The number of reported cases for the virus in the United States surpassed 11 million on Sunday and closed in on a weekly case count of one million.

The vicious second wave of the deadly disease—amid tanking temperatures—has sent hospitalizations and daily reported case counts to figures higher than its peak in the spring, with the country averaging more than 100,000 cases per day for the month of November. The widespread surge in the number of infections has pushed governors across the country to impose strict orders to tame its spread. 

“In 1918, there were two distinct waves of the Spanish virus—and the second one was actually worse than the first,” Kenneth Foard McCallion, healthcare infrastructure expert and author of the new book COVID-19: The Virus That Changed America and The World, said. “Some could say that the first wave really never let up here, but as we’re entering, at least a lot of the states are entering, a cold season, the coronavirus can stay longer on surfaces and as people spend more time in an indoor environment, it’s more likely in a confined space of a transmission.”

While some states have implemented a statewide lockdown like in New Mexico and Oregon, others have ruled for firmer restrictions regarding indoor gatherings, as well as forceful stay-at-home orders.

Michigan Gov. Gretchen Whitmer (D) announced a slew of painful restrictions Sunday, with in-person classes halted for high school and college students, in addition to indoor dining for three weeks. Other indoor places that bring congregation, including movie theaters and casinos, have also received an indoor ban, an order that will take effect on Wednesday. Michigan reached its peak in daily new cases at 6,674 on Nov. 11, according to Johns Hopkins University data, totaling the number of cases to more than 276,000 and roughly 8,300 deaths in the state as of Monday.

“This is the worst public health emergency our nation has faced in over a century, and our response has got to reflect the same level of urgency,” Whitmer said on Sunday when she put out the new restrictions.

In some areas, indoor operations in California and Connecticut have also been prohibited, while Washington Gov. Jay Inslee (D) ordered a block on indoor dining at restaurants and bars, but they will be allowed for limited outdoor dining and carry out service. On Tuesday, fitness facilities and some entertainment businesses will be forced to temporarily suspend indoor activities, but grocery stores will be allowed to operate at a slimmed-down capacity.

In Chicago, a stay-at-home advisory took effect Monday morning, as Illinois ranks in the top five in terms of the number of infections. The state surpassed New York’s case count, reaching more than 575,000 on Monday. Chicago Mayor Lori Lightfoot (D) tweeted Sunday that 1 in 18 Chicagoans “have active COVID-19 infections as of Nov. 13.” Chicago public health officials also urged residents to cancel Thanksgiving celebrations with guests outside of their private households.

The Navajo Nation—boiled by the virus at its onset—also imposed a stay-at-home order for three weeks to keep residents at home as the virus rampages across the country.

New Jersey Gov. Philip D. Murphy (D) lowered the number of people at indoor gatherings from 25 to 10 and outdoor gathers from 500 to 150, as the state closed in on an infectious week, with 3,877 reported cases on Tuesday alone.

“Particularly with the holidays coming up, we’ve got to plead with people to not let their hair down,” Murphy told MSNBC on Monday.

With cases rising in almost every state, some Republican governors and officials have agreed to impose a statewide mask mandate. Gov. Doug Burgum (R) of North Dakota issued a mask mandate late Friday, as well as new limits on indoor dining. The move comes roughly a week after Utah Gov. Gary R. Herbert (R) announced the same face-covering mandate.

“Our hospitals are full,” Herbert said in a video message that also declared several other restrictions. “This threatens patients who rely on hospital care from everything from covid-19 to emergencies like heart attacks, strokes, surgeries and trauma. We must work together to keep infections low until a vaccine is available.”

While a vaccine won’t be widely available to all Americans until the spring or summer, McCallion noted the “only effective weapons” to use against the virus are face coverings and social distancing.

“In the meantime, the only effective weapons that we have are what we have traditionally, which are the wearing of masks in public or in private and social distancing,” McCallion said.

The sweep in infections comes as President Donald Trump hasn’t attended a coronavirus task force meeting in “several months,” according to the nation’s top infectious disease expert, Dr. Anthony Fauci, as election litigation battles have become a top priority for the president. 

With Trump’s neglect to nationally handle the pandemic, it swirls a new urgency for a divided Congress to convene and strike a deal that will help states fund new restrictions set in place, as well as provide aid for Americans who still remain unemployed. 

“If cities and states had the funding, they could provide some economic relief to people that they are urging to stay home or ordering to stay home, quarantine, that would put them at, to the extent it puts them out of work,” McCallion said. “Those families need some economic, obviously needs an economic relief.”

But talks between leaders from both sides of the aisle remain inconclusive as specific language within the next relief bill remains a topic of debate. Congress passed the Cares Act in March that provided temporary aid for states and Americans bubbling in economic turmoil, but most of the programs in the legislation have expired at this point, pushing the country into a seeping economic crisis as it faces a second, 

Rachel Bucchino is a reporter at the National Interest. Her work has appeared in The Washington Post, U.S. News & World Report and The Hill