A solid majority of Americans trust that the results of the 2020 presidential election are accurate, but only about a quarter of Republicans do, according to a new NPR/PBS NewsHour/Marist survey.

Sixty-one percent say they trust the results, including two-thirds of independents, but just 24% of Republican respondents say they accept the results.

Nonetheless, President-elect Joe Biden is set to take office Jan. 20, and the coronavirus pandemic will be a central focus. On that front, Americans largely have confidence in Biden’s ability to handle the crisis, and the number saying they’ll take a vaccine when it comes available has risen over the past few months. But skepticism about a vaccine is driven by Republicans, particularly Republican women.

A rocky transition

More than a month after Biden won the election and was declared president-elect, President Trump continues to baselessly allege widespread voter fraud and falsely claim the outcome is not yet known.

“We’re going to have to see who the next administration is because we won in the swing states,” Trump said Tuesday when asked why he wasn’t including Biden transition officials during a coronavirus summit. “Hopefully, the next administration will be the Trump administration.”

Unlike past presidents, Trump has refused to formally concede. That’s something that two-thirds of Americans think he should do, according to the survey. Sixty-two percent of Republicans, however, don’t think he should.

While he may not be acknowledging his loss publicly, behind the scenes, Trump has been discussing the possibility of running again in 2024, sources tell NPR.

A strong majority of Americans — 60% — don’t want him to run again, but two-thirds of Republicans do. That effectively freezes the potential 2024 Republican primary field.

As far as Biden goes, most Americans (56%) so far approve of how he’s handling himself during the transition. That’s more than the 49% that approved of the job Trump was doing during the 2016 transition.

What’s more, by a 59%-to-35% margin Americans think Biden will do more to unite than divide the country. That’s far higher than the 43%-to-53% margin for whether Trump in 2016 would do more to unite than divide.

“There’s not going to be a honeymoon from olden politics days, but there does appear to be some room with people willing to give [Biden] a chance,” said Lee Miringoff, director of the Marist Institute for Public Opinion, which conducted the poll.

The impact of the coronavirus

One of the measures of Biden’s presidency will be how he handles the coronavirus crisis. Americans appear to have confidence in the president-elect’s ability to handle the pandemic — 62% said they were either confident or very confident.

But in his first year specifically, Biden is going to be judged on how vaccines are distributed and whether they are administered. Sixty-one percent of Americans now say they will take a vaccine when one comes available, up from just 49% in September.

The movement, though, comes mostly from increases with Democrats and independents.

The number of Republicans who said they will increased as well, but they remain largely split. That skepticism, however, is driven by Republican women. Just 34% of Republican women say they would take a vaccine when it comes available, compared with 61% of Republican men.

Also among the most reluctant to get the vaccine: Trump supporters (only 47% said they would), people who live in rural areas (51%), people without college degrees (53%), white evangelical Christians (54%) and non-whites (58%).

The coronavirus has affected a broad swath of Americans. About two-thirds said they or someone they know has gotten COVID-19. Forty percent said they or someone in their household has lost a job or income due to the coronavirus. Younger Americans and Americans of color are more likely to have been affected.

By a 51%-to-31% margin, those younger than 45 have been hurt financially — by them or someone in their household losing a job or income — compared with those who older.

Nonwhites are 14 points more likely to have been hurt than whites (49% to 35%).

With that, the message to Washington in this survey is: Do more.

Two-thirds said the U.S. government hasn’t done enough financially to help Americans. While Congress has passed multiple relief packages since the virus first struck, Democrats and Republicans have been in a stalemate for more due to disputes over cost, business liability, and funding for states and localities to shore up their budgets.

And two-thirds, in general, think compromise is more important than standing on principle, which just a quarter of Americans think is most important. Republicans are less likely to think compromise is a good idea, but 53% still lean toward compromise to find solutions.

Behavioral changes

Americans themselves are trying to mitigate risk of catching the disease. More than 8 in 10 have changed their behavior by wearing masks, washing their hands more often, avoiding large gatherings and cutting back on where they go.

Traveling for the holidays was viewed as particularly risky, as the Centers for Disease Control and Prevention has advised — with 51% saying it is a major risk and another 28% saying it is at least a minor one.

Some three-quarters or more said they think there’s at least some risk in eating inside at restaurants (81%), going in-person family gatherings (81%), having schools hold in-person classes (76%) and attending church (73%). But a plurality of Americans said those things only represent minor risks.

There is overwhelming support for a national mask-wearing mandate — nearly three-quarters of Americans say one would be a good idea — but there is less support for a national stay-at-home order if recommended by public health officials.

Americans were split on that question with 51% saying it’s a good idea, but 45% saying it’s a bad one. This was a polarizing question with three-quarters of Democrats saying it’s a good idea, three-quarters of Republicans saying it’s a bad one and independents split down the middle.

The survey was of 1,065 U.S. adults was conducted between Dec. 1 and Dec. 6 by telephone using live callers. The margin of error is 3.7 percentage points. There were 916 registered voters with a margin of error of 4.0 percentage points.

When earmarks were a regular feature of congressional business, Rep. Emanuel Cleaver, D-Mo., said Democrats and Republicans were able to cut more deals and pass more bills with bipartisan support.

“This used to be time where everybody was ‘Hallelujah,’ I mean Republicans, Democrats, dancing, kissing. This is the time to be saved,” he recalled at a congressional hearing earlier this year in regards to legislation like the highway bill.

Cleaver served on the bipartisan Select Committee on the Modernization of Congress that was established by Democrats after they won control of the House in 2018. One of the conclusions issued in the committee’s final report released in October: Bring back earmarks. (The committee ditched the term ‘earmark’ for a new ‘Community-Focused Grant Program.’)

The committee’s recommendations were weighed after hearing testimony from advocates like John Hudak of the Brookings Institution who has long argued the earmark ban over-corrected the problem. The ban was instituted by then-Speaker John Boehner in 2011, but the practice had been under scrutiny for years following a series of spending scandals in the mid 2000’s. Democrats overhauled the process when they controlled the House from 2007-2010, but they did not ban them.

“Earmarks were painted as a coven for corruption, a practice reserved for the funding of needless projects to benefit the friends, supporters and donors of members of Congress. Much of this was hyperbole, as earmarking was only abused by a handful of members in the past,” Hudak told the committee.

House Majority Leader Steny Hoyer< Md., is one of the leading advocates to reinstate earmarks, with stricter limits and more transparency. He argues the ban didn’t stop earmarks, it just transferred spending power from Congress, where it constitutionally belongs, to the executive branch, where it doesn’t.

“My belief is that members of Congress elected from 435 districts around the country know, frankly, better than those who may be in Washington what their districts need,” he told the House Rules Committee in October.

In the past decade, both parties have attempted and failed to reinstate earmarks primarily due to concerns about how it would play politically. Currently, there is broad support for it among House Democratic leaders, including Majority Whip James Clyburn, D-S.C., and incoming House Appropriations Committee Chair Rosa DeLauro of Connecticut. “It is a dynamic environment and I think we are in a better position now to move forward in this area,” she told NPR.

Steve Ellis runs Taxpayers for Common Sense, a budget watchdog group that helped expose earmark abuses. “House Democrats can push as much as they want but they’re going to have to have a dance partner in the Senate and they’re going to have to have a dance partner with Republicans,” he said, “It’s one of these things where it just won’t stand politically and optically if they don’t all jump together.”

Senate Republicans voted to permanently ban earmarks in their internal party rules just last year, but control of the Senate won’t be clear until after a pair of Georgia special elections in early January. Missouri Republican Sen. Roy Blunt, a long-time appropriator, made it clear the Senate is not currently rushing to join with House Democrats. “I don’t think senators are thinking about this much until it’s clear what the House really intends to do,” he said.

Vermont Senator Patrick Leahy, the top Democrat on the Senate Appropriations Committee, supports bringing back earmarks and said, in private, the idea is quite popular. “Oh yes, there’s very quiet support for it among Republicans. There will be some opposed but they don’t have to have earmarks if they don’t like them.”

Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Mitch McConnell, R-Ky., both appropriators who have embraced earmarks in the past, haven’t yet taken a position on this round to revive them.

Former President Barack Obama opposed earmarks, famously pledging to veto any bill that came to his desk that included them. President-elect Joe Biden also hasn’t weighed in yet, but Biden says he wants to bring Republicans and Democrats together, and advocates say earmarks is one way to do it.

The federal government on Monday released detailed hospital-level data showing the toll COVID-19 is taking on health care facilities, including how many inpatient and ICU beds are available on a weekly basis.

Using an analysis from the University of Minnesota’s COVID-19 Hospitalization Tracking Project, NPR has created a tool that allows you to see how your local hospital and your county overall are faring. (Jump to look-up tool.)

It focuses on one important metric — how many beds are filled with COVID-19 patients — and shows this for each hospital and on average for each county.

The ratio of COVID-19 hospitalizations to total beds gives a picture of how much strain a hospital is under. Though there’s not a clear threshold, it’s concerning when that rate rises above 10%, hospital capacity experts told NPR.

Anything above 20% represents “extreme stress” for the hospital, according to a framework developed by the Institute for Health Metrics and Evaluation at the University of Washington.

If that figure gets to near 50% or above, the stress on staff is immense. “It means the hospital is overloaded. It means other services in that hospital are being delayed. The hospital becomes a nightmare,” IHME’s Ali Mokdad told NPR.

The University of Minnesota’s analysis shows that there are 55 counties where the hospital average has reached that rate.

Use the look-up tool below the map to find details about hospitals in your county.

Thomas Wilburn contributed to this report.