Attorney General Merrick B. Garland directed prosecutors on Wednesday to prioritize the prosecution of federal crimes on commercial aircraft, as millions of travelers make their way across the United States for Thanksgiving, the most traveled holiday in the country.
As travel in the United States nears prepandemic levels, the federal government has ramped up prosecution of crimes on flights, especially by passengers refusing to abide by Covid protocols. In some cases, passengers have assaulted or threatened flight attendants.
Federal law prohibits assaults, intimidation and threats of violence that interfere with workers on flights, as well as other criminal acts that can occur during a flight.
“Passengers who assault, intimidate or threaten violence against flight crews and flight attendants do more than harm those employees; they prevent the performance of critical duties that help ensure safe air travel,” Mr. Garland said in a statement on Wednesday.
In the last year, there have been 5,338 unruly passenger reports, and 3,856 were mask related incidents, according to the Federal Aviation Administration.
Historically, the F.A.A. has handled these cases with civil penalties, warning notices and counseling. However, under the current zero-tolerance policy toward unruly passengers established in January, the F.A.A. has opted to charge an unruly passenger with civil penalties. A passenger can be fined up to $37,000 per violation, and can be cited for multiple violations at a time.
Canada’s health regulator on Wednesday granted full approval for Johnson & Johnson’s single-dose vaccine, making Canada the first nation to do so.
The decision was made after a third phase of a study showed the shot was 85 percent effective in preventing severe disease and, starting 28 days after vaccination, from death.
“Today marks the first major regulatory approval for the Johnson & Johnson Covid-19 vaccine and an important moment to recognize the dedication of everyone involved in our Covid-19 vaccine development, our partners, the regulators and clinical study participants,” said Paul Stoffels, the company’s chief scientific officer.
Use of the Johnson & Johnson vaccine in the United States has not been as widespread as that of the Pfizer-BioNTech or Moderna vaccines, and studies have found the Johnson vaccine provides less protection than the other two. In April, use of the vaccine came to a sudden halt after U.S. health agencies called for a brief pause so they could study a rare blood-clotting disorder that emerged in six recipients.
The Food and Drug Administration authorized Johnson & Johnson booster shots last month, despite concern among the F.D.A.’s expert advisory panel that data in the company’s application was limited and wasn’t independently verified.
Some F.D.A. experts and committee members argued that recipients of the Johnson & Johnson vaccine needed an additional shot to bolster against severe Covid-19, since that vaccine was less effective than those of Moderna and Pfizer-BioNTech.
The F.D.A. discussed data with the committee showing that Johnson & Johnson’s vaccine was only roughly 70 percent effective against hospitalization, compared with around 90 percent for the Moderna and Pfizer shots. But other data, including from a study of nearly nine million people in New York State, found better results from a single dose of Johnson & Johnson’s vaccine, including for older Americans, by offering durable protection.
Johnson & Johnson doses have been distributed abroad through Covax, the global vaccine-sharing program, in an effort to bolster immunity in poorer countries, including many in Africa.
Many of those shots have been provided through a deal reached in May, under which Johnson & Johnson agreed to sell about 200 million doses to Covax at a discounted rate. Last week, Secretary of State Antony J. Blinken said that the United States had negotiated a deal to ship additional doses of the vaccine overseas, to help people living in conflict zones.
Hospitals in Massachusetts will cut back on nonurgent scheduled procedures starting on Monday because of staffing shortages and longer patient hospital stays, according to the state’s health authorities.
Coronavirus cases have been rising in Massachusetts for several weeks, but hospitalizations have risen at a lower rate. The pressure on hospitals relates to other consequences of the coronavirus pandemic, the authorities said.
The staffing shortage, largely driven by the pandemic, has contributed to the loss of approximately 500 medical, surgical and I.C.U. hospital beds in Massachusetts, according to the state. And hospitals are seeing an influx of patients who need more complex treatment for health issues because they delayed visiting the doctor when Covid cases were higher.
The order, issued on Tuesday, applies to hospitals that have less than 15 percent of beds available, and applies only to procedures that are scheduled in advance and can be delayed without having a negative effect on patients’ health. It does not apply to urgent and essential procedures.
The authorities said the order would help prepare for the annual increase in hospitalizations typically seen after Thanksgiving and through January.
Marylou Sudders, the state’s secretary of health and human services, said in a statement on Tuesday: “Covid hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the health care system face remain, and this order will ensure hospitals can serve all residents, including those who require treatment for Covid-19.”
In Massachusetts, new cases have risen from an average of about 1,300 early this month to more than 2,800, and hospitalizations are up 47 percent over the past 14 days, according to a New York Times database. As of Wednesday morning, 740 people were hospitalized for Covid-19, according to the Massachusetts Department of Public Health.
State officials worked with the Massachusetts Health & Hospital Association to develop the guidelines. Dr. Eric Dickson, the board chair of the association and the president and C.E.O. of UMass Memorial Health, said in a statement: “While we recognize that delaying some prescheduled surgeries may present a significant hardship for patients, we believe it is a necessary step to assure that all of the Commonwealth’s hospitals can continue to meet the needs of patients requiring emergency care.”
Some Republican state lawmakers in Washington State are suing Democratic leaders in the Legislature over a rule barring unvaccinated people from entering the statehouse.
Since October, the Washington State House of Representatives has not allowed representatives and constituents that have not been vaccinated against the coronavirus into the Capitol building based on a set of interim operation rules.
But last week, Bernard Dean, the chief clerk of the House of Representatives, emailed the members of the State Legislature to say that the rules would become permanent for the 2022 legislative session, with some added requirements.
The new rules say representatives who do not verify their vaccination status must get tested for Covid-19 three times a week in order to work in their on-campus offices. The plan also requires members of the public to show proof of vaccination or a negative coronavirus test taken within 72 hours in order to sit in the House gallery that overlooks the lawmakers as they work.
Gov. Jay Inslee’s vaccination proclamation, which went into effect in October, did not require elected officials to get the vaccine, but it did recommend that governmental bodies adopt their own vaccine requirements.
The lawsuit was filed Monday in Thurston County Superior Court by six G.O.P. representatives — Jim Walsh, Robert Sutherland, Jenny Graham, Rob Chase, Bob McCaslin and Jesse Young — and citizens from their districts.
It called the Legislature’s ban on the unvaccinated “an underhanded method used by a few tyrannical members to impose Governor Inslee’s mandate on a legislative body specifically exempt from the mandate,” the lawsuit filed on Monday read.
The speaker of the house, Laurie Jinkins, a Democrat, dismissed the lawsuit as a meritless political grandstanding in a statement on Tuesday.
“Once again, certain members of the House Republican Caucus are choosing to engage in performative stunts for media attention rather than modeling public health best practices to keep fellow lawmakers, legislative staff, and the public safe from a highly contagious virus,” she said.
The legislative session begins Jan. 10.
Olaf Scholz, the incoming Germany chancellor, and his partners in the country’s new coalition government will face a slate of pressing issues, including how to manage relations with China and the United States, and how to address climate change.
But at the top of the agenda is the worrisome spike in Covid cases that has thrust the country into its worst crisis since the pandemic began nearly two years ago.
In the last week, virus cases have increased by 79 percent from the average two weeks ago, while deaths have increased by 60 percent. November has seen the highest average cases since the start of the pandemic.
A number of factors are driving the new surge, including colder temperatures, a slow rollout of boosters and escalating infections in neighbors like the Czech Republic. Most important, though, is the continued resistance to vaccination, especially in the former Communist east.
About 68 percent of the German population is fully vaccinated — one of the lowest rates in Western Europe. In the eastern state of Saxony, which has seen violent anti-vaccination protests, just under half of residents have rejected vaccination. Among all German states, Saxony has the lowest vaccination rate — and the highest per capita number of new infections.
On Wednesday, Mr. Scholz and his coalition partners — from the progressive Greens and the pro-business Free Democrats — stepped in front of the cameras to announce a 177-page governing deal they have negotiated under strict secrecy since the Sept. 26 election. Mr. Scholz started with the pandemic.
“Corona is still not defeated,” Mr. Scholz said. “Intensive care wards in some places are reaching their limit. The situation is serious. The future government, along with the states, has initiated decisive steps to rein in infections.”
The new government will institute a permanent Covid crisis committee inside the chancellery as well as a panel of experts who will give Mr. Scholz daily updates on the pandemic. He also plans to make a billion euros available for bonus payments to workers in hospitals and nursing homes.
In recent weeks, the incoming government had sent decidedly mixed signals — allowing emergency powers for the pandemic to expire, ruling out another lockdown and playing down the latest wave.
But after reports of ambulances driving Covid patients from overfilled hospitals in Bavaria to northern Germany and even Italy to have them treated, the incoming coalition hastily reworked a draft law and added a raft of tougher measures states could impose.
Those steps included vaccine mandates for people in certain high-risk jobs, mandatory tests in nursing homes and a vaccine or test requirement for those riding public transport or using a shared work space.
In the four months since Prime Minister Boris Johnson took a gamble by lifting virtually all of England’s coronavirus restrictions, his country has settled into a disquieting new normal: more than 40,000 new cases a day and a thousand or so fatalities every week.
Yet those grim numbers have put Britain “almost at herd immunity,” one of the government’s most influential scientific advisers said this week — a much-discussed but elusive epidemiological state that some experts say could leave the country well placed to resist the fresh wave of infections now sweeping across continental Europe.
The comments, made in an interview by Neil Ferguson, an epidemiologist at Imperial College in London — whose projections about the pandemic have often swayed government policy — are likely to revive the debate about Britain’s status as a Covid outlier: a country willing to tolerate a widely circulating virus and a steady death toll as the price of a return to economic normalcy.
They may also touch a nerve in a nation where herd immunity has been a fraught concept since it was raised by Patrick Vallance, England’s chief scientific adviser, in March 2020 as the virus was first bearing down on Britain. His openness to the advantages of herd immunity provoked such a backlash that, ever since, the government has rejected any suggestion that it embraces such a strategy.
Speaking to a group of international reporters on Tuesday, Professor Ferguson said he expected Britain to mostly avoid the spike in cases seen on the continent in recent weeks. This was in part, he said, because so many Britons had been infected since the lockdown was lifted in July, giving the population as a whole greater immunity.
Other public health experts are skeptical of Professor Ferguson’s theory, not least because Britain’s high infection rate suggests there is still a large number of people with little or no immunity. They say it also does not take into account other factors, like new variants or waning protection from vaccines.
ROME — Trying to stem a resurgence in coronavirus infections and prevent closures affecting everyone, Italy announced new restrictions for the unvaccinated on Wednesday, barring them from dining indoors in restaurants and bars; attending shows, sport events and public ceremonies; and entering nightclubs.
“We want to be very cautious,” Prime Minister Mario Draghi of Italy said at a news conference on Wednesday. “We want to keep this normality.”
The decision came after presidents of the most infected Italian regions pressured the government to crack down on the unvaccinated, worried that new lockdowns and restrictions would hamper the economic recovery in a country that imposed Europe’s first lockdown and experienced some of the pandemic’s most devastating consequences.
“I don’t think that anyone prefers a lockdown to different measures for citizens who protected themselves with a vaccine and citizens who chose not to do it,” Giovanni Toti, the president of the northern region of Liguria, said last week. “We have to assure families, citizens and businesses that this country will not close again.”
Starting in the summer, Italy embraced the broad use of a health pass — called the Green Pass — as its primary strategy to fight the virus. People who want access to indoor dining, museums, gyms, theaters and high-speed trains are required to show proof of vaccination, a negative rapid swab test or recent recovery from the virus.
In October, Italy became the first major European country to require the Green Pass for all workers, private and public, to earn their salary.
Italy’s health authorities say the measure has largely pushed Italians to get vaccinated and reduced the severity of the fourth wave as compared with other European countries. But about 13 percent of the country’s adults have still not received a shot.
Under the new restrictions announced Wednesday, the unvaccinated will be barred from a wide range of social activities starting on Dec. 6, and lasting until Jan. 15. But if they have a negative swab test, they will be allowed to go to work.
If further spikes in Italian regions require tougher restrictions, those will apply only to the unvaccinated.
The government extended a vaccination mandate that was already in place for health care workers to schoolteachers and school staff, and to law-enforcement officers. The booster shot will also become compulsory for these categories.
The Green Pass will now also be required to use public buses and regional trains, and to stay in hotels.
Thousands of people gathered at the Circus Maximus in Rome and in Milan last weekend to protest the Green Pass, decrying a “dictatorship.”
But with hospital beds and intensive care units filling up with unvaccinated patients, Italy joined a group of countries that are toughening their approach toward citizens who shun the shot.
Italy’s announcement followed a groundbreaking decision by Austria to impose a lockdown for the unvaccinated, restricting their movement to traveling for work, school, buying groceries and medical care. Last week, Prime Minister Kyriakos Mitsotakis of Greece also announced more restrictions for the country’s unvaccinated, barring them from cinemas, theaters and gyms.
A spokesman for the French government said on Wednesday that the country would tighten its health pass, speed up its vaccination campaign and strengthen social distancing rules.
Constant Méheut contributed reporting from France
Over eight hours last Thursday night and into Friday morning, Representative Kevin McCarthy of California hit on many issues as he spoke on the House floor in an unsuccessful effort to thwart House passage of President Biden’s social safety net and climate change bill. But among his most audacious assertions was that Mr. Biden was to blame for the country’s failure to quell the pandemic.
Mr. McCarthy used this line of attack even as members of his own Republican Party have spent months flouting mask ordinances and blocking the president’s vaccine mandates, and the party’s base has undermined vaccination drives while rallying around those who refuse the vaccine. Intensive care units and morgues have been strained to capacity by the unvaccinated, a demographic dominated by those who voted last year for President Donald J. Trump.
Yet Mr. McCarthy, the House Republican leader, pressed his point: “I took President Biden at his word; I took him at his word when he said he was going to get Covid under control,” he declared in the dead of night. “Unfortunately, more Americans have died this year than last year under Covid.”
As cases surge once again in some parts of the country, Republicans have hit on a new line of attack: The president has failed on a central campaign promise, to tame the pandemic that his predecessor systematically downplayed. Democrats are incredulous.
Chris Taylor, a spokesman for the Democratic Congressional Campaign Committee, called House Republicans “Covid’s biggest promoter” for “recklessly hand-waving lifesaving vaccines” and for promoting ivermectin, an antiparasitic drug falsely said to cure Covid-19.
The nation’s 14-day average of new infections is up 25 percent, to over 94,000 new cases a day, with the upper Midwest again the hottest of hot spots. At the same time, the efficacy of the coronavirus vaccines is holding, according to the latest data from the Centers for Disease Control and Prevention. Unvaccinated people are 5.8 times as likely to test positive than fully vaccinated people, and 14 times as likely to die if infected.
The partisan gap in infection and vaccination rates is only slightly narrowing. The most Republican counties have 2.78 times as many new cases than the most Democratic counties, down from three times as many a month ago, according to the Democratic health care analyst Charles Gaba, using data from Johns Hopkins University. The death rate in those Republican counties is nearly six times as high as the death rate in the Democratic counties.
The burden on national health systems in Europe from Covid will be “very high,” in December and January unless governments ramp up prevention efforts, the European Center for Disease Prevention and Control warned on Wednesday.
European governments should accelerate their vaccination rates, administer booster shots and reintroduce restrictions, Andrea Ammon, the E.C.D.C. director said in a statement. “And all those three things have to be done now,” she said. “This is not pick and choose.”
About 66 percent of the European Union’s total population has been fully inoculated, according to the E.C.D.C. data. This leaves “a large vaccination gap that cannot be bridged rapidly and gives ample room for the virus to spread,” Ms. Ammon said.
Recommended restrictions could include wearing face masks, working from home, keeping a safe distance and reducing social interactions. Lockdowns are like an “emergency brake,” Ms. Ammon said, used when “you want to bring down a very high case number in a short period of time.”
Asked whether seasonal festivities should be canceled, Ms. Ammon replied: “We still have some time until Christmas. But if the situation doesn’t get better, it might mean that these measures should be taken over Christmas as well.”
On Wednesday, Italy announced new restrictions for the unvaccinated, barring them from dining indoors in restaurants and bars; attending shows, sport events and public ceremonies; and entering nightclubs.
The E.C.D.C. also recommended that booster doses should be “considered” for all adults, with a priority given to those above 40 years old. On Tuesday, Italy allowed vaccinated people to get a booster shot five months after the second shot of their initial vaccination. On Wednesday, Portugal’s health secretary said the country would give booster shots to a quarter of its population by the end of January, Reuters reported.
Europe has seen a sharp spike in the number of new infections, hospitalizations and deaths in recent weeks, prompting governments to impose new restrictions, including a lockdown in Austria, one of the first in Western Europe since vaccines became available.
Over the weekend, tens of thousands of Europeans across the continent protested, sometimes violently, against vaccine mandates and new restrictions, and on Wednesday, more than 1,000 people protested in the Ukrainian capital, Kyiv, according to The Associated Press.
The coronavirus pandemic has made women feel more vulnerable to abuse, sexual harassment and violence, which is in turn harming their mental health and emotional well-being, according to a report by U.N. Women, a United Nations organization dedicated to gender equality.
Forty-five percent of women surveyed in 13 countries reported that they or a woman they knew had experienced a form of violence since the start of the pandemic, and the women who said this were 1.3 times more likely than the others surveyed to report greater mental and emotional stress.
The surveys defined violence against women to include physical abuse; verbal abuse; the denial of basic needs like health care, food and shelter; the denial of communication with other people, including being forced to stay alone for long periods of time; and sexual harassment.
The countries surveyed were Albania, Bangladesh, Cameroon, Colombia, Ivory Coast, Jordan, Kenya, Kyrgyzstan, Morocco, Nigeria, Paraguay, Thailand and Ukraine. U.N. Women said that the countries had been selected based on regional diversity, with priority given to low- and middle-income nations that were implementing the organization’s programs.
The report was released ahead of the International Day for the Elimination of Violence Against Women, which falls on Thursday and begins an annual 16-day campaign of activism against gender-based violence.
Among the report’s findings:
Four in 10 women said they felt more unsafe in public spaces.
One in four said that household conflicts had become more frequent, and the same proportion felt more unsafe in their home.
Seven in 10 said that they thought verbal or physical abuse by a partner had become more common.
Six in 10 said they thought sexual harassment in public had worsened.
Three in 10 said they thought that violence against women in their community had increased.
“The Covid-19 pandemic, which necessitated isolation and social distancing, enabled a second, shadow pandemic of violence against women and girls, where they often found themselves in lockdown with their abusers,” said Sima Bahous, the executive director of U.N. Women and a former Jordanian ambassador. “Our new data underlines the urgency of concerted efforts to end this.”
Since the first doses of Covid vaccines arrived in New Mexico last December, Uri Bassan, a pharmacist, has traveled the state to bring vaccines to those hardest to reach; nearly a quarter of the population lives in rural areas.
From the desert plains of the southeast to the snow-covered northern mountains, Mr. Bassan and a team of Medical Reserve Corps volunteers set up mobile clinics in all kinds of places — fire stations, motels, even his own backyard. Between December 2020 and May of this year, Mr. Bassan and his team logged more than 19,000 miles to administer 41,794 vaccines.
Now, with the state’s seven-day average of new cases up by 90 percent since October, he is rushing back into the fray, administering as many as 700 shots at a single event. “To me, it feels like the beginning all over again,” he said.
Despite improvements in the vaccine distribution infrastructure, Mr. Bassan said, the need is overwhelming. “We used to take the kids to the zoo in the minivan, with the strollers and the diaper bag,” said Mr. Bassan, a father of four. “Now the minivan has turned into a cargo van — it’s full of containers and syringes and Band-Aids.”
Lalisa Manoban, a global megastar who performs as Lisa in the K-pop group Blackpink, tested positive for the coronavirus on Wednesday, her production company announced.
The other members of Blackpink — Jennie, Jisoo and Rosé — all tested negative for the virus, the production company, YG Entertainment, said in an emailed statement on Thursday. The band’s production staff, security personnel and acquaintances have also tested negative, YG said, adding that all four members of the group had been vaccinated against Covid-19.
As of Thursday morning local time, Ms. Manoban, 24, had not addressed her nearly 68 million Instagram followers on the positive test. But YG said she was “without symptoms and in very good condition.”
A Thai-born singer and rapper, Ms. Manoban is among the most acclaimed faces of K-pop, with legions of fans. She is part of K-pop’s most globally successful all-female group, whose fame and commercial success have traveled far beyond South Korea. Five of Blackpink’s videos have been watched more than one billion times on YouTube, including 1.7 billion views for “DDU-DU DDU-DU.”
Ms. Manoban’s debut solo album, “Lalisa,” was released on Sept. 10; her first single, “LALISA,” set a YouTube record for the most-viewed music video by a solo artist in 24 hours with 73.6 million views, dethroning Taylor Swift’s “ME!” in 2019.
With strict limits on international travel and consistent masking, South Korea has been among the world’s most successful countries at limiting coronavirus outbreaks, reporting about 3,300 total deaths. Cases have surged to record levels in the past two weeks, reaching a new high of 4,115 new cases on Tuesday, but they have remained relatively low compared to much of the world: currently six daily cases per 100,000 people, compared with 29 in the United States, 35 in Singapore and 158 in Austria.
In today’s edition of the Morning newsletter, David Leonhardt explains rapid Covid-19 tests, which have not been as readily available in the U.S. as they have elsewhere around the world. He writes:
If the U.S. government had done a better job making rapid Covid-19 tests available, the advice for how to use them this holiday weekend would be easy: Take one at the start of every day when you planned to spend time with people outside your household.
That approach is possible in other countries. In Britain, pharmacies offer free packs of seven tests that people can take at home. In Germany, rapid tests are also widely available and mostly free. In this country, the situation is different, largely because the F.D.A. has been slow to approve the tests.
The Biden administration has not been as aggressive in fixing the situation as it could have been, but it has made progress. A couple of months ago, tests were often impossible to find. Now, they are sporadically available at many stores. Friends and family around the country have told me this week that they have usually been able to find a test after looking in enough places.
The tests are not free, however. They typically cost about $25 for a pack of two. The combination of their cost and irregular availability means that Americans interested in rapid tests often must make choices about when to use them.
“Rapid tests can help reduce worries about gathering with loved ones for the holidays,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told me. Nuzzo’s immediate family plans to take tests on Thanksgiving, before going over to their hosts’ for the meal. So do I.
Even with the limitations of rapid testing in the U.S., the tests can play an important role in slowing the spread of the virus. And the situation does seem to be improving. The F.D.A. approved three more tests this week, and the Biden administration continues to spend more to expand their availability.
By Christmas and New Year, tests should be easier to find than they are this week.
After a steady decline since mid-September, coronavirus cases are once again rising in most of the United States. New cases have increased by 25 percent nationally in the past two weeks. In 14 states, cases have climbed by 40 percent or more.
In the largest revision of state vaccination numbers to date, the Centers for Disease Control and Prevention updated those for Pennsylvania, which had counted about 1.2 million more doses than had actually been administered.
The C.D.C. said the data, updated almost every day on its website, had been corrected. As of Tuesday evening, about 81 percent of people in Pennsylvania had received at least one shot of a vaccine, according to C.D.C. data, whereas on Monday the data indicated that about 84 percent of people in the state had gotten a shot.
The agency has been periodically revising vaccination numbers in states since July 14. Altogether, the C.D.C. and the states have reduced the number of reported doses in the U.S. by about 2 million.
The C.D.C. has posted on its website that the revisions are part of a collaboration with states to gather their most “complete and accurate” data. Sometimes the revisions result in more shots being added to a state’s tally. Other times they result in a drop. Illinois, for example, revised its data to add about 316,000 doses in late October only to subtract about 214,000 doses a few weeks later.
Barry Ciccocioppo, communications director for Pennsylvania’s Department of Health, said that the department “continues to update and refine our vaccination data throughout the commonwealth to ensure duplicate vaccination records are removed and dose classification is correct.” He said that the C.D.C. had now begun to “rectify” the data.
“This is not a practice specific to Pennsylvania and the C.D.C. is going through a similar process with other states across the country,” he said.
Cindy Prins, a professor of epidemiology at the University of Florida, said she feared that people might jump to the conclusion that there were deliberate errors in the initial reporting, but she did not believe that was the case. “I think it’s just a process of cleaning up and making sure what is in there is accurate to the best of our ability to know that,” Dr. Prins said.
Still, without fully accurate and up-to-date vaccination rates, it would be difficult for counties to make informed health recommendations, she said. If vaccination rates were overreported, that could give counties a false sense of confidence that more people are vaccinated than actually were.
More than 230 million people across the United States have received at least one shot of a coronavirus vaccine, according to the C.D.C. Last week, the agency authorized booster shots for all adults. Across the U.S., Covid-19 infections have been rising, with more than 90,000 cases reported on average each day.