City led to his surname being stripped from some building exteriors.
Credit…Chang W. Lee/The New York Times

In the final weeks of the presidential race, President Trump cannot seem to stop harping on New York City.

“Look at what’s happened to New York, it’s a ghost town. It’s a ghost town,” he said at the debate on Thursday night. “For so many years I loved it, it was vibrant. It’s dying, everyone is leaving New York.”

For the president, belittling New York seems to serve two purposes: It appeals to his base as a campaign strategy, and allows him to address personal scores with his foes.

While many New Yorkers feel that Mr. Trump has turned his back on the city, the feeling is mutual with Mr. Trump. The city overwhelmingly voted for Hillary Clinton in 2016. There were protests when he returned to Trump Tower. His name was stripped from skyscrapers.

Democratic prosecutors in New York are digging into his family’s finances, and Democratic leaders, like Gov. Andrew M. Cuomo and Mayor Bill de Blasio, frequently accuse him of betraying his hometown.

The president is now balking at granting New York more coronavirus recovery funds, despite entreaties from Representative Peter T. King to reconsider. But the constant taunting from Mr. Cuomo and Mr. de Blasio — including painting “Black Lives Matter” on the street in front of Trump Tower — does not help, Mr. King said.

In May, Mr. Trump said that he would visit New York City, where more than 20,000 people have died from the coronavirus, “when things calm down.” He has not done so.

Jesse Garcia, a county Republican leader on Long Island, said Mr. Trump had shown his love for the city by providing relief funds through the $2 trillion CARES Act in March and sending the Navy hospital ship U.S.N.S. Comfort to the city, along with the Army Corps of Engineers.

Disinfecting a hall to protect against the coronavirus in Pyongyang, North Korea, this week.
Credit…Cha Song Ho/Associated Press

North Korea urged its people to stay indoors this weekend with their windows shut because “yellow-dust” storms blowing in from China may help spread the coronavirus.

Yellow dust storms have been a recurring curse for Koreans for years, with many people complaining of burning eyes and sore throats and resorting to wearing masks when going outside. But the North’s main state-run newspaper, Rodong Sinmun, said on Thursday that North Koreans should be more vigilant this year.

“Given the fact that the coronavirus continues to spread around the world and given data suggesting that malicious viruses may spread through air, we need to deal with yellow dust with more vigilance and thorough countermeasures,” the newspaper said.

It urged North Koreans to refrain from leaving homes or traveling, to wear masks and to keep their windows shut.

In South Korea, where people also guard against yellow dust, health officials did not suggest a link between the dust and the virus.

The subject of airborne transmission of the virus has been fraught. In the United States, the Centers for Disease Control and Prevention has said that the coronavirus is most often spread through close contact, not airborne transmissions. “There is no evidence of efficient spread (i.e., routine, rapid spread) to people far away or who enter a space hours after an infectious person was there,” the agency says.

But North Korea has taken more aggressive measures against the virus than most other countries, shutting down its borders since January. In February, it said it was studying water samples from rivers, streams and lakes because it was hard to predict how the virus spread. The C.D.C. says it is not aware of any scientific reports of the virus spreading to people through lakes, oceans or rivers.

North Korea claims it has not found any cases of coronavirus in the country, though outside experts remain skeptical.

The Italian rapper and performing artist known as Myss Keta poses in front of a toy store in Milan this month.
Credit…Fabio Bucciarelli for The New York Times

When the pandemic first hit Italy and masks became scarce, Myss Keta, the mysterious Queen of the Milan Night, came to the rescue. The Italian rapper, performance artist and L.G.B.T.Q. icon had amassed a vast collection of face coverings that she wore for years to hide her identity. So she began distributing them to her friends in need.

“I had so many,” she said. “Surgical, cloth, vinyl, silk, whatever material.”

This month, with a second wave of the coronavirus rising and Italy requiring the wearing of masks in public at all times, grandparents, politicians, middle-management businesspeople, doctors, lawyers, delivery people — just about everyone — is covering up. That has rendered Myss Keta — whose use of masks took her from underground clubs to the cusp of national, if incognito, celebrity — an improbable authority on life behind the surgical veil.

It has also threatened to strip her of her defining shtick.

“Before, it was a distinguishing characteristic. Now, it’s something we all have in common,” she said as she lifted a black surgical mask — the casual black T-shirt of her vast collection — to sip a Bloody Mary at Bar Basso in Milan. Under her trademark blond bangs, her eyes remained covered as usual in dark Givenchy sunglasses.

It used to be only the front-row fans at her concerts who emulated her by wearing masks. “Now, everyone seems like a Myss fan,” she said.

Reporting was contributed by Michael Levenson, Sheila Kaplan and Gina Kolata.

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