The United States has ended 2020 with a record number of people hospitalised for COVID-19 and with discouraging forecasts for the first months of 2021 after the arrival of the mutated strain first identified in the UK.
New Year's Eve has been sombre in the country where the pandemic has led to almost 20 million confirmed cases and more than 343,000 deaths.
December has seen new records for fatalities set on consecutive days, according to the independent tally being kept by The Johns Hopkins University.
And the outlook for January looks extremely dark with the US Centres for Disease Prevention and Control predicting that in the coming three weeks at least 80,000 Americans could die from disease.
California, one of the states where hospitalisations have skyrocketed in recent weeks, announced on Wednesday that it had detected the first case in the state of the viral strain reported in the UK , one day after Colorado diagnosed the first US case there.
Dr. Anthony Fauci said in a Thursday interview with NBC News that it was "inevitable" the new strain would get to the US and very soon cases will be detected in other states.
Given this panorama, many Americans are putting all their hopes on the vaccines, but the immunisation campaign - was launched two weeks ago - has progressed much more slowly than predicted by the Donald Trump administration.
As of Wednesday, fewer than 2.8 million people had received the first dose of the two-injection vaccine series, just 14 per cent of the 20 million Americans the government said it planned to immunise before the end of December.
Fauci said that he and other health experts would have liked things to move more smoothly and quickly, but obviously that has not occurred and that is "disappointing."
The man who will be President-elect Joe Biden's main medical advisor for the Covid-19 pandemic said health authorities are considering not reserving the second doses of the vaccine for those who have already had the first Pfizer and Moderna doses, but instead giving more people at least a first injection, which does provide a certain amount of protection, although two doses are required to get the efficacy up above 90 per cent.
Fauci said that giving just one shot is not an ideal solution and he urged the local authorities be given additional resources to be able to administer the vaccine in their areas.
In many cases local health clinics have been overwhelmed by the pandemic and have been unable to manage distributing and administering the meds, including training and scheduling health care personnel to do so.
Many health professionals are frustrated with the slowness of the campaign, including Jonathan Reiner, a professor of medicine at Johns Hopkins University, who says the government should repurpose big facilities like football stadiums into temporary vaccination clinics.
He told CNN the US needs to vaccinate two million people each day, not the 150,000 who are currently getting the vaccine, adding that he does not see the authorities moving with urgency to ramp up to the ideal level.
Meanwhile Trump, whose presidency ends on January 20, posted a new message on Twitter touting his alleged accomplishments, despite the tough scenario across much of the nation.
"(Amid) great challenges this year Americans showed incredible grit, strength, tenacity and resolve, and together we achieved truly historic victories like nobody ever thought possible," said Trump on a video he posted minutes after returning to the White House from a golfing vacation at his Mar-a-Lago resort in southeast Florida.