The coronavirus pandemic reached a grim milestone this week in the United States, as more loss of life and hospitalizations were reported in a single day than ever before.

Wednesday’s 3,157 deaths attributed to COVID-19 broke the previous record of 2,603 set on April 15, according to CNN.

Also Wednesday, the number of people hospitalized with the coronavirus in the United States surpassed 100,000, the most at any point since the beginning of the pandemic, according to reports.

The thousands of hospitalizations more than doubled from one month earlier and topped any total since the beginning of the pandemic, according to The Associated Press. The nation is averaging more than 160,000 cases and 1,500 deaths per day, and hospital rooms are running thin as a record number of new patients seek care.

The worst-hit areas appear to be South Dakota, Nevada and Indiana, which lead the nation in hospitalizations per capita, while California has the highest number with 9,365 hospitalizations, according to CBS News, which cited the COVID Tracking Project.

There are multiple reports around the country of health care workers forced to use alternate care sites such as parking garages to treat patients.

CBS reports there are 66% more people hospitalized now than there were during the first peak in April, when the first shortage of hospital beds became apparent in large cities across the country.

Staffing shortages are also an issue, with more than 1,000 hospitals nationally struggling to meet the heavy demand, according to the network.

“The reality is, December, January and February are going to be rough times. I actually believe they’re going to be the most difficult time in the public health history of this nation — largely because of the stress that’s going to put on our health care system,” Director Dr. Robert Redfield said Wednesday during a U.S. Chamber of Commerce event.

He also predicted that U.S. virus deaths, which are now around 273,000, could approach 450,000 by February.

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