Even with vaccines widely and freely available, the country has lost more lives to the virus this year than in 2020 due to the more contagious Delta variant and people refusing to get inoculated against COVID-19.

Since the start of the year, over 450,000 people in the United States have died after contracting COVID-19, or 57% of all U.S. deaths from the illness since the pandemic started.

The deaths this year were mostly in unvaccinated patients, health experts say. Deaths have increased despite advances in caring for COVID patients and new treatment options such as monoclonal antibodies.

It took 111 days for U.S. deaths to jump from 600,000 to 700,000, according to Reuters analysis. The next 100,000 deaths took just 73 days.

Other countries have lost far fewer lives per capita in the past 11 months, according to the Reuters analysis.

Among the Group of Seven (G7) wealthiest nations, the United States ranks the worst in terms of per capita deaths from COVID-19 between Jan. 1 and Nov. 30, according to the Reuters analysis.

The death rate in the United States was more than three times higher than in neighboring Canada and 11 times more than Japan.

Even when the United States is compared with a larger pool of wealthy countries with access to vaccines, it ranks near the bottom. Among the 38 members of the Organization of Economic Cooperation and Development (OECD), the United States ranks 30th. Only Hungary, Slovakia, Czech Republic, Lithuania, Latvia Colombia, Poland and Slovenia had more COVID-19 deaths per capita. New Zealand had the least.

When compared with the European Union, the United States has 1.3 times the per capita deaths reported in the last 11 months than the entire bloc.

Among more than 200 nations and territories tracked by Reuters, the United States ranks 36th.

The United States has the highest number of reported total COVID-19 deaths in the world, followed by Brazil and India, according to the Reuters tally. With just 4% of the world’s population, the country accounts for about 14% of all reported COVID-19 deaths and 19% of cases worldwide. The country is set to soon surpass 50 million cases.

New infections in the United States were averaging around 120,000 a day, with Michigan contributing the most cases a day. COVID-19 patients were filling Michigan hospitals at record levels, with three out of four of them unvaccinated, according to Michigan Health & Hospital Association (MHA).

Scientists are still evaluating the impact of the new Omicron variant and whether vaccines could provide adequate protection against it.

‘Must Act Together’

The Delta variant remains the dominant version of the virus in the United States.

Of the 10 states that reported the most deaths per capita in the last 11 months, eight were from the country’s south – Alabama, Georgia, Florida, Kentucky, Oklahoma, Mississippi, South Carolina and West Virginia, according to the Reuters analysis.

Roughly 60% of the U.S. population has been fully vaccinated against COVID-19, CDC data showed.

Fears of the new variant have prompted Americans to line up for booster doses of COVID-19 vaccines at a record pace. Just under a million people a day received booster doses of one of the three authorized vaccines last week, the highest rate since regulators gave the nod to additional shots.

“We must act together in this moment to address the impact of the current cases we are seeing, which are largely Delta, and to prepare ourselves for the possibility of more Omicron,” U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said at a White House briefing on Tuesday.

India reported 379,257 new infections and 3,645 new deaths on Thursday, health ministry data showed, the highest number of fatalities in a single day since the start of the pandemic.

The world’s second most populous nation is in deep crisis, with hospitals and morgues overwhelmed.

Mumbai gravedigger Sayyed Munir Kamruddin, 52, said he and his colleagues were working non-stop to bury victims.

“I’m not scared of COVID, I’ve worked with courage. It’s all about courage, not about fear,” he said. “This is our only job. Getting the body, removing it from the ambulance, and then burying it.”

Each day, thousands of Indians search frantically for hospital beds and life-saving oxygen for sick relatives, using social media apps and personal contacts. Hospital beds that become available, especially in intensive care units (ICUs), are snapped up in minutes.

“The ferocity of the second wave took everyone by surprise,” K. VijayRaghavan, principal scientific adviser to the government, was quoted as saying in the Indian Express newspaper.

“While we were all aware of second waves in other countries, we had vaccines at hand, and no indications from modelling exercises suggested the scale of the surge.”

India’s military has begun moving key supplies, such as oxygen, across the nation and will open its healthcare facilities to civilians.

The oxygen crisis is expected to ease by mid-May, a top industry executive told Reuters, with output rising by 25% and transport systems ready to cope.

“My expectation is that by the middle of May we will definitely have the transport infrastructure in place that allows us to service this demand across the country,” said Moloy Banerjee of Linde Plc, India’s biggest oxygen producer.

Hotels and railway coaches have been converted into critical care facilities to make up for the shortage of hospital beds.

India’s best hope is to vaccinate its vast population, experts say, and on Wednesday it opened registration for all above the age of 18 to receive shots from Saturday.

But although it is the world’s biggest producer of vaccines, India does not have the stocks for the estimated 800 million now eligible.

Many who tried to sign up for vaccination said they failed, complaining on social media of being unable to get a slot or even to simply get on the website, as it repeatedly crashed.

“Statistics indicate that far from crashing or performing slowly, the system is performing without any glitches,” the government said on Wednesday.

More than 8 million people had registered, it said, but it was not immediately clear how many had got slots.

A local official in Mumbai said the city had paused its vaccination drive for three days as supplies were running short, while officials said the worst-hit state of Maharashtra was likely to extend strict coronavirus curbs by another two weeks.

Deaths most likely under reported

Only about 9% of India’s population of about 1.4 billion has received a dose since the vaccination campaign began in January.

However, while the second wave overwhelms the health system, the official death rate is below that of Brazil and the United States.

India has reported 147.2 deaths per million, the Reuters global COVID-19 tracker shows, while Brazil and the United States reported figures of 1,800 and 1,700 respectively.

However, medical experts believe India’s true COVID-19 numbers may be five to 10 times greater than the official tally.

At Delhi’s Holy Family Hospital, patients arrived in ambulances and private vehicles, some gasping for air as their oxygen cylinders ran out. In the ICU, patients lay on trolleys between beds.

“Someone that should be in the ICU is being treated in the wards,” Dr Sumit Ray, head of the unit, told Reuters.

“We are completely full. The doctors and nurses are demoralised, they know they can do better, but they just don’t have the time. No one takes a break.”

The U.S. State Department issued a travel advisory on Wednesday against travel to India because of the pandemic and advised its citizens to leave the country. Family members of U.S. government employees in India can voluntarily return to the United States, it added.

Prime Minister Narendra Modi has been criticised for allowing massive political rallies and religious festivals which have been super-spreader events in recent weeks.

Aid starts arriving

India expects close to 550 oxygen generating facilities from around the world as medical aid starts pouring in, Foreign Secretary Harsh Vardhan Shringla said on Thursday.

Two planes from Russia, carrying 20 oxygen concentrators, 75 ventilators, 150 bedside monitors, and 22 tonnes of medicine, have arrived in Delhi.

The United States is sending supplies worth more than $100 million, including 1,000 oxygen cylinders, 15 million N95 masks and 1 million rapid diagnostic tests, the White House said on Wednesday.

The United States also has redirected its own order of AstraZeneca manufacturing supplies to India, to allow it to make more than 20 million doses, the White House said.

India will receive a first batch of Russia’s Sputnik V vaccine on May 1. Russia’s RDIF sovereign wealth fund, which markets Sputnik V globally, has signed deals with five Indian manufacturers for more than 850 million vaccine doses a year.

Bangladesh said it would send about 10,000 vials of anti-viral medicines and 30,000 PPE kits.

Germany will send 120 ventilators on Saturday, and a mobile oxygen production facility next week, its defence ministry said.