NEW YORK (Reuters)

More Americans were hospitalised with COVID-19 on Wednesday than at any time since the pandemic began, as coronavirus infections and deaths soared across much of the United States and a historic vaccination effort lagged.

U.S. COVID-19 hospitalisations reached a record 130,834 late on Tuesday, according to a Reuters tally of public health data, while 3,684 reported fatalities was the second-highest single-day death toll of the pandemic.

In hard-hit California, public health authorities ordered hospitals in more than a dozen southern and central counties overwhelmed with COVID-19 patients to suspend elective surgeries for at least three weeks.

The order, issued late on Tuesday by the state’s Department of Public Health, applies to 14 counties, including Los Angeles, Orange and San Diego, where hospital critical care capacity has been severely stretched.

With total U.S. COVID-19 cases expected to surpass the 21 million mark on Wednesday, pressure mounted on state and local officials to speed up distribution of the two authorised vaccines from Pfizer Inc with partner BioNTech SE and Moderna Inc.

The lack of a federal blueprint for the crucial final step of getting the vaccines into tens of millions of arms has left state and local officials in charge of the monumental effort, creating a patchwork of different plans across United States.

Some states have summoned extra resources to speed vaccine administrations. North Carolina Governor Roy Cooper on Tuesday mobilised the state’s National Guard to “provide support to local health providers” to more quickly distribute coronavirus vaccines.

“We will use all resources and personnel needed,” Cooper said in a statement.

Maryland Governor Larry Hogan also announced that, beginning on Wednesday, the emergency support teams from the state’s National Guard will lend a hand to local health departments in their vaccination efforts.

“At the current pace of allocation,” Hogan said, the state expects to be able to start vaccinating the 1b priority group – people age 75 and older and frontline essential workers – by late January.

In New York City, where Mayor Bill de Blasio and Governor Andrew Cuomo have sparred over slow vaccine distribution, officials said on Wednesday the city was ramping up its “vaccine hubs,” which would include 15 locations by January 16, five “mega sites” among them. The sites will have the capacity to vaccinate 100,000 New Yorkers a week, official said.

De Blasio said at a press briefing that home health aides and some members of the New York Police Department could receive the vaccine for the first time on Wednesday.

Another 3 million doses of the two vaccines were sent to U.S. states on Tuesday, acting Secretary of Defense Christopher Miller said in a statement, bringing the total to more than 19 million doses in 21 days, only a fraction of which have been administered so far.

Both authorised vaccines require two doses three or four weeks apart. Healthcare workers in several states this week began getting their second dose of the Pfizer/BioNTech vaccine, which was approved prior to the Moderna shot.

The U.S. government was considering halving the doses of Moderna’s vaccine to free up supply for more vaccinations. But scientists at the National Institutes of Health and Moderna said it could take two months to study whether the halved doses would be effective.

Meanwhile, CVS Health Corp said on Wednesday it expected to complete administering the first doses of COVID-19 vaccines at nearly 8,000 U.S. nursing homes by January 25.

A massive global vaccination campaign will be needed to establish a level of herd immunity that could put an end to the devastating pandemic raging across much of the United States and many other countries, with more highly-transmissible variants of the virus cropping up.