The United States has reported more than 4,000 COVID-19 deaths on Thursday local time for the first time, as health systems struggle to cope with the number of sick and dying patients.
A total of 4,033 people died in connection with the virus within 24 hours, according to the Covid Tracking Project.
The country has seen a total of 365,000 deaths linked to the coronavirus so far, according to data from Johns Hopkins university, out of a population of 330 million people.
As well as the deaths, Thursday brought reports of more than 266,000 new cases, bringing the total tally to in excess of 21.6 million cases.
Case numbers are particularly high in the state of California, and in Los Angeles County where more than one in five test results are coming back positive.
Los Angeles is now at the heart of the country's COVID-19 pandemic, with hospital medics saying they have never seen anything on this scale.
"It's hard. We're human, and we're trying our best," said nurse Vanessa Arias. "But we've seen so much death during the past few weeks."
Barely moments earlier, she had informed another tearful family that their mother had just passed.
"We're in the midst of the eye of the storm," she said.
Martin Luther King Jr Community Hospital, sandwiched between the neighbourhoods of Watts and Compton, is stretched far beyond capacity by an unrelenting influx of coronavirus patients.
When AFP visited this week, it had converted a chapel and former gift shop into overflow and examination rooms, created new makeshift ICU beds in the post-surgery ward, and built field hospital tents outside its front entrance.
The 131-bed hospital had 215 patients, the majority with COVID-19. National Guard medics had just arrived to ease the strain on overwhelmed doctors and nurses.
"If Los Angeles is the epicentre of the world, this community is the epicentre of COVID in Los Angeles," said hospital CEO Elaine Batchlor.
Surrounding neighbourhoods are overwhelmingly Hispanic and black - two demographics hit hardest by the virus.
At the MLK hospital, many of the patients are essential workers, highly exposed at jobs in grocery stores and public transport, and living in crowded homes where isolating is near-impossible.
Even before COVID-19, the community suffered from epidemic levels of preventable and chronic disease, including diabetes, obesity, heart disease and sepsis.
"We're seeing whole families, groups of them, getting sick at the same time," said Arias, who like many MLK staff is herself Hispanic and grew up locally.
"I could have been one of these people... It's very unfortunate to see people that look like you die."
'Worst I've been to'
The infection numbers affecting Los Angeles since November have been staggering, even after 10 long months of pandemic in the nation's second largest city.
A record 8,000 county residents are currently hospitalised with COVID-19. Around one in 12 have already been infected, and one in five of those tested recently are positive. More than 11,000 have died.
"I was also in New York when it was really bad. But this has probably been the worst I've been to," said Taylor Reed, a 24-year-old travelling nurse, who also worked in Washington, DC and Minnesota last year.
California was initially praised for its handling of the pandemic in the spring, but skyrocketing cases have sent most of the state back under "stay-at-home" orders.
Ambulance workers have been told to stop transporting some patients with extremely low survival chances.
California hospitals were this week ordered to postpone non-urgent surgeries and to accept COVID-19 patients from elsewhere in the hard-hit state if they have space.
Still reeling from a spike caused by Thanksgiving gatherings that spread infections, state public health chiefs expect the Christmas coronavirus "surge upon a surge" to peak in the next two weeks.
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