A weekend of record-breaking numbers has pushed the US to the brink of 10 million coronavirus infections. And the pace keeps accelerating.
As of Monday, 43 states reported at least 10% more new Covid-19 cases compared to last week, according to data from Johns Hopkins University.
And the rate of new infections keeps outpacing the rate of testing.
The average daily number of new cases soared 34% over the past week, but testing has only increased 7.41% over the past week, according to data from the Covid Tracking Project.
'We absolutely need more testing. Cases are rising faster than testing rates are rising,' said Dr. Rochelle Walensky, a professor of medicine at Harvard Medical School.
More than 9.9 million people have been infected with coronavirus in the US and more than 237,000 have died.
While hospitalizations and deaths keep rising, there's good news on the vaccine front.
One vaccine may be 90% effective
On Monday, the drugmaker Pfizer said early data show its Covid-19 vaccine is more than 90% effective.
More than 43,000 volunteers had received either two doses of the vaccine or a placebo.
A so-called interim analysis looked at the first 94 coronavirus infections among the group. Fewer than 10% of infections were in participants who had been given the vaccine. More than 90% of the cases were in people who had been given a placebo.
Pfizer said it plans to seek emergency use authorization from the US Food and Drug Administration soon after volunteers have been monitored for two months after getting their second dose of vaccine, as requested by the FDA.
That request could be made by the third week of November.
Pfizer CEO Albert Bourla said so far, the vaccine has shown no safety problems.
'But we need to wait until the results are there,' Bourla told CNN Chief Medical Correspondent Dr. Sanjay Gupta.
It's not clear exactly when the vaccine might be publicly available to most Americans. But when it is, 'the vaccine will be available for free to all American citizens,' Bourla said.
'Pouring gasoline on a fire'
While America waits for a vaccine, coronavirus is raging at levels never before seen during the pandemic.
The US has averaged 108,737 new Covid-19 cases a day over the past week -- a new record high, according to Johns Hopkins.
The most infections ever reported in one day was on Saturday, with 128,412 new cases.
'Over the last week, about 23 states in all regions of the country reported record (new) cases,' Walensky said.
'The death rates are high, and in fact they represent case counts from two to three weeks ago. So that's when we had case counts in the 60,000-70,000 range. So you can imagine what's going to happen in the weeks ahead.'
And 19 states reported record-high Covid-19 hospitalizations over the weekend, according the Covid Tracking Project.
Emergency medicine physician Dr. Megan Ranney said the US is 'heading into the very worst of this pandemic,'
'We're about to see all of these little epidemics across the country, crossed and mixed,' Ranney said.
'It's going to be an awful lot like pouring gasoline on a fire,' she said.
'We must ... avoid further devastation'
Of the 43 states where new cases soared more than 10% this past week, 10 states have seen increases of more than 50%: Hawaii, Iowa, Kansas, Maine, Minnesota, Nebraska, Oklahoma, Oregon, Vermont and Washington state.
Seven states are relatively steady: Alabama, Georgia, Kentucky, North Carolina, South Carolina, South Dakota and Virginia.
No state has decreased the rate of new infections by more than 10% this past week.
Utah is one of many states cracking down with new mitigation efforts.
Gov. Gary Herbert issued an executive order Sunday declaring a state of emergency and issuing a mask mandate for all of Utah.
He also limited social gatherings to households only until November 23.
'Hospitalizations and ICUs are nearing capacity and healthcare providers will be unable to care for Utahns in the coming days if this surge continues,' the governor's office said in a statement.
'We must take action now to protect our hospitals and healthcare workers and to avoid further devastation on our families, communities, and businesses.'