At the current rate of daily fatalities, the US death toll from the Covid-19 pandemic may reach 400,000 before President-elect Joe Biden is sworn in on Wednesday.
The Centers for Disease Control and Prevention's ensemble projections estimate 403,000 total Covid-19 deaths in the US by the third week of January. This comes as hospitals and health care systems scramble to keep up with the influx of new patients.
In the US, 388,533 people have died from Covid-19 since the beginning of the pandemic. Thursday's figures showed 229,386 new cases and 3,769 new deaths, according to Johns Hopkins University data.
The City of Laredo, Texas, tweeted an "emergency message" Thursday saying their medical professionals are overwhelmed with the surge in Covid-19 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.
As front line workers struggle to keep patients alive and hospital ICU wings operational, the success of the vaccine rollout remains inconsistent.
Discrepancies in vaccine distribution
More than 9.6 million people have received their first dose of a Covid-19 vaccine, according to data published by the CDC. Of those, more than 1.3 million have received their second dose.
The Pfizer and Moderna vaccines, which were given emergency use authorization by the Food and Drug Administration in December, require a second dose in order for the vaccines to reach 95% effectiveness in preventing symptomatic infections.
Biden called the vaccine distribution rollout so far "a dismal failure." Officials with Operation Warp Speed set a target of 20 million doses issued by the end of 2020, which fell short. The operation's chief adviser, Moncef Slaoui, told CNN the figure was a "hope" and not a promise.
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's John King on Thursday. Instead of using chain drugstores to administer the vaccine, the governor said the state has relied on partnerships with local pharmacies as well as the state health department and National Guard to distribute the vaccines effectively.
"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."
The successes in West Virginia are unmatched anywhere else in the nation.
Texas Gov. Greg Abbott declared Thursday that the state is leading the nation in total vaccine distribution, with 1 million vaccines administered according to CDC data.
However, 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. One CEO of a rural hospital group reported that some employees had to get vaccines from a local supermarket, which had extra doses to spare.
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.
A member of Biden's coronavirus advisory board said Thursday this could have almost 180 million Americans eligible for the vaccine, yet the supply to handle this number won't be reached until summer at best.
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.
The need for continued adherence to Covid-19 precautions is evident, as demonstrated in states such as California. The situation faced by its hospital ICUs and emergency rooms is ever-present.
Available ICU beds have reached their lowest level, according to the California Department of Public Health. Less 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 struck hard. The seven-day average of deaths in the county from Covid-19 is 1,644 people, according to JHU data. This averages to about one death every six minutes.
CNN's Haley Brink, Christina Maxouris, Lauren Mascarenhas, Raja Razek, Maggie Fox, Deidre McPhillips, Cheri Mossburg, Jessica Firger and Nick Watt contributed to this report.