The staggering toll of America's coronavirus approach can be seen in soaring death rates across the country that are much worse than deaths from the flu.
As coronavirus cases begin to climb again in the United States, Covid-19 is now the third leading cause of death there, with 2020 statistics showing it's beaten only by heart disease and cancer.
It comes as a forecast published by the US Centres for Disease Control and Prevention (CDC) projects there will be 243,000 to 256,000 coronavirus deaths in America by November 21.
At least 228,143 Americans have died from the coronavirus this year, representing about 8 per cent of all deaths in the country, according to Johns Hopkins University data.
This compares to cancer and heart disease, which made up about 20 per cent each.
Influenza and pneumonia only accounted for about 2 per cent of deaths, which is about the same as last year.
The coronavirus has been more deadly than stroke, Alzheimer's and diabetes, which have all killed less than 121,000 people each this year.
Graphs show a huge surge in coronavirus deaths, peaking in April, when it became the leading cause of death in the US for a brief period.
There has been reluctance in many US states to introduce lockdowns to tackle what some say is "just the flu", but these figures put to rest the argument that coronavirus is no worse than yearly influenza.
Death rates for the flu and pneumonia combined between January and October 10 were only around 2 per cent in the US.
In contrast, the coronavirus caused 8 per cent of deaths and this could grow as infections are again on the rise.
In the US, which has recorded more than 9 million coronavirus cases, deaths have been higher than expected in 74 of 126 weeks, according to the CDC.
This means deaths were higher in almost 60 per cent of those weeks.
Concern over what's to come
America's top Covid-19 expert, Dr Anthony Fauci, this week praised Australia's recovery from its second coronavirus outbreak in the state of Victoria, saying Australia had done "quite well" handling the pandemic.
During a University of Melbourne panel discussion, Fauci noted Australia had a geographical advantage over the US because it was an island and said America's southern border with Mexico had been "problematic".
He also pointed to the independence of each of America's states as a weakness in the country's coronavirus response and agreed introducing mandatory masks was difficult as "masks in the United States have almost become a political statement".
"I'm really concerned now," he said. "Thanksgiving [on November 26] is one of our most important holidays. A lot of travel, a lot of family settings.
"That's going to be really difficult. We're going to have a tough time in the next few months."
However, Fauci said he wouldn't dare publicly suggest measures like those that had been adopted in Victoria.
"If I were to use the words shutdown and lockdown, I'd be in serious trouble … they'd probably throw tomatoes at me."