The third wave of the COVID-19 pandemic in the United States is wreaking havoc on the already beleagured health systems throughout a large swath of the country. There were 200,000 confirmed cases on Friday alone, along with nearly 2,000 deaths. The Institute for Health Metrics and Evaluation is projecting another 50,000 fatalities before the winter holidays end.

Despite these disastrous surges, both the outgoing Trump and incoming Biden administrations reaffirmed this week that there will be no nationally coordinated lockdowns to combat the pandemic.

To date, there have been 12.2 million confirmed coronavirus cases in the US and more than 260,000 deaths. This includes a record 4.5 million active cases, more than one percent of the entire US population, and more than 80,000 hospitalizations. Not only are both figures at record highs, the pace at which both are increasing far exceeds even the sharp rise in cases and hospitalizations in April, a measure of how widespread the pandemic has become in the United States and how little is currently being done to slow the spread.

What measures are being taken are limited to mask mandates, short term and limited restrictions such as limiting the operating times of bars and restaurants, and advisories to remain vigilant. The two main vectors of infection, schools and workplaces, are being kept open even as workers and students continue to lose their lives.

The explosion of cases nationwide also belies any hopes linked to vaccines as logistical challenges loom in the face of the sheer mass of infections and rapidly rising death tolls. According to many in the public health sector, it will take the better part of next year to see a vaccine widely distributed, along with $4.5 billion in federal aid to build and coordinate the vaccine distribution network.

A case in point, Wisconsin's hospital association, has warned that the health system within the state is on the brink of "catastrophe." President of Wisconsin's Hospital Association, Eric Borgerding, wrote to Democratic Governor Tony Evers that the state needed more field hospitals. He said: "Wisconsin faces a public health crisis the likes of which we have not experienced in three generations. A crisis of this magnitude caused by a virus that is so clearly raging across all of Wisconsin demands a unified and substantial response." Yet, the state government is in gridlock on any measures that restrict local businesses' operations. All that has been tentatively agreed to is extending the already in place mask mandate into 2021.

On Thursday, the Centers for Disease Control and Prevention (CDC) issued a dire warning against Thanksgiving travel. "The safest way to celebrate Thanksgiving this year is at home with the people in your household," said Dr. Erin Sauber-Schatz of the CDC. Despite this warning, the American Automobile Association predicts that up to 50 million Americans will visit family or friends during the period, 95 percent traveling by car. This massive movement of the population will only exacerbate the situation. In 2019, it was estimated that 55 million people traveled.

Along with the shortage in material preparedness, the critical shortage of health care workers is pushing health systems to the brink. STAT News reported that hospitals across 25 states are severely understaffed, forcing facilities to transfer severely ill patients hundreds of miles, often across state lines, just for a hospital bed.

John Henderson, chief executive of the Texas Organization of Rural & Community Hospitals, put it bluntly: "Care is about more than a room with a hospital bed. It's about medical professionals taking care of patients. If you don't have the staff to do that, people are going to die." Texas has more than 8,000 hospitalized patients, up from 3,000 in September.

At the Odessa Regional Medical center, the neonatal intensive care unit has been converted into a COVID-19 ICU for adults. Its ICU capacity was beyond capacity, necessitating an overflow unit to be established in a separate building. Instead of the usual limit of two patients to a critical care nurse, nurses there see six or eight.

Dr. Rohith Saravanan, the hospital's chief medical officer, told CNN, "The only space that's not full right now is the hallways. For every patient that you see here, there's several more that are positive outside the hospital that could have used some care, but there's no space. The more critical people get admitted and the rest get sent home."

These scenarios play out from rural areas of Kansas, Missouri, Utah and the Dakotas to metropolitan communities in Los Angeles County and the Chicago suburbs. Health care workers infected with COVID or in quarantine on top of chronic shortages of nurses and doctors in rural communities means the backup nurses available in the spring are now practically non-existent.

A spokesman for the Ohio Hospital Association, John Palmer, explained that 20 percent of 240 hospitals across the state are facing staffing shortages.