As the number of U.S. coronavirus cases topped 3.5 million on Wednesday, more states, cities and major retailers turned to face mask mandates to try to stem the spread of COVID-19.

Increasingly seen as a last hope to slow soaring infection rates across the country, Alabama, Montana and the city of Tulsa on Wednesday moved to make face coverings required in public settings, the Washington Post reported. Several large retailers also joined the trend: Walmart, Kroger and Kohl’s.

Until now, only a handful of national retailers, including Costco, Apple and Best Buy, had instituted blanket policies requiring masks at all of their stores, the newspaper said.

“Workers serving customers should not have to make a critical decision as to whether they should risk exposure to infection or lose their jobs because a minority of people refuse to wear masks in order to help stop the spread of the deadly coronavirus,” the National Retail Federation trade said in a statement.

“Shopping in a store is a privilege, not a right. If a customer refuses to adhere to store policies, they are putting employees and other customers at undue risk,” the statement added, the Post reported.

The new restrictions suggest that officials and business leaders across America are painfully aware that cases have spiked in 41 states over the past two weeks and things will only worsen if nothing is done, The New York Times reported.

Still, Georgia Gov. Brian Kemp went against the tide and nullified all local mask mandates on Wednesday, the Post reported.

Local officials who had issued mask mandates as hospitals filled up across the state were outraged by the move, the newspaper said. On Wednesday, Georgia recorded it second-highest number of coronavirus cases since the start of the pandemic, with 3,871 new infections reported.

Kemp’s office emphasized that the governor is still asking the state’s residents to voluntarily wear masks.

In a move that could complicate the gathering of hospital data on COVID-19 hospital patients, the Trump Administration on Tuesday stripped the country’s leading public health agency of the ability to collect hospitalization data on COVID-19.

Instead of patient information going to the U.S. Centers for Disease Control and Prevention, it will now be sent to a central database in Washington, the Times reported. The unprecedented move has alarmed health experts who fear the data will be politicized or withheld from the public, the newspaper said.

States roll back reopening plans as cases surge

Meanwhile, states continued to try to rein in surging case counts. California and Oregon rolled back their reopenings on Monday, two of several states across the country that are seeing spikes in cases.

More than 900 U.S. coronavirus deaths were reported on Tuesday, including single-day records in Alabama, Florida and Utah, the Times reported.

On Wednesday, Florida surpassed 300,000 confirmed cases, according to a Johns Hopkins University tally. The state is now third in case counts, behind California and New York.

Florida took more than three months to reach 100,000 coronavirus cases, but then took just two weeks to jump to 200,000, CBS News reported. Gov. Ron DeSantis said in a news conference Wednesday said the state is doing roughly 90,000 tests per day but the results were taking too long to process.

“One thing that I think is clear is that we need to get these testing results back in a timely fashion,” DeSantis said. He added that the state would be shifting business away from commercial labs that have not been able to return test results in 48 hours, as originally agreed upon when testing was expanded in the beginning of May, the newspaper said. Contact-tracers have also said delays in testing results are making their jobs more difficult.

Meanwhile, signs of new trouble are emerging in regions outside current hotspots: Twenty states and Puerto Rico reported a record-high average of new infections over the past week, the Post reported. In the Midwest, cases have been trending upward in every state except Nebraska and South Dakota.

Adding to the problem, long delays in testing are hampering efforts to contain future spread of the coronavirus, the Post reported. Many testing sites are struggling to provide results in five to seven days. Others are taking even longer, the newspaper reported, as outbreaks across the Sun Belt have strained labs beyond capacity.

Hospitals filling up

The case spikes are resulting in another grim fact: Hospitals across the South and West are being flooded with COVID-19 patients and are having to cancel elective surgeries and discharge patients early as they try to keep beds open, the Times reported.

In Miami-Dade County, Fla., six hospitals have reached capacity as virus cases spike. In response, Miami Mayor Carlos Gimenez rolled back reopening plans by imposing a curfew and closing restaurants for indoor dining, the Times reported.

“We’ve definitely had a sharp increase in the number of people going to the hospital, the number of people in the ICU, and the number of people on ventilators,” he told the Times. “We still have capacity, but it does cause me a lot of concern.”

To try to address the shortage of beds in Texas, Gov. Greg Abbott has ordered an increase in hospital bed capacity in nearly 100 counties, extending a ban on elective procedures to new corners of the state, the Times reported.

Even though regular wards are being converted into intensive care units and long-term care facilities are being opened for patients too sick to go home, doctors say they are barely managing, the newspaper said.

“When hospitals and health care assistants talk about surge capacity, they’re often talking about a single event,” John Sinnott, chairman of internal medicine at the University of South Florida and chief epidemiologist at Tampa General Hospital, told the Times. “But what we’re having now is the equivalent of a bus accident a day, every day, and it just keeps adding.”

Staffing shortages

While hospital beds are easily converted for ICU use, the more difficult challenge is having enough advanced practice nurses who are qualified to care for such patients and equipment such as ventilators, hospital experts told the Times.

Hospitals can “pivot enough space,” Jay Wolfson, a professor of public health at the University of South Florida, explained. “The trick is going to be staffing. If you get people burned out, they get sick, then you lose critical care personnel.”

Beds aren’t the only thing hospitals are running out of now: Some states have ordered refrigerated trucks, to increase morgue space, the Times reported. In Texas, officials said the trucks were being readied because hospital morgues were filling up. In Arizona, two hospital systems in Maricopa County, which includes Phoenix, also plan to use refrigerated trucks. The mayor of Phoenix said Tuesday that the county morgue is close to capacity.

Medical supplies are also running short: Roopa Ganga, an infectious disease specialist at two hospitals near Tampa, told the Times that they lacked sufficient supplies of the COVID-19 medication remdesivir, forcing her to choose which patients need it the most. Patients were also being discharged “aggressively,” sometimes returning in worse shape a few days later.

“About five people came back in one week last week,” she said. “That is making me feel like, you know, you got to slow down.”

By Thursday, the U.S. coronavirus case count passed 3.5 million as the death toll passed 137,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Thursday were: New York with over 408,700; California with over 355,000; Florida with over 301,800; Texas with over 295,000 and New Jersey with over 178,000.

Nations grapple with pandemic

Elsewhere in the world, the situation remains challenging.

Even as the pandemic is easing in Europe and some parts of Asia, it is worsening in India. A record 606 deaths were reported on Thursday, along with 32,695 new infections, the Post reported. The number of cases detected since the pandemic began is rapidly approaching 1 million, though shortfalls in testing mean that number is widely thought to be an undercount, the newspaper said. Only the United States and Brazil have higher caseloads.

About a dozen Indian states have re-instituted lockdowns in high-risk areas, the Associated Press reported. Two weeks after welcoming back travelers, the country is seeing an influx in new cases and has enacted a nightly curfew. India now has over 968,000 infections, a Johns Hopkins tally showed.

Brazil has also become a hotspot in the coronavirus pandemic, with nearly 2 million confirmed infections by Thursday, according to the Hopkins tally. It has the second-highest number of cases, behind only the United States.

Cases are also spiking wildly in Russia: As of Thursday, that country reported the world’s fourth-highest number of COVID-19 cases, at more than 751,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 13.5 million on Thursday, with nearly 585,000 deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.