The US reported its highest daily number of Covid-19 deaths on Tuesday with more than 4,320 fatalities attributed to the virus.

It marked the second time -- both this month and since the pandemic's start -- that the US reported more than 4,000 Covid-19 deaths in a single day.

Over the past week, the US has averaged more than 3,300 deaths every day, a jump of more than 217% from mid-November.

The numbers are grim, but to some experts they're not surprising. They follow Covid-19 case surges -- fueled by holiday gatherings -- across the country and weeks of record-high hospitalization numbers.

Now more than 131,300 Americans are hospitalized with the virus, according to the COVID Tracking Project -- and in some parts of the country, hospitals have reached their breaking point.

Arizona reported a record-high 5,082 hospitalized Covid-19 patients Tuesday and on the same day broke a second record: more than 1,180 patients with the virus in ICU beds. In Louisiana, Gov. John Bel Edwards extended an order which keeps Covid-19 mitigation measures in place for nearly another month, saying the state was seeing a "huge spike" in cases and hospitalizations.

Those numbers are also on the rise in college towns as students return for the first semester of 2021.

Full-time enrollment at higher education institutes accounts for more than a quarter of the population in 30 US counties, according to the National Center for Education Statistics. Infections increased in 26 of the counties over a week, by an average of 50%. In Williamsburg, Virginia -- home to William & Mary -- cases nearly tripled over seven days. Cases more than doubled in Whitman County, Washington, home of Washington State University and Albany County, Wyoming, home of University of Wyoming.

And at least 90% of staffed ICU beds are occupied in 10 of the counties, including Mississippi State University's Oktibbeha County, where nearly all ICU beds are occupied by Covid-19 patients.

Track Covid-19 cases in the US

Government announces vaccine rollout changes

Also Tuesday, Health and Human Services Secretary Alex Azar announced the federal government will no longer hold back Covid-19 vaccine doses it kept in reserve and encouraged states to open vaccinations to more people.

"We are telling states they should open vaccinations to all people ... 65 and over and all people under age 65 with a comorbidity with some form of medical documentation," Azar said.

More than 27.6 million vaccine doses have so far been distributed, according to CDC data, and more than 9.3 million people have received their first dose -- a far cry from where some experts hoped the country would be by now.

In many cases, it's been the rigid following of guidance on who should get the vaccines first that has slowed the vaccine rollout, Dr. Anthony Fauci said Tuesday.

While priorities recommended by the CDC shouldn't be abandoned, Fauci said, "When people are ready to get vaccinated, we're going to move right on to the next level, so that there are not vaccine doses that are sitting in a freezer or refrigerator where they could be getting into people's arm."

Azar added Tuesday that second doses will still be available to those who need them, saying "based on the science and evidence we have, it is imperative that people receive their second doses on time."

The Pfizer vaccine doses should be spaced 21 days apart, and the Moderna doses should be 28 days apart.

And there are more changes on the way: Starting two weeks from now, vaccines will be distributed to states based on which jurisdictions are getting the most doses into arms and where the most older adults reside.

"We will be allocating them based on the pace of administration as reported by states and by the size of the 65 and over population in each state," Azar said. "We're giving states two weeks' notice of this shift to give them the time necessary to plan and to improve their reporting if they think their data is faulty."

Nearly 2.3 million children have tested positive for Covid-19

Meanwhile, a new report from the American Academy of Pediatrics and the Children's Hospital Association shows that as of January 7, nearly 2.3 million children had tested positive for Covid-19 since the pandemic's start.

More than 171,000 of those cases were reported between December 31 and January 7, while over two weeks -- between December 24 through January 7 -- there was a 15% increase in child Covid-19 cases, the report said.

The findings mean children now represent 12.5% of all Covid-19 infections in the US.

"At this time, it appears that severe illness due to Covid-19 is rare among children," the report said.

"However, there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects."

CNN's Amanda Watts, Joe Sutton, Jacqueline Howard, Naomi Thomas, Jacqueline Howard, Nick Neville, Maggie Fox, Deidre McPhillips, Jessica Firger and Jamiel Lynch contributed to this report.



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