That’s a sobering if not altogether surprising admission at a moment when—18 months into the pandemic and with a handful of effective vaccines already developed— the world is still very much scrambling in its battle with the coronavirus.

That’s especially true in the U.S., where against the back-to-school backdrop, cases remain staggeringly high and are straining the health infrastructure in many states, thanks to the continued spread of the highly contagious Delta variant. As of Wednesday, Sept. 8, seven states had more than 90% of their ICU beds occupied, according to data from the Department of Health and Human Services. Alabama, where 52% of ICU patients have COVID, has more ICU patients than beds and is operating at 102.5% capacity. Idaho, meanwhile, has begun rationing care due to the crisis-level volume of COVID patients there. Another 10 states have fewer than 20% of ICU beds available; high occupancy rates signal not just a high level of severely ill COVID patients but also limited resources to treat other patients suffering serious, often life-threatening conditions.

The high level of hospitalizations in many states reflects the surging number of new cases experienced in recent weeks, particularly among populations with relatively low vaccination rates. While the rise in new cases reported daily has begun to slow—the national average currently stands at 152,393 per day according to New York Times data—that level remains higher than at most other points during the pandemic. Deaths per day due to the virus, meanwhile, increased 34% in that same period.

COVID cases among the population are currently highest in Tennessee, where 110.2 people per 100,000 are infected, followed by Kentucky and South Carolina. Cases are lowest in the Northeast; in Connecticut, just 14.7 people per 100,000 have the virus.

New coronavirus cases are rising fastest in Maine—where they are up 96.7% over the level two weeks ago—followed by Ohio and West Virginia. If there’s good news, it’s that new cases are falling, down more than 20% compared to two weeks ago, in some of the recently hard-hit states of Arkansas, Louisiana, Mississippi, and Florida.

One worrying trend to emerge in the case data in recent weeks is the record number of children among those getting COVID—roughly 252,000 in the past week, according to the American Academy of Pediatrics. While kids are unlikely to become severely ill, they do make up a large chunk of the nation’s unvaccinated population and so remain among those more vulnerable to infection.

As of Wednesday, Sept. 8, 177.1 million Americans, or 53.3% of the population, are fully vaccinated against COVID, according to data from the Centers for Disease Control and Prevention.