The US has hit a record number of coronavirus hospitalisations and surpassed 1m new confirmed cases in just the first 10 days of November.
Infections are now running at all-time highs of well over 100,000 per day, pushing the total to more than 10m and eclipsing 1m since Halloween.
There are now 61,964 people hospitalised, according to the Covid Tracking Project.
Several states posted records on Tuesday, including over 12,600 new cases in Illinois, 10,800 in Texas and 7,000 in Wisconsin.
Deaths — a lagging indicator, since it takes time for people to get poorly and die — are climbing again, reaching an average of more than 930 a day.
“The virus is spreading in a largely uncontrolled fashion across the vast majority of the country,” Dr William Schaffner, an infectious-disease expert at Vanderbilt University, told AP.
State governors have made increasingly desperate pleas for people to take the fight against the virus more seriously.
In an unusual prime-time speech hours after Wisconsin set new records for infections and deaths, Democratic governor Tony Evers advised people to stay in their houses and said businesses should allow people to work remotely, require masks and limit the number of people in stores and offices.
Minnesota governor Tim Walz, a Democrat, ordered bars and restaurants to close at 10pm. His Iowan Republican counterpart, Kim Reynolds, said she will require masks at indoor gatherings of 25 or more people, inching toward more stringent measures after months of holding out.
In Massachusetts, Republican governor Charlie Baker is warning that the health care system could become overwhelmed this winter. He recently ordered restaurants to stop table service, required many businesses to close by 9.30pm, and instructed residents to stay home between 10pm and 5am.