The United States endured its worst day of the pandemic, with three Americans dying every minute, as Japan and China on Wednesday joined other nations in tightening virus restrictions and Russia prepared to begin its mass vaccination campaign.
Global infections have soared past 91 million, and the spikes have forced governments around the world to reimpose restrictions such as unpopular and economically painful lockdowns, including in Europe which is battling a devastating second wave.
The United States is still the worst-hit nation, logging a record 4,470 deaths in 24 hours on Tuesday, as it reeled from a winter surge in infections that has overwhelmed hospitals and clinics in many areas even as vaccines are rolled out.
"It's most definitely the darkest period of my entire career," said Kari McGuire, a palliative care supervisor at the St Mary hospital in Apple Valley, a small rural town in California.
"I've personally had to watch people that I know, that I care for, watch their loved ones die. It's been very difficult."
Authorities also announced that starting January 26, all travelers entering the United States by air will need a negative Covid-19 test before departure.
Neighboring Canada also scrambled to contain a worrying outbreak, ordering residents in Ontario -- its economic engine and most populous province -- to stay home.
Ontario Premier Doug Ford warned that the healthcare system was "on the brink of collapse."
- Japan emergency -
Japan was also set to expand its state of emergency in greater Tokyo from Thursday to seven more regions including the major cities of Osaka and Kyoto, and also to tighten border restrictions as cases surge.
"We continue to see a serious situation," Prime Minister Yoshihide Suga said, adding that the measures were "indispensable".
"We must overcome this challenge that we face."
While Japan's outbreak remains comparatively small, with around 4,100 deaths overall, medics say hospitals are under heavy strain from the spikes in the worst-affected areas.
China, where the virus first emerged in late 2019, has largely eliminated its outbreak through a number of strict lockdowns and extensive testing and tracing, but recent weeks have seen a smattering of cases.
That has forced more than 20 million people under some form of lockdown in the country's northern regions.
The government of northeastern Heilongjiang province -- home to 37.5 million people -- declared an "emergency state" on Wednesday after 28 cases were found, telling residents not to leave the province unless necessary.
China is rushing to inoculate millions using homegrown vaccines ahead of the Lunar New Year travel rush, which authorities fear could boost the risk of transmission.
- Indonesia kicks off vaccinations -
Governments worldwide are racing to acquire and deliver several approved vaccines to help end the Covid-19 crisis, though the World Health Organization has warned that coverage is not expected to be wide enough for population-level immunity this year.
Russian President Vladimir Putin on Wednesday tasked officials with launching mass coronavirus vaccinations from next week, touting Russia's homemade jab.
Moscow in August registered Sputnik V -- named after the Soviet-era satellite -- months ahead of Western competitors but before the start of large-scale clinical trials, which left some experts wary.
Britain will make appointments for coronavirus vaccinations available 24 hours-a-day "as soon as we can", Prime Minister Boris Johnson said Wednesday, reversing his opposition to the idea.
The government has come under increasing pressure to speed up its vaccination program.
One of the Chinese-developed vaccines, CoronaVac, demonstrated a 50 percent efficacy following tests in Brazil, the organization in charge of its production in the South American country said.
While that figure is much lower than the Moderna and Pfizer-BioNTech vaccines, Indonesia -- one of the world's most populous nations -- has given it the green light and kicked off a mass inoculation drive with it on Wednesday.
President Joko Widodo became Indonesia's first recipient of that shot on live television.
While criticism and fears over slow vaccine rollouts are growing in North America and Europe, there was some positive news Tuesday when the European Union started the approval process for the Oxford-AstraZeneca shot.
FROM THE ARCHIVES