The U.S. surpassed 400,000 COVID-19-related deaths Tuesday morning, marking the latest grim milestone in the country’s fight against the pandemic.

“Deaths certainly did not take a holiday,” said Dr. Michael Saag, University of Alabama at Birmingham Associate Dean for Global Health.

In fact, Saag said the holidays fueled the surge in cases and deaths in a double whammy. Health officials had warned that an increase in travel during both the Thanksgiving and year-end holidays would undoubtedly result in a surge.

Last week marked the deadliest week so far, rendering true predictions by top health officials and experts who warned in December of a peak in mid-January. More than 4,000 American daily deaths were reported for at least six of the past 13 days, and an average of 3,200 died daily.

U.S. Centers for Disease Control and Prevention (CDC) Director Robert Redfield correctly predicted in December that the daily death toll would eclipse the total deaths of 9/11 or Pearl Harbor by this time.

Parts of the country, such as Los Angeles, are overwhelmed by the surge in cases, and have begun to ration care — likening it to wartime medical care.

While overall hospitalizations nationally have started to decline, as have daily cases and deaths, the pandemic shows no signs of waning. Testing continues to be a constraint for health professionals, and a new CDC report showed the Abbott (ABT) rapid antigen testing machine, BinaxNOW— which was delivered to nursing homes around the country— detected only 36% of asymptomatic cases. But it remained highly sensitive to symptomatic cases, though still lower than the gold standard PCR tests.

Complicating the efforts to fight the pandemic is a slow and confusing rollout of vaccines.

While officials expected a slow ramp-up, confusing public pronouncements have made it hard for states to plan accordingly for administrations.

Last week, at the annual JPMorgan health conference, incoming CVS (CVS) CEO Karen Lynch said the company has already administered 1 million doses in nursing homes and is ready to administer 1 million doses daily — but supply is not ready to meet demand just yet.

A Health and Human Services spokesperson told Yahoo Finance that the government is able to ship about 4 million doses per week, and had about 13 million doses left to distribute last week, with no reserve stockpile remaining for additional doses.

States began expanding to lower priority groups to get vaccines after U.S. Health Sec. Alex Azar directed them to do so, saying that they were not beholden to ensuring every single person in a single category was vaccinated in order to move on to the next group.

But states were not able to order any more than the allocated amounts from the past few weeks, thereby stunting their abilities to roll out more vaccination sites and leading to thousands of appointment cancellations.

Meanwhile, New York Gov. Andrew Cuomo attempted to buy doses directly from Pfizer (PFE), but was told he could not.

On his last official day, Azar delivered a speech touting the 14 million doses administered to-date, and meeting the goal of 1 million doses per day.

Continuing that pace will be important for the incoming Biden administration, which has pledged to get 100 million doses administered in 100 days.

But some warn it is a hefty goal with little support to ensure it can happen, as the current rollout has shown.

President-elect Joe Biden’s nominee to lead the CDC, Dr. Rochelle Walensky, told the Journal of the American Medical Association Tuesday that the team would not have committed to that goal if it didn’t think it was possible.

Walensky also said the vision includes a state-by-state interaction in which the federal government would provide whatever resources are available to help states vaccinate more people efficiently.

Dr. Craig Spencer, director of global health in emergency medicine at Columbia University Irving Medical Center, told Yahoo Finance that there will likely be growing pains at the start of the new administration.

“It was always going to be difficult to get these vaccines out,” he said.

“I think what we have now is we are kind of in a limbo ... it’s hard to know whose policy and whose plan to follow,” Spencer added.

More from Anjalee:

• To combat vaccine hesitancy in minority communities we must address past wrongs: Surgeon General

• What you need to know about at-home, over-the-counter COVID-19 tests

• Biden COVID-19 adviser: Vaccine news is great, but we still have a ways to go

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