Despite a coronavirus vaccine expected to get final approval this month, the virus continues to ravage America and healthcare providers. U.S. hospitals had about 100,800 Covid patients last Friday, creating a crisis-level shortage of beds and staff in some places. (The previous peaks were just under 60,000 patients nationwide last April and July.) Rising infection rates among nurses, respiratory therapists and other hospital workers strain capabilities even more as they miss work.

No end is in sight as the pandemic continues to hammer cities and rural areas, totaling 14.3 million cases so far this year. New diagnoses have climbed to nearly 200,000 daily, and health experts warn that December holidays may speed the already fast pace of infection. "We're drowning," says Dr. Micah Luderer at Barnes Jewish Hospital in St. Louis.

Medical staff reinforcements, such as temporary hires and traveling nurses, are harder to find because of the intense demand in most states. Some hospitals recruit retired professionals or ask family doctors to help fill gaps. Non-critical surgeries and other procedures are delayed to focus on Covid care. In Tennessee, Gov. Bill Lee issued an emergency order loosening regulations to give hospitals more staffing flexibility. In California, stay-home orders took effect late last week in 23 southern counties -- including Los Angeles -- because intensive care units exceeded 85 percent of capacity. Residents must keep inside except for essential tasks and exercise. Some governors prepare for possibly opening or reopening overflow "field hospitals" staffed by military doctors, nurses and technicians.

While scrambling to cope with Covid, hospitals also serve other patients. Some of those coming to emergency rooms or making appointments for tests had stayed away earlier this year, fearful of being infected. "That's changed,” says Claude Stang, emergency department director at Cedars-Sinai Medical Center in Los Angeles. "In this third wave, patients are coming to the hospital for various conditions, and they don't seem as fearful about coming to the hospital." That's good, he adds, though challenging to accommodate right now.

Hospital executive says: "The entire country is looking for the same staff that every single health care system and every state is looking for." -- Dr. Marjorie Bessel, chief clinical officer at Banner Health in Phoenix

California governor says: "This is the most challenging moment since the beginning of this pandemic." – Gavin Newsom

Nurse says: "This is definitely the worst that it's been for us right now. It's a time that I've never experienced before." -- Amy Spitzner, registered nurse in the Covid intensive care unit at Mayo Clinic in Rochester, Minn.