On the day before the US election, the coronavirus pandemic is the worst it has ever been in the country.

Extract from ABC News 

Analysis

By Casey Briggs and Leigh Tonkin

Posted 1hour ago

In the week that voters cast their judgement on the record of the President, the pandemic is, on many measures, worse than it has ever been in the United States.(ABC News: Emily Olson)

The ebbs and flows of the coronavirus pandemic have set the rhythm in the US in 2020, a year that was expected to focus on the race for the White House.

Since the United States recorded its first coronavirus case in January, Donald Trump has declared dozens of times that the virus will simply "go away".

But now, in the week that voters cast their judgement on the record of the President, the pandemic is, on many measures, worse than it has ever been in the United States.

The country has just recorded in a single week the same number of infections that it took three months to accrue at the start of the pandemic.

At least 31 states have set new records for average daily cases in the past week, with some of the worst hit now in the electorally important Midwest and so-called rust belt, and many states are now reimposing restrictions in an effort to reduce the spread.

Many experts are calling it the pandemic's third wave, although given case numbers have remained high since the start, you'd be justified in saying the first wave never ended.

"The metaphor of a wildfire is probably better," said William Hanage, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health, told NBC News.

"It's indisputable that the US is now seeing a pretty widespread transmission across the board."

It couldn't be worse political timing for the President, with opinion polling consistently showing voters do not think he's handled the issue well.

Deaths rates showing signs of growth

America's second virus surge had eased off in August and September, but infections are again sharply climbing.

In the second half of October the United States again took the unwelcome position recording more infections each day than any other country.

The country's seven-day average soared from around 55,000 cases a day a fortnight ago, to around 80,000 a day now.

Hospital admissions have now followed suit and are now climbing dramatically.

That means death rates, which have already shown signs of growth, will likely start to speed up, adding to the more than 230,000 Americans who have already died with COVID-19.

The hotspots have shifted

In the early months of the pandemic the north-east of the country bore the brunt of the virus.

States like New York, New Jersey and Connecticut were rapidly overwhelmed and recorded tens of thousands of deaths.

The second surge took place more in the south of the country, in states with big populations like Florida, Texas and California.

But now, the hotspots have shifted again, with states in the northern half of the country, particularly the Midwest, worst affected on a per capita basis.

North and South Dakota have recorded the most infections per capita of any state in the past four weeks.

The situation is also worsening in Wisconsin, a battleground state in the election.

In fact, the 10 states that have recorded the most infections per capita in the past four weeks are all states won by Donald Trump four years ago.

Navigating the election — and winter

Election week is proving to be a line in the sand for the US for coronavirus as well.

Americans are looking ahead at a long winter of outbreaks, changing restrictions and a mounting death toll.

As Europe moves to a second round of lockdowns to try and stem the tide of illness in the lead up to winter and Christmas, restrictions are being reimposed across many US states.

But there is little consistency in the response across state and city lines, with politics playing a huge part of whether restrictions stick.

Illinois joined states, including Wisconsin and New York, to establish a ban on indoor dining and bar service from last Friday. El Paso, Texas brought in a two-week stay-at-home order.

In Louisiana, a mandatory mask rule and other restrictions brought in by the Governor John Bel Edward were in doubt after legislators used an obscure state law to suspend a public health emergency notice. Restrictions were also overturned by the courts in Wisconsin.

As the country waits for their political leadership for the next four years to be decided, they're also waiting to see what that means for the response of the pandemic — on a state and national level.

But if there is a change in occupancy at the White House, it will be well into the coronavirus winter before Joe Biden takes charge in January.