CNN  — 

America enters the somber holiday weekend following a Thanksgiving Day that saw more than 100,000 new Covid-19 cases and 1,200 deaths – skyrocketing numbers given that 20 states did not report data.

Traditionally the start of a time of shopping and giving, the final days of November have seen record highs in the worsening pandemic – surpassing previous surges and showing no signs of slowing down in the precarious winter months.

“We’re talking about numbers that are approaching what we experienced in the 1918 flu pandemic, except it’s happening over a much shorter period of time,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

“This is going to be very destabilizing for the country, not only in terms of health but also our economy, as well as our homeland security.”

The US on Friday marked the 25th day in a row with more than 100,000 new cases, including cases from states that didn’t report on the holiday. Hospitalizations hit a new high Thursday – for the 17th consecutive day – with more than 90,400 Covid-19 patients nationwide, according to the COVID Tracking Project.

The country’s death toll since the pandemic’s start is now more than 264,000. And nearly another 60,000 people could lose their lives over the next three weeks, according to an ensemble forecast published by the US Centers for Disease Control and Prevention this week.

The number of daily deaths will likely double in the next 10 days, prolonging a sense of loss and isolation in a season traditionally spent with family and friends.

“So, we’ll be seeing close to 4,000 deaths a day, which is how you get another 60,000 deaths in only about 20 days,” Dr. Jonathan Reiner, a professor of medicine at George Washington University, said Wednesday.

Thanksgiving gatherings could fuel the already ferocious surge, officials had warned, urging Americans to avoid travel and celebrate with immediate household members only. Many listened, a poll showed this week, but millions boarded planes across the country since last week.

“In a week, more likely two weeks, we will see a surge upon a surge,” Dr. William Schaffner, professor of infectious diseases at Vanderbilt University, said Wednesday. “We’re in for a tough time.”

Statistics reported in the days right after the holiday will likely show a relative dip in Covid-19 case numbers, followed by a surge. This reflects government agencies’ lag in reporting over the long weekend. And given coronavirus’ incubation time and how long it takes someone to test positive, cases related to Thanksgiving are unlikely to showing in public data until the first full week of December at the earliest.

Projections for the coming weeks may be grim, but it’s not too late for a turnaround.

“It we all got together, wore the masks and did the social distancing, we could bend this curve within two or three weeks,” Schaffner said. “We would see actually transmission go down even before we get to the vaccines.”

Dr. Joseph Varon hugs and comforts a patient in the Covid-19 ICU during Thanksgiving at the United Memorial Medical Center in Houston.

What it would take to turn the tide

While a possible vaccine candidate could soon get the green light, widespread effects of a vaccine are months away. Still, Americans right now have valuable tools that can help.

They are the safety measures touted by officials for months – face masks, social distancing, avoiding crowds and practicing good hygiene, like regular hand washing.

These are simple steps that could make a world of a difference. More than 40,000 lives could be saved over the next two months if 95% of Americans wore face masks, according to projections from the University of Washington’s Institute for Health Metrics and Evaluation.

More local and state leaders have pushed mask orders in the past few weeks in an attempt to curb the spread – including GOP governors who previously resisted similar mandates.

In West Virginia, Gov. Jim Justice has pleaded with residents in recent weeks to wear face coverings, saying masks are “really the only bullet in the gun.”

“If you’re inconvenienced, if you don’t believe in it, please wear it … what’s the downside,” Justice said in a news conference this week. “Look, we’re not one to take anybody’s rights. My good lord, I get it wholeheartedly, we don’t want to do that in any way. But you gotta help me.”

It’s the kind of message that needs to be echoed by local leaders across the country, Dr. Peter Hotez, dean of tropical medicine at the Baylor College of Medicine, told CNN Thursday morning.

“Keep saying it every day and hope that some people actually start to believe it. That’s our only hope at this point. We’ve got to limit those surges, and we need those local leaders to really step up, so this is absolutely vital,” he said.

The hope is to help keep more people alive until a vaccine, he said.

“It’s a matter of keeping your mother, your father, your brother, your sister alive between now and then,” Hotez added. “If we could just get those messages out.”

FDA could authorize vaccine weeks after December meeting

The message is crucial since a US Food and Drug Administration decision authorizing Pfizer’s coronavirus vaccine may not come until a few weeks after a meeting scheduled for December 10, according to an agency official.

President Donald Trump on Thursday said vaccine deliveries will start “in the next week or the week after,” but the director of the FDA’s Center for Biologics Evaluation and Research a day earlier offered a vastly different time frame.

“It will be a matter of weeks. It could be from days to weeks” after the December 10 meeting, according to Dr. Peter Marks.

“I can’t give you an exact date that we’re going to have an emergency use authorization issued because we have to do it right,” the FDA official said Wednesday.

The FDA’s Vaccines and Related Biological Products Advisory Committee will discuss at the meeting the application from Pfizer – the only company to apply for authorization for the vaccine to be shipped.

Another committee that advises the CDC about vaccines – the Advisory Committee on Immunization Practices, or ACIP – has scheduled an emergency meeting for Tuesday to vote on which groups of people they recommend to get a Covid-19 vaccine first, once one is approved, ACIP Chair Dr. Jose Romero told CNN Friday.

“We are meeting because the FDA, the Operation Warp Speed, have asked states and other jurisdictions to please submit their plans on Friday of this coming week,” Romero told CNN.

While the FDA authorizes a vaccine, the CDC, based on the committee’s advice, determines who should get it and when.

Vaccinations will begin in the US “towards the latter part of December,” according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

The Federal Aviation Administration announced Friday it supported ‘the first mass air shipment” of a Covid-19 vaccine.

The FAA also said it is working with manufacturers, air carriers and airports to provide guidance on regulations to safely transport large quantities of dry ice in air cargo. Pfizer’s Covid-19 vaccine requires large amounts of dry ice to keep it at approximately negative 75 degrees Celsius.

Cities enforce restrictions

Despite the uncertain schedule for a vaccine, masks remain a point of contention in many parts of the US.

Los Angeles County announced Friday that all public and private gatherings with people outside a single household will be prohibited for three weeks starting Monday, according to the county’s health department. The new order will be in effect until December 20.

While beaches, trails, and parks remain open, only gatherings from a single household will be allowed. Maximum occupancy for essential businesses will be reduced to 30% and 20% for nonessential businesses, personal care services, and libraries. Businesses operating outdoors – including fitness centers, zoos, botanical gardens, and batting cages – will be reduced to 50% maximum capacity.

Florida Gov. Ron DeSantis extended an order this week that bans municipalities from issuing fines for violations of pandemic-related rules – like mask mandates – or limiting restaurant capacity without justification.

The extension is in stark contrast with other state leaders’ recent announcements of further restrictions and more enforcement. In Connecticut, Gov. Ned Lamont issued an executive order this week increasing the maximum fine for businesses violating Covid-19 orders to $10,000. The previous maximum penalty was $500.

Miami-Dade County Mayor Daniella Levine Cava took to Twitter on Wednesday after the Florida governor’s extension, noting “bipartisan governors nationwide are putting mask orders in place as one of the best tools we have to fight COVID19.”

“It’s deeply frustrating that @GovRonDeSantis continues to block local actions and make it harder for local leaders to keep our communities safe,” Cava wrote.

“I’m asking the governor to work with local mayors so we can bring our local knowledge to the table,” Cava added. “We need to work together to create policies that will protect all our families and our economy in this moment of crisis.

In the past week, Florida has reported more than 56,400 new infections and more than 520 deaths, according to Johns Hopkins University data.

CNN has reached out to DeSantis’s office for comment.

Only 1 in 8 US Covid-19 cases may have been counted

In total, more than 13 million Americans have tested positive for the virus since the pandemic’s start. But a new study suggests that could only be a small fraction of the true number of infections in the US.

Only about 1 in 8 – or 13% — all of Covid-19 infections in the country were recognized and reported through the end of September, researchers at the CDC estimate. That means as many as 53 million people in the US could have been infected from February through September – yet during that time, only about 7 million confirmed cases of symptomatic Covid-19 were reported nationally, the researchers noted.

To estimate the number of Covid-19 cases that may have been missed since the beginning of the pandemic, the researchers used a model to adjust the reported numbers of symptomatic cases in the US. They considered what’s known about detecting cases, asymptomatic infections, patients seeking care or not and the risk of false negative test results.

The study’s limitations included that the availability and use of testing has changed over time and their findings serve only as estimates.

While the numbers may seem large, the researchers wrote that, still “this indicates that approximately 84% of the US population has not yet been infected and thus most of the country remains at risk, despite already high rates of hospitalization.”

CNN’s Elizabeth Cohen, Ben Tinker, Evan Simko-Bednarski, Jacqueline Howard, Melissa Alonso, Amanda Watts and Lauren Mascarenhas contributed to this report.