The Mountain West, which for months avoided the worst of the pandemic, has rapidly devolved into one of the most alarming hot spots in the United States, which recorded its eight millionth confirmed case on Thursday.
Seventeen states, including many in the Mountain West, have added more cases in the past week than any other week of the pandemic. And the spread through sparsely populated areas of rural America has created problems in small towns that lack critical resources — including doctors — even in ordinary times.
Wyoming, which did not have 1,000 total cases until June, recently added more than 1,000 in a single week. Reports of new infections have recently reached record levels in Alaska, Colorado and Idaho. And Montana, where more than half of the state’s cases have been announced since August, is averaging more than 500 cases per day.
One place where the infections have spread has been local jails, which are confined, often crowded spaces. They are risky venues for inmates and workers, but the short-term holding facilities also pose a threat for surrounding communities because people filter in and out of them constantly.
For months, the jail in central Montana’s Cascade County was free of the coronavirus, which seemed as distant a threat as it did in much of the rural Mountain West.
Then a few people who had the virus were arrested. By the time Paul Krogue, the jail’s medical director, realized there was a problem, nearly 50 inmates were infected. After weeks battling to contain the outbreak, Mr. Krogue got a call that infections were spreading to a side of the jail that had been virus-free.
“I just kind of lost it, like, ‘My God, I don’t know how much longer I can do this,’” Mr. Krogue, a nurse practitioner, recalled. “I was just scared that I’m not going to be able to see it through, that I’m going to get sick — you just feel so exhausted and it’s just a lot.”
Now more than 300 inmates and staff members have been infected in a facility meant to hold 365 people, Cascade County’s first major outbreak in a region where the virus is suddenly surging.
— Lucy Tompkins, Maura Turcotte and
Pfizer’s chief executive said on Friday that the company would not apply for emergency authorization of its coronavirus vaccine before the third week of November, ruling out President Trump’s assertion that a vaccine would be ready before Election Day on Nov. 3.
In a statement posted to the company website, the chief executive, Dr. Albert Bourla, said that although Pfizer could have preliminary numbers by the end of October about whether the vaccine works, it would still need to collect safety and manufacturing data that would stretch the timeline to at least the third week of November.
Close watchers of the vaccine race had already known that Pfizer wouldn’t be able to meet the Food and Drug Administration’s requirements by the end of this month. But Friday’s announcement represents a shift in tone for the company and its leader, who has repeatedly emphasized the month of October in interviews and public appearances.
In doing so, the company had aligned its messaging with that of the president, who has made no secret of his desire for an approved vaccine before the election. Mr. Trump even singled out the company by name and said he had spoken with Dr. Bourla, whom he called a “great guy.”
Dr. Eric Topol, a clinical trial expert at Scripps Research in San Diego, said that while Pfizer officials had assured him that a vaccine would likely not be authorized before the election, the company’s letter on Friday was “even more solid about their not being part of any political machinations.”
“This is good, really good,” said Dr. Topol, who was one of 60 public health officials and others in the medical community to sign a letter to Pfizer urging it not to rush its vaccine.
Dr. Bourla has pushed back against any suggestion that the company’s vaccine timeline was politically motivated. In September, Pfizer was the driving force behind a pledge by nine vaccine companies to “stand with science” and not put forward anything that had not been properly vetted.
Earlier this month, he published an open letter to employees that said he “would never succumb to political pressure” and expressed disappointment that “we find ourselves in the crucible of the U.S. presidential election.”
Pfizer is one of four companies testing a coronavirus vaccine in late-stage clinical trials in the United States, and it has been the most aggressive in its timeline estimates. Moderna, AstraZeneca and Johnson & Johnson have said that later in the year is more likely, matching the predictions of federal health officials.