US officials have reported more than 11 million cases of coronavirus as of Sunday (Nov 15), as the country's outbreaks speed to agonising new levels of hospitalisations.
The tally passed 10 million just a week ago, and more than 1 in 400 Americans have tested positive since.
The country logged more than 159,100 new cases Saturday, the third highest total of the pandemic, raising the new seven-day average to more than 145,000, with upward trends in 48 states and an 80% increase in added cases from the average two weeks ago.
Ten states set single-day case records; 29 states added more cases in the past week than in any other seven-day period. On Sunday, officials in New Jersey announced 4,538 new cases, the second single-day record in a row.
Deaths nationwide remain at lower levels than in spring's peak, but they are rising rapidly.
More than 1,200 new deaths were reported Saturday, pushing the seven-day average to more than 1,120 a day, a 38% increase from the average two weeks ago. Four states set new death records on Saturday: Montana, Oklahoma, Wyoming and South Dakota.
Dr Michael Osterholm, an adviser to President-elect Joe Biden, said the country was "in a very dangerous period," calling it the most dangerous public health crisis since the 1918 influenza pandemic, which killed an estimated 50 million worldwide, including some 675,000 Americans.
"My worst fear is we will see what we saw happening in other countries, where people were dying on the streets," he said on the NBC programme Meet the Press.
"The health care system is breaking, literally breaking."
Adm. Brett Giroir, assistant secretary of health and human services, called the situation "critical" on ABC's The Week.
The pandemic continues to take a disproportionate toll on Americans of colour, who have been hospitalised at rates roughly four times higher than non-Hispanic whites since the start of the epidemic.