The dire situation in some hospitals is starting to sound like January’s infection peak: surgeries cancelled in hospitals in Washington state and Utah. Severe staff shortages in Kentucky and Alabama. A lack of beds in Tennessee. Intensive care units at or over capacity in Texas.

The deteriorating picture nine months into the nation’s vaccination drive has angered and frustrated medical professionals who see the heartbreak as preventable. The vast majority of the dead and the hospitalised have been unvaccinated, in what has proved to be a hard lesson for some families.

“The problem now is we have been trying to educate based on science, but I think most of the education that is happening now is based on tragedy, personal tragedy,” said Dr Ryan Stanton, an accident and emergency doctor in Lexington, Kentucky.

In Kentucky, 70 per cent of the state’s hospitals – 66 of 96 – were reporting critical staff shortages, the highest level yet during the pandemic, the governor said.

“Our hospitals are at the brink of collapse in many communities,” said Dr Steven Stack, Kentucky’s public health commissioner.

The US is averaging over 1,800 Covid-19 deaths and 170,000 new cases per day, the highest levels respectively since early March and late January. And both figures have been on the rise over the past two weeks.

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The country is still well below the terrifying peaks reached in January, when it was averaging about 3,400 deaths and a quarter-million cases per day.

The US is dispensing about 900,000 vaccinations per day, down from a high of 3.4 million a day in mid-April. On Friday, a Food and Drug Administration advisory panel will meet to discuss whether the US should begin giving booster shots of the Pfizer vaccine.

On a positive note, the number of people now in the hospital with Covid-19 appears to be levelling off or even declining at around 90,000, or about where things stood in February.

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US Covid-19 deaths could increase by another 100,000 unless Americans change their ways

US Covid-19 deaths could increase by another 100,000 unless Americans change their ways

Last week, the president ordered all employers with more than 100 workers to require vaccinations or weekly tests, a measure affecting about 80 million Americans. And the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.

“We read about and hear about and we see the stories of hospitalised people, people on their deathbeds among the unvaccinated over the past few weeks,” Biden said in announcing the rules. “This is a pandemic of the unvaccinated.”

In Alabama, hundreds of Covid-19 patients fill intensive care units, and one hospital contacted 43 others in three states to find a speciality cardiac ICU bed for Ray Martin DeMonia. It wasn’t soon enough. The 73-year-old died September 1.

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“In honour of Ray, please get vaccinated if you have not, in an effort to free up resources for non-Covid related emergencies,” his family pleaded in his obituary.

In Hidalgo County, Texas, along the Mexican border, about 50 patients were in the hospital with Covid-19 on a given day in July. By early August, the number had soared to over 600.

The biggest surge over the summer occurred in states that had low vaccination rates, particularly in the South, where many people rely on air conditioning and breathe recirculated air, said Linsey Marr, a professor of civil and environmental engineering at Virginia Tech. She said states farther north could see upticks as the onset of cold weather sends people indoors.

Vaccination rates are not as low in some Northern states, but “there’s still a lot of unvaccinated people out there. Delta is going to find them,” Marr said.