Global confirmed cases of COVID-19 crossed the 90 million mark with an astounding growth rate at approximately 600,000 new cases per day this year. American cases have risen faster, at a clip of well above 225,000 over the same period. Confirmed cases in the United States have topped 22 million, or 25% of the world’s total.

The ratio shows the extent to which America has not been able to arrest the growth of the disease. California, the country’s largest state by population, has 2,686,999 confirmed cases, higher than all but six countries, which include America. The others are India (10,451,346), Brazil (8,075,998), Russia (3,401,954), the United Kingdom (3,017,409) and France (2,767,312).

The American number is dominated by a few states with counts over a million. Aside from California, these are Texas (1,967,859), Florida (1,464,697), New York (1,119,541) and Illinois (1,026,639). The confirmed cases among those states are, in turn, dominated by a few counties. The hardest-hit county in America is its largest by population. Los Angeles County has 907,077 cases. Cook County, home to Chicago, has 415,991. Maricopa, home to Phoenix, has 374,740. Miami-Dade has 324,360, and Harris County, home to Houston, has 259,773.

State and county size do not tell the entire COVID-19 story in America. The brutal spread of the disease has been worst in some smaller states over the past two months. North and South Dakota each have a population under a million. Yet, confirmed cases in South Dakota have hit 102,901. In North Dakota, they currently total 94,566. The worst of the spread has moved to Rhode Island, which has the highest cases per 100,000 people, based on a seven-day average, among all states by far.

America’s past may not be the worst of it. Only a little more than 8 million Americans have been vaccinated. Most of these are frontline health workers and some people in nursing homes. The goal had been to vaccinate 20 million people in the United States by the end of December. The figure will not approach that by mid-January. The distribution system for vaccines is in disarray and may not be sorted out for weeks, at best. Scientists estimate that well over 150 million people will be vaccinated before the spread of the disease has been mostly arrested. The end date for the number may stretch well into late summer or early autumn.

The rapid spread of COVID-19 in America and the slow rollout of the vaccines means as many as 700,000 people will die by April 1, based on the carefully followed model maintained by the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine.

America’s progress compared to the balance of the world, on the whole, is worsening.

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