With help from Myah Ward and Tyler Weyant FAUCI AND BIDEN CAN'T TALK YET — Joe Biden wants Anthony Fauci to play a leading role in his administration’s response to the coronavirus pandemic. But he and his transition advisers are staying away from the nation’s top infectious-disease expert for now. President Donald Trump’s refusal to concede the election means that officials at the FDA, CDC and NIH cannot legally speak with Biden’s advisers about the progress of vaccine development, plans for distributing an eventual shot, or testing capacity. THE VIRUS DOESN’T NEED A RECOUNT — Today El Paso County extended an order shutting down its non-essential businesses to Dec. 1. Even as Covid-sickened patients overwhelmed local hospitals and flooded morgues, the original two-week order became embroiled in politics: City leaders said they weren’t consulted on the order and refused to enforce it. Texas’ attorney general Ken Paxton joined a suit against the county order. Finally, on Friday a state judge kept the order in place. An appeals court could yet overturn it. El Paso’s Covid situation in November recalls New York’s situation in April: Hospitals have set up tents in parking lots. They’ve evacuated patients to other cities. The county ran out of morgue space. The public health department reported another 14 deaths and 863 cases today. But this time the virus hasn’t just settled into one isolated hotspot. Covid Exit Strategy’s map shows a sea of dark red across the country, indicating uncontrolled spread in all but three states. In many ways the country is worse off than it was in the spring . Yes, Covid treatments have improved and researchers have figured out more about how the virus spreads. There’s more testing. A vaccine may be around the corner. But the country is entering this new phase with already high transmission levels, so spread is faster. It took just 10 days for the country to get to 10 million Covid cases from 9 million. It took 44 days to get to 2 million cases from 1 million. Like El Paso, cities and towns across the country are facing circumstances that make it harder to combat the virus. The public is weary of stay-at-home orders. There is no new support from Congress for hospitals and businesses affected by closures. Many people remain skeptical of masks, despite new CDC guidance that they also protect the mask-wearer. Winter is around the corner, making outdoor socializing more difficult and bringing holidays when people want to gather. Airlines are no longer blocking off middle seats. In short, there’s more reason to panic, but less panicking. The lack of a national strategy, and sometimes state strategy, is forcing cities and towns to figure things out on their own. Utah Gov. Gary Herbert announced a statewide mask mandate earlier this week, but more than a dozen states still don’t require masks. Nevada’s Gov. Steve Sisolak asked residents Tuesday to stay at home for two weeks and urged cities to step up mask enforcement. The places now being hit aren’t as equipped as bigger cities to deal with the crisis. “El Paso is by far the worst place that I have ever gone,” said one travel nurse who has worked in intensive care units in New York City, California and Florida since March and who didn’t want to give her name because it would jeopardize her job with her agency. The El Paso hospital where she is now stationed does have protective equipment, she said, but it is severely understaffed even with the more than 1,300 personnel the city has brought in from out of state. She will often spend her entire 12-hour shift covered in protective equipment in a room with two patients hooked up to a ventilator without a break to go to eat or go to the restroom, she said. The hospital lacks equipment to monitor patients remotely. About a quarter of the small businesses in El Paso have shut down since March, El Paso mayor Dee Margo told me today. “If you have financial support to subsist with a shutdown, then fine that’s OK,” said Margo. “That’s not occurring now. People are trying to put food on the table, to pay their rent.” The mayor, a former Republican state representative now occupying a nonpartisan office, said he and other city leaders were caught between state and county officials. “We felt like we were in a legal juggling act because the governors’ orders said, ‘No, you can’t do this’; the county judge said, ‘Oh yes I can.’” Rural areas seeing surges for the first time are ill-equipped to deal with rising cases. Already this year 17 rural hospitals have closed, said Alan Morgan, CEO of the National Rural Health Association. Because Covid is now so widespread, health care staff frequently quarantine after coming into close contact with someone who tests positive for Covid, said Darrold Bertsch, CEO of Sakakawea Medical Center and Coal Country Community Health Center in the North Dakota towns of Hazen and Beulah. Plus there’s only one day care in the area. When it closes, health care workers have no place to send their kids. Because of statewide staffing shortages, North Dakota Gov. Doug Burgum is now allowing some nurses who test positive for Covid but are asymptomatic to remain at work. But he’s not mandating masks, which is especially needed in rural areas where people remain skeptical of them, said Morgan and Bertsch. Morgan thought that by the time the virus hit rural areas, the country would be better prepared for the surge it’s now seeing. “When you and both I talked at the beginning of this, I was very careful because I didn’t want to be alarmist,” he said. “In hindsight that was the wrong approach. I should have been an alarmist about this.” The nurse said that despite skyrocketing caseloads, El Paso residents aren’t taking the pandemic seriously enough. This is the first time since March, she said, that she’s been concerned for her own safety. She is considering going back to New York City. Welcome to POLITICO Nightly. Kamala Harris is first vice president-elect to do a victory lap to the beat of Mary J. Blige. Read about what she faces with all of her firsts. Reach out at rrayasam@politico.com, or on Twitter at @renurayasam.
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