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As Interim Asst. Secretary Office of Public Health Dr. Joseph Kanter, right, watches, Gov. John Bel Edwards, left, gathers his thoughts before addressing the media on the state's response to COVID-19. LDH announced a big jump in coronavirus numbers Friday November 13, 2020, in Baton Rouge, La.

Louisiana officials issued dire warnings Friday after seeing the largest increase in coronavirus cases on record, as the unprecedented nationwide surge in the virus threatens to hammer the state.

For weeks, Louisiana has avoided the record-breaking increases in cases, hospitalizations and deaths seen in large swaths of the country. But that wall is showing signs of cracking.

The state Health Department recorded 3,492 cases, a number that includes 680 cases discovered using rapid antigen tests that had previously not been included in the case total. Hospitalizations are at 692, the highest point since early September. The share of tests coming back positive – a key metric for deciding whether bars can remain open – has inched up.

State and local officials warned more restrictions are on the horizon if numbers don’t improve.

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“We have a window of opportunity,” said Dr. Joe Kanter, the state’s top coronavirus response official. “That window is closing as we speak. We have to be more vigilant than we ever have right now, particularly going into the holiday season and Thanksgiving.”

The virus ravaged Louisiana with two significant waves already, one focused on the New Orleans area in the spring and another that hit Baton Rouge, Lafayette and other parts of the state in the summer. After local and then statewide mask mandates and other restrictions implemented this summer, the virus levels plateaued. Still, the virus never left Louisiana, and wasn’t tamped down to levels health officials hoped.

Every part of the state is now seeing increases in key metrics like cases, hospitalizations, percent positivity and COVID-19-like illness, Kanter said.

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There are some positive signs in Louisiana. The flu season has been historically good in the state this year, with a lower infection rate than the national average. That eases some concerns of a double-hit to hospital capacity this fall, when flu patients typically take up many of the ICU beds.

Plus, hospitalizations, while up, are still under 700, Gov. John Bel Edwards noted. In the first and second waves of the virus earlier this year, that number reached 1,900 and 1,600, respectively. And, a vaccine appears to be on the horizon.

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The bad news: Louisiana is going to have a hard time increasing hospital capacity like it did earlier in the year, Edwards said. The biggest issue facing many hospitals is a lack of available health workers. While the government and hospitals recruited workers earlier in the year, the pool of available workers will likely be tapped because the rest of the country is seeing levels of hospitalizations and new cases never before seen.

The vaccine touted by Pfizer and other leaders likely won’t be available to the general public for many months. And the holiday season, when the types of informal gatherings that have driven much of the spread of the virus flourish, is here.

“We do not have to go backwards in terms of re-imposing restrictions we’ve already moved through ... but the people of Louisiana will determine whether in fact we have to do that,” Edwards said.

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“I know we’re all tired. I get it. COVID fatigue is real,” Edwards said. “But just because we’re tired of COVID doesn’t mean COVID is going to leave us alone. That’s not the way it works.”

Edwards blamed the recent increase in cases on a number of factors. Halloween, when many people held parties and other events with potential to spread the virus, was roughly two weeks ago. The governor also pointed to the petition signed by House Republican lawmakers that ordered him to revoke all virus restrictions. That was declared unconstitutional by a state judge Thursday, but Edwards said it succeeded in confusing the public as to whether restrictions were in place.

Louisiana confirmed 22 new deaths Friday and two additional “probable” deaths, bringing the death toll from the virus to more than 5,885. Another 236 are listed as probable deaths from COVID-19.

The uptick comes at an inopportune time for New Orleans, where Mayor LaToya Cantrell said Monday the city would relax rules for “Phase 3.3” of the city’s reopening plan. That allows for larger private indoor gatherings and indoor seating at bars for the first time since March.

Dr. Jennifer Avegno, the city’s top health official, said it’s “very likely” restrictions will be reinstated if numbers don’t improve. "We don't have a lot of time to get this right," Avegno said, noting Thanksgiving is coming up.

In Baton Rouge, Mayor-President Sharon Weston Broome warned residents that the numbers show the region is trending in the wrong direction. The parish’s weekly positivity rate hit 5% after weeks of remaining below that threshold.

"This is very concerning as much of our country is in the midst of the latest coronavirus resurgence," she said in the statement. "In some places, patients are being airlifted to other cities because their local hospitals are at maximum capacity."

Across the state, bars are likely to feel the first wave of new restrictions.

That’s because the governor only allowed bars to reopen in parishes where the test positivity remained below 5% for two weeks. If such a parish sees that number spike above 10% for two weeks, bars must close down again. That has already happened in Ascension and Concordia parishes.

Edwards warned of a worsening of numbers over the next two weeks, even if people suddenly start complying more with the restrictions. The virus data typically lags two weeks after major changes, like restrictions or super-spreader events.

The U.S. has confirmed 100,000 new cases a day for more than a week, the worst stretch since the pandemic began. More than 240,000 Americans have died from COVID-19, and more than 10 million have been infected.

The governors of Oregon and New Mexico ordered some businesses to close, with Oregon pitching the restrictions as a two-week “freeze” to get the virus under control. Meanwhile, Texas passed 1 million COVID cases and parts of the state have brought in temporary morgues to handle the increasing number of bodies.

The White House Coronavirus Task Force this week warned of accelerating spread across much of the country, including in northern states where cooler weather has driven people indoors as well as Sun Belt states were restrictions were loosened.

The task force in its report urged Louisiana to do proactive testing to identify community spread of the virus and to keep “mitigation efforts” like mask-wearing, distancing and quarantine.

“Louisiana must expand mitigation efforts statewide as test positivity and cases are increasing,” the report said. “New hospital admissions in Louisiana continue to be at a moderate plateau; there must be increased mitigation at the community level. Mitigation efforts should continue to include wearing masks in public; physical distancing; hand hygiene; avoiding or eliminating the opportunities for mask-less crowding in public, including bars, and eliminating all social gatherings beyond the immediate household; and ensuring flu immunizations.”

Staff writers Matt Sledge, Jeff Adelson and David Mitchell contributed to this report.

Email Sam Karlin at