The death toll from the spread of coronavirus in the United States closed in on 200,000 on Monday.
That's more than twice the number of fatalities in India, the country reporting the second-highest number of cases in the world.
And as the U.S. crosses that milestone - losing on average 800 people a day to virus - the pandemic here is not localized in one or two epicenters: it's smoldering across the nation.
Former FDA commissioner Scott Gottlieb painted a grim picture.
"The Northeast still is holding on to the gains that it achieved in driving down infections. But we're seeing infections starting to rise in the South as well. And you're definitely seeing a concentration of new infections in the Midwest. So that's- that's driving a lot of the growth and infections. But it's getting more distributed around the country."
That's fueling fears that as cooler weather drives Americans indoors and flu season hits, new outbreaks could surpass the surge seen over the summer.
Although new cases are down about 50% from the peak in July, the United States is still reporting on average nearly 40,000 new infections a day - the highest number in the developed world.
"The United States has done really well."
U.S. President Donald Trump last week continued to paint an optimistic picture of pandemic.
"And I really do believe we're rounding the corner. And the vaccines are right there."
His own heath experts, including the U.S. top infectious disease expert Dr. Anthony Fauci, disagree.
"We need to be doing much better than we're doing that's for sure."
The president is seeking re-election amid the health crisis. He's repeatedly claimed a vaccine could be available within weeks.
The director of the Centers for Disease Control bluntly disagreed, saying he didn't see one widely available until the middle of next year.
"I think we're probably looking at late second quarter, third quarter, 2021."
CDC Director Robert Redfield has also warned that with flu season approaching, Americans are in for “the worst fall, from a public health perspective, we’ve ever had,” citing concerns of a possible “twindemic” of COVID-19 cases and influenza overwhelming hospitals.