Coronavirus deaths in the United States approached 190,000 on Wednesday.
The rising toll comes amid a spike in new cases in parts of the Midwest, with Iowa and South Dakota emerging as new hotspots.
The surge in Iowa comes after that state reopened its colleges, and it now has one of the highest infection rates in the nation, with 15 percent of tests turning up positive last week.
In nearby South Dakota, a Reuters analysis puts the positive test rate at 19 percent, with many cases linked to a densely-packed motorcycle rally last month in the town of Sturgis.
"We're starting to see the beginning of surges in places like Montana, the Dakotas, Michigan, Minnesota, Iowa."
The top U.S. infectious disease expert, Dr. Anthony Fauci, this week told a health forum the nation the situation was "very serious and very concerning."
"If you look at the country as a whole, we need to be doing much better than we're doing that's for sure."
New U.S. coronavirus infections have fallen for seven weeks in a row.
The U.S. has over 6.3 million confirmed cases of the disease - the highest in the world.
Roughly 6,100 Americans died each week from COVID-19 in the last month.
The U.S. Centers for Disease Control forecast that the death toll would top 200,000 by the end of September.
A closely-watched metric from University of Washington last week predicted U.S. deaths from the coronavirus would reach 400,000 by the end of the year.