The U.S. COVID-19 death rate continued to climb in the week ending Nov. 27, according to public health specialists who are advising the White House Coronavirus Task Force. There are signs that the number of new cases of the virus that causes COVID-19 might have started to level off, but the task force advisors say they are worried about Thanksgiving gathering spikes. "The COVID risk to all Americans is at a historic high," the advisors write in a list of recommendations for state officials. "If you are under 40, you need to assume you became infected during the Thanksgiving period if you gathered beyond your immediate household." |

• A copy of a state-level version of the White House Coronavirus Task Force weekly report is available here.
• The CDC's weekly COVID-19 report is available here.

The COVID-19 advisory group said the threat to people over 65 and to other people with risk factors is grave. "It must be made clear that if you are over 65 or have significant health conditions, you should not enter any indoor public spaces where anyone is unmasked, due to the immediate risk to your health," the advisors warned. "You should have groceries and medications delivered." Here's what happened to key national COVID-19 indicators between the week ending Nov. 27 and the previous week: |

• New cases per 100,000 people: 349 (down from 356)
• Percentage of people tested who had COVID-19: 9.7% (down from 10.5%)
• COVID-19 deaths per 100,000: 3.1 (up from 3)
• Nursing homes with 1 or more new resident COVID-19 deaths: 9% (up from 7%)

The White House advisors said that they are seeing clear improvement in European countries with strong infection control efforts. "In many areas of the USA, state mitigation efforts remain inadequate, resulting in sustained transmission or a very prolonged time to peak — over 7 weeks," the advisors write. There are different situation assessments and lists of recommendations for each state developed by the advisory group. In the report for Pennsylvania, for example, the advisors note that local hospitals are facing shortages. "Recent restrictions are warranted and commendable," the advisors say. In the report for officials in Missouri, the advisors say hospitals are reporting critical staffing shortages. "The state is managing and is working on a staffing contract," the report states. "The depth of viral spread across Missouri remains significant and without public health orders in place compelling Missourians to act differently, the spread will remain unyielding with significant impact on the health care system," officials say. "Mitigation and messaging need to be further strengthened, as other states have done... Strong mitigation efforts by neighboring states are showing early impact."