CNN  — 

October was a month of grim records in the Covid-19 pandemic, and as November begins, experts say the United States hasn’t seen the worst of it.

From Alaska to Maine, at least 31 states across the US reported at least one record-high day of new coronavirus cases in the past month, according to data from Johns Hopkins University. Fifteen reported their highest one-day tallies of Covid-19 deaths.

The country’s seven-day average of new daily cases was 78,380 Saturday – a number that has risen 128.2% since a post-summer-surge low on September 12. With any potential vaccine still a ways off from distribution, and the colder months threatening to increase spread, experts emphasize more people need to regularly take precautions to stem the rise anytime soon.

“It’s the way we protect our neighbors and our communities. And we need to avoid crowds. We have to socially distance. You can’t go to a mass gathering now. We need to lower our viral footprint,” Dr. Jonathan Reiner, professor of medicine at George Washington University, told CNN.

October was unprecedented for several recorded metrics associated with the pandemic.

Of the country’s seven highest daily tallies of new cases, six were in October. The highest – 99,321 recorded on Friday – was the most recorded in one day for any one nation so far.

The number of US Covid-19 patients in hospitals on Saturday, October’s last day, was 47,374 – 65.6% higher than it was on September 20, when it was at a low following the summer surge.

And Reiner said there is no sign that the number of daily cases will drop soon.

“We won’t peak until we change our behaviors. And our behaviors that principally need to change are our lack of masking all over the country,” he said.

The country has recorded more than 9.1 million infections and 230,548 deaths during the pandemic, according to JHU.

December could be ‘toughest month’

Hospitals could become overwhelmed as the number of coronavirus cases continues to climb, Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, told CNN’s Anderson Cooper on Friday.

In El Paso, Texas, where hospitals are struggling to keep up with the number of Covid-19 patients, officials are preparing to add a third mobile morgue unit in anticipation of a spike in deaths.

“If that doesn’t put our situation into perspective, I don’t know what will,” County Judge Ricardo Samaniego wrote on Facebook.

El Paso County reported a daily high of new cases Saturday, with 1,642.

Hospitalization numbers are the best measure of how the nation is faring in the coronavirus pandemic, Murray said.

“They are a leading indicator ahead of deaths,” he said.

Murray and his colleagues at IHME are responsible for an influential coronavirus model, which most recently projected 399,000 coronavirus deaths in the US by February 1.

“The fall/winter surge should lead to a daily death toll that is approximately three times higher than now by mid-January,” the IHME said in its latest forecast.

Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, told CBS’ “Face the Nation” on Sunday that several states are at “the beginning of what looks like exponential growth” and that the US is in a “very worrisome” position heading into winter.

“I think Thanksgiving is really going to be an inflection point. I think December is probably going to be our toughest month,” he said.

“I think the facts are going to overtake any political dialogue very quickly. I think as we get into the next two or three weeks, it’s going to be unmistakable what’s happening around the country and we’re going to have to start taking tough steps,” Gottlieb said.

Window to get control over cases narrows

Dr. Leana Wen, a former Baltimore health commissioner, echoed those thoughts, saying the US has a narrow window of time before more drastic measures like mandatory lockdowns will have to be considered.

“We are seeing Covid-19 hotspots raging all over the country, and right now we have an opportunity to implement targeted measures like universal mask wearing, like making sure that high-risk businesses like bars in certain areas are shut down, like instructing the public that we should be avoiding social gatherings of extended family and friends,” she told CNN.

“If we don’t do these things now, we’re going to be overwhelming our health systems, and then a lockdown may be necessary.”

With 3,792 new coronavirus cases reported Saturday, Michigan set a record for its highest daily count since the pandemic began, according to Bob Wheaton, spokesman for the Michigan Department of Health and Human Services.

To help combat Covid’s spread, the Michigan health department issued rules for restaurants, to take effect Monday. The order says all restaurants must “maintain accurate records of the names and phone numbers of patrons who purchase food for consumption on the premises, and the date and time of entry.”

Illinois also broke its daily case record Saturday, with 7,899 new cases reported, bringing the total to 410,300 in the state.

Kentucky had more new virus cases in the past week than any other week during the pandemic, Gov. Andy Beshear said in a statement Sunday.

“I know we’re tired, but if we do not get the spread of this disease under control, we risk a darker, more deadly period this winter than we ever experienced in the spring,” Beshear said.

New York requires most travelers to get negative tests

With cases surging through the country, New York Gov. Andrew Cuomo announced Saturday that most travelers must now get Covid-19 tests before and after arrival in the state.

The new policy replaces a previous advisory list of states with rising case counts from which travelers were required to quarantine for 14 days upon arrival in New York, the governor said during a call with the media.

Most travelers to New York state will be required to obtain a negative Covid-19 test three days prior to setting out on their trip to the state, Cuomo said. Once in New York, travelers will be required to quarantine for three days before getting another test. If the second test is negative, the traveler will no longer be required to quarantine.

State officials said the new requirement will be enforced in the same way as the previous 14-day quarantine policy, with travelers being asked to fill out questionnaires. The policy leans on individual compliance.

“New York had the highest positivity rate in the nation at the peak of this crisis. Now, we have the third-lowest in the nation. New Yorkers should be very proud of that fact, but we also need to remain vigilant,” Cuomo said.

CNN’s Eliott C. McLaughlin, Amanda Watts, Evan Simko-Bermarski, Laura Ly, Susannah Cullinane, Ray Sanchez, Lauren Mascarenhas, Jonny Hallam, Raja Razek and Naomi Thomas contributed to this report.