The United States could face as many as 100,000 more COVID-19 deaths in less than a month, according to the US Centers for Disease Control and Prevention.
The nation reported more than 4,000 COVID-19 deaths Wednesday, only the third day ever to cross that threshold, bringing the death toll to at least 406,001 people, according to the Johns Hopkins University tracking data.
And by February 13, that number could reach 508,000, according to an ensemble forecast published by the CDC. The last forecast, on January 13, projected up to 477,000 deaths by February 6.
The CDC's ensemble forecast comes as the US on Thursday marks one year since the first patient with COVID-19 was identified in the US -- a number that has since ballooned to more than 24.4 million, per Johns Hopkins.
In the meantime, President Joe Biden is taking steps to recalibrate the country's response to the virus, with an emphasis on vaccine distribution. There remain significant challenges with vaccine supply across the country, according to state officials. And sources tell CNN that Biden and his advisers are inheriting no coronavirus vaccine distribution plan from the outgoing Trump administration.
New CDC director Dr. Rochelle Walensky on Thursday told NBC News the agency was working with the federal government's Operation Warp Speed, vaccine manufacturers and the states to understand the supply issues.
But in the meantime, "right now, I think we still have vaccine on the shelves that we need to get into people," she said. Federal officials are looking at a "diverse" rollout plan, she said, involving community vaccination centers, stadiums and mobile units to get vaccines to everyone across the country.
Dr. Anthony Fauci, the nation's top infectious disease expert and Biden's chief medical adviser, said the United States can reach the President's goal of 100 million shots in 100 days -- and may even be able to surpass it."
"The President has made this his top priority," Fauci told ABC's "Good Morning America," adding he was set to meet with Biden later Thursday to brief him on COVID-19 and vaccine distribution.
"As he says, he's going to do everything that he needs to do to make sure we have a successful rollout of the vaccines, get it into people's arms and get as many people vaccinated as we possibly can," Fauci said.
Biden also announced the US would rejoin the World Health Organization, a move Fauci said was important for an effective global response.
"The official announcement that we are rejoining, we're going to live up to our financial commitments and a whole bunch of other things, it was really a very good day," Fauci said. "The response I'm getting from my colleagues all over the world is really very, very refreshing."
California deaths and severity of cases remain high
Most coronavirus metrics have been improving in California, an epicenter of the virus in the US. But the severity of cases in the state and the death toll remain high.
California added 22,403 new cases Wednesday, which is well below the average daily number for the state of 38,000.
But it also reported 694 new COVID-19-related deaths Wednesday, the second-highest single-day toll to date. The previous high of 708 was recorded nearly two weeks ago.
In Los Angeles, the rate of death among hospitalized COVID-19 patients has nearly doubled in recent months.
Since November, hospitalized patients in Los Angeles County have had about a 23% chance of dying from the disease, health officials said Wednesday. That rate marks a significant increase from the prior three months when COVID-19 patients had an approximately 12% chance of dying, according to the county's Department of Health Services.
Along with the fatality rate, the length of hospital stays for coronavirus in Los Angeles County jumped from about seven days between September and November to about nine and a half from November to January, suggesting the severity of illness in those hospitalized has jumped, LADHS said.
"This trend does not mean the virus has become more virulent or that care in hospitals worsened during the surge," Health Services Director Christina Ghaly explained. "Rather, we believe these trends are because hospitals, facing capacity constraints in the setting of the surge, became more selective in determining which patients to admit.
"In other words, hospitals are discharging more of the lower-acuity patients home with oxygen. They are admitting only the most critically ill patients."
But with a limited supply of coronavirus vaccine, state epidemiologist Erica Pan said it may take four to five months to get all Californians over the age of 65 vaccinated.
'A constant pattern of basically running out' of vaccine
The push to get people vaccinated has grown as officials race to distribute doses to meet their demand.
As of Wednesday, more than 16.5 million doses have been administered in the US and nearly 2.2 million Americans are fully vaccinated, the CDC said.
New York Gov. Andrew Cuomo said the state is administering about 65,000 doses a day -- a rate that will deplete its current supply in two or three days. "What's clear now is that we will be going from week to week and you will see a constant pattern of basically running out, waiting for the next week's allocation and then starting up again," Cuomo said.
The state will receive 250,400 doses next week, but Cuomo urged Biden to increase the supply to states immediately.
"At this current rate of supply, it takes seven and a half months to get enough vaccine for the currently eligible population," Cuomo said.
In Missouri, Gov. Mike Parson said that the state is on pace with its vaccination plan, but that the National Guard will be activated to help administer it as eligibility expands to include first responders, emergency services and those in public health infrastructure.
A mass vaccination team will be set up in each of the nine Highway Patrol regions in the state, he said, and they will be able to administer up to 2,500 doses a day.
The early weeks of spring could see another boost in vaccinations, as the WHO is evaluating 15 vaccines it could list for emergency use, according to a new guidance document.
"I call on all countries to work together in solidarity to ensure that within the first 100 days of this year, vaccination of health workers and older people is underway in all countries," WHO Director-General Tedros Adhanom Ghebreyesus said.
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