The US has counted more COVID-19 deaths these last two weeks than any other 14-day stretch of the pandemic.
And at this rate, the nation's overall coronavirus death toll may hit 400,000 before President-elect Joe Biden is sworn in on Wednesday.
The country reported more than 42,800 COVID-19 deaths during the first 14 days of January, averaging more than 3,050 per day -- the highest for any two-week stretch of the pandemic, according to Johns Hopkins University data.
Another 14,400 Americans are projected to die from the virus over the next six days, according to an ensemble forecast published by the US Centers for Disease Control and Prevention.
This comes as the nation's health care system scrambles to keep up with influxes of patients, with more than 128,900 COVID-19 patients Thursday in hospitals across the country. That's not far from the pandemic's peak of more than 132,400 reached eight days earlier -- according to the COVID Tracking Project.
The city of Laredo, Texas, tweeted an "emergency message" Thursday saying its health care workers are getting crushed by the swell in cases.
"Our medical professionals are overwhelmed with the surge in COVID-19 cases. Lives are at stake, and we are asking you to stay home unless it's absolutely necessary ... save a life," the tweet said.
Case levels across the country are near the highest they've been. On Thursday, the US recorded its 10th straight day of more than 200,000 newly reported infections.
And the country's average of new daily cases across a week was about 238,830 on Thursday, short of a peak average of about 249,800 reached just three days prior.
Since the pandemic began, more than 388,000 people in the US have died from COVID-19, according to Johns Hopkins data.
As frontline workers struggle to keep patients alive and hospital ICU wings operational, the success of the vaccine rollout remains inconsistent.
Discrepancies in vaccine distribution
Nearly 9.7 million people have received at least their first dose of a COVID-19 vaccine, with more than 1.3 million of those having also received their second dose, according to data published by the CDC.
It's far from the target of 20 million vaccinated by the end of 2020 set by officials with the federal Operation Warp Speed effort. While the operation's chief adviser, Moncef Slaoui, told CNN the figure was a "hope" and not a promise, Biden on Thursday called the vaccine distribution rollout so far "a dismal failure."
At least one state, however, says its distribution is ahead of the game.
West Virginia Gov. Jim Justice told CNN that as of Monday, every vaccine dose received by the state had been administered or assigned to be given within a day or so. The state leads the nation in terms of first doses administered per capita, according to the CDC data, nearly doubling the national rate.
"We've absolutely not gone with the federal model," Justice told CNN on Thursday. Instead of using chain drugstores to administer the vaccine, the state has relied on partnerships with local pharmacies, the state health department and National Guard to distribute the vaccines effectively, he said.
"It's as simple as mud. If you can get shots in arms, you're going to save lives," Justice said. "We don't need to sit around trying to develop systems or meeting with committees or whatever. We needed to act. We needed to move."
Other states are not having the same success as West Virginia.
Texas -- the second-most populous state -- has administered the most doses of any state so far, with more than 1 million total doses put into arms, according to CDC data. Yet about 10% of the rural hospitals in Texas have yet to receive a single COVID-19 vaccine dose, according to a group representing rural hospitals in the state.
The state was tied for 18th in total doses administered per capita as of Thursday, according to CDC data.
One CEO of a rural hospital group in Texas reported that some employees had to get vaccines from a local supermarket, which had extra doses to spare.
In some metropolitan areas, including Houston, Phoenix and Los Angeles, stadiums and theme parks or their parking lots are being used as mass-vaccination sites.
One such site, outside Los Angeles' Dodger Stadium, was opening Friday. More than 2,000 people were registered to receive shots there Friday, and the site eventually is expected to serve more than 12,000 per day, officials have said.
Biden to unveil vaccine distribution plan on Friday
The incoming Biden administration has been critical of the Trump administration's most recent vaccine distribution plan that calls for states to open vaccination access to all Americans ages 65 or older, as well as those with chronic conditions who are at higher risk of severe disease.
The Trump administration's new plan aims to increase mass vaccination efforts and add more accessible venues, a senior administration official told CNN.
A member of Biden's coronavirus advisory board on Thursday cautioned against the new parameters. Although almost 180 million Americans would be eligible for the vaccine under the plan, he said, the supply necessary to handle this number would not be reached until summer at best.
Biden has said he will lay out a vaccination plan on Friday to "correct course" and to meet his goal of 100 million shots over his first 100 days in office.
That goal is feasible, Dr. Anthony Fauci said Friday on NBC's "Today" show.
"Even now, we've gone from half a million a day to 750,000 (doses) a day. I believe strongly that it (1 million per day) is doable -- and if we do it, stay on target to get the overwhelming majority of the country vaccinated," said Fauci, director of the National Institute of Allergy and Infectious Diseases.
Biden on Thursday announced a plan -- as part of a wider $1.9 trillion economic rescue proposal -- to send $350 billion to state, local and territorial governments, in part to help distribute the vaccine, as well as to increase testing, keep frontline workers employed, reopen schools and maintain vital services.
Precautions still necessary
While the vaccine rollout generally provides long-term hope for the country to overcome the pandemic, the situation nationwide still requires preventive measures.
In Missouri, lawmakers canceled next week's legislative session due to the rise in COVID-19 infections.
"Due to the rising number of COVID-19 cases in the building, we are exercising an abundance of caution to protect members, staff, and visitors by canceling session next week. Our goal is to return to work the following week," read the statement from Missouri House leadership.
Experts are hoping precautions can help turn the tide of debilitating case numbers, like those faced in California.
Available ICU beds have reached their lowest level, according to the California Department of Public Health. Fewer than 1,100 ICU beds remain throughout the state, a shrinking number from the beginning of the surge in November.
Los Angeles County has been particularly hard struck. The seven-day average of deaths in the county from COVID-19 is 1,644 people, according to Johns Hopkins data. This averages to about one death every six minutes.
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