More Americans who don't even have coronavirus are suffering from soaring Covid-19 hospitalizations.
Newly released data from the US Department of Health and Human Services show at least 200 hospitals were at full capacity last week.
And in one third of all hospitals, more than 90% of all ICU beds were occupied. Coronavirus patients occupied 46% of all staffed ICU beds -- up from 37% in the first week of November.
Hospitalizations in the US reached a record high of 107,248 on Thursday, according to the Covid Tracking Project.
'Things are really bad,' said Dr. Ashish Jha, dean of the Brown University School of Public Health.
'What we have seen over the last few weeks is a sharp rise in infections. And what we know -- from the beginning of this pandemic -- is infections are followed by hospitalizations, which are then followed by death.'
'The impact is not just on people with Covid. It's an impact on anybody who needs hospital care,' Jha said. 'The hospitals are running out of beds for everybody. So it's a much broader public health problem than just a Covid problem.'
A day of extreme hope and despair
Thursday should have been a day of great hope, as a US Food and Drug Administration committee recommended a Covid-19 vaccine be authorized for emergency use.
But it's also a day of devastating loss. The single-day death toll from Covid-19 reached a record high of 3,124 on Wednesday, according to Johns Hopkins University.
That's more deaths than those suffered in the 9/11 attacks. And experts say the death toll will get worse.
And more than 200,000 new infections were reported Thursday -- inevitably leading to even more hospitalizations and deaths.
'We are in a totally unprecedented health crisis in this country,' former HHS Secretary Kathleen Sebelius said.
'The disease is everywhere -- Midwest, West Coast, East Coast, North, South. Health care workers are exhausted. Hospitals are totally full.'
Model still forecasts 500,000 deaths by April
More than 500,000 people in the United States will have died from Covid-19 by April, a model from the Institute for Health Metrics and Evaluation forecasts.
The death toll could reach 502,000 by April 1, but it will be lower if more people wear masks, the researchers said. Dr. Chris Murray told CNN's Anderson Cooper that his group has found 72% of Americans wear masks, and 56,000 fewer people would die if mask use rises to 95%.
A worst-case scenario, predicated on states easing health orders, forecasts 598,000 deaths by April.
The current model predicts 37,000 fewer deaths than the one preceding it because hospitalizations and cases numbers are leveling off in the Midwest. Americans in general have reduced their traveling and some states have imposed new health measures, affecting the model, the institute said in a news release.
Vaccinations will also help. Between 25,200 lives and 44,500 could be saved by April, the researchers said, depending on the speed of the rollout.
A composite forecast from the US Centers for Disease Control and Prevention projects a total of 332,000 to 362,000 Covid-19 deaths by January 2. That forecast combines modeling from 40 independent research groups.
The 'light at the end' of a very long tunnel
That means the first Americans outside of clinical trials could start getting inoculated in the coming weeks.
The FDA will take the next step toward authorization by deciding whether to accept the recommendation. Officials have signaled that the agency will issue the emergency use authorization.
Officials will meet again later this month to evaluate the Moderna vaccine, which has also shown to be highly effective in a clinical trial.
Covid-19 vaccines are a 'really significant light at the end of the tunnel,' Sebelius said.
But the US probably won't see any significant impact from vaccines until well into 2021 -- and that's only if enough people choose to get vaccinated, said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases.
'Let's say we get 75%, 80% of the population vaccinated. I believe if we do it efficiently enough over the second quarter of 2021, by the time we get to the end of the summer ... we may actually have enough herd immunity protecting our society that as we get to the end of 2021, we could approach ... some degree of normality that is close to where we were before,' Fauci said at a Harvard T.H. Chan School of Public Health virtual event Wednesday.
But with many more infections and deaths expected before widespread vaccinations, personal responsibility is key to getting through this winter.
That means wearing face masks and hunkering down in your Covid-19 social bubbles.
'We've got to take what we've learned in the last eight months and really put it into practice so we don't continue to have this unthinkable death toll and disease toll,' Sebelius said.
Some Idaho morgues are full
The governor of Idaho said several counties will need to use mobile morgues.
'The morgues are full and they are starting to ask for refrigerated trailers to hold bodies,' Gov. Brad Little said. In some parts of the state, 'emergency calls for Covid-19 victims are up 300%.'
The governor warned that the surge in cases is 'taking up ICU resources and staff, has pushed capacity to nearly full.'
Covid-19 was the No. 1 cause of death in Idaho in November. Health officials on Wednesday reported 2,298 new coronavirus cases, the most announced in one day.
'We are fast approaching a point where we simply may not have enough beds, critical care doctors, nurses, and technicians to handle the number of Covid-19 patients in need of care,' Little said.
New shutdowns and extended mask mandates
State and local leaders from both parties are doubling down on safety mandates as coronavirus runs amok across the country.
Baltimore's Democratic Mayor Brandon Scott announced the temporary shutdown of all restaurant dining and indoor recreation like bowling alleys, pool halls and hookah bars.
'Baltimore City has not had to implement such severe restrictions since the very earliest days of the pandemic and the implementation of the stay-at-home order,' the city's health department tweeted.
'Unfortunately, with the volume of new cases that we are seeing and the implications it has on hospital utilization, during a period of widespread, community transmission, activities such as eating, drinking and smoking in close proximity to others, should not continue.'
In Ohio, Republican Gov. Mike DeWine said state officials are extending a curfew until January 2.
'We believe that the curfew, along with the enforcement of mask wearing in retail -- that was also started about the same time -- have had an impact,' DeWine said.
'We cannot afford, on the very eve of a safe and effective vaccination, to further overwhelm our hospitals and health care providers with a holiday tsunami,' he added.
In Mississippi, Republican Gov. Tate Reeves signed a new executive order adding stricter limitations on indoor and outdoor gatherings and moving more counties to the state's mask mandate list -- meaning 61 of the state's 82 counties are under a mask mandate.
Indiana's Republican Gov. Eric Holcomb ordered hospitals to postpone or reschedule non-emergency procedures done in an inpatient hospital setting from December 16 through January 3 to preserve hospital capacity.
Holcomb also announced new caps on social gatherings starting this weekend, based on which color zone (determined by weekly cases per 100,000 and seven-day positivity rate) counties are in.