By Gabriella Borter and Anurag Maan

(Reuters) – The death toll from COVID-19 in the United States approached 250,000 on Wednesday, the day after the country recorded the highest number of victims in nearly four months, a chilling sign for a healthcare system already struggling to cope.

On Tuesday, the pandemic claimed 1,596 lives in the United States, more than on any single day since July 27, contributing to a total of 248,898 confirmed deaths since the pandemic began, according to a Reuters tally.

For weeks, health officials and healthcare workers have warned that hospitals in all regions could soon become overwhelmed, with widespread community transmission of the virus evident in many places.

“I’m the most concerned I’ve been since this pandemic started,” Dr. Tom Inglesby, director of Johns Hopkins Center for Health Security, told CNN on Wednesday.

Nationwide, the number of patients hospitalized with COVID-19 topped 75,000 on Tuesday, setting a new record. The Midwest has become the epicenter, reporting almost a half-million cases in the week ending on Monday. In Wisconsin, 90.6% of Intensive Care Unit beds were occupied as of Wednesday, state data showed.

Forty-one U.S. states have reported daily record increases in COVID-19 cases in November, 20 have registered new all-time highs in coronavirus-related deaths from day to day, and 26 have reported new peaks in hospitalizations, according to a Reuters tally of public health data.

Government officials in at least 18 states, representing both sides of the U.S. political divide, have issued sweeping new public health mandates this month. These range from stricter limits on social gatherings and non-essential businesses to new requirements for wearing masks in public places.

Even officials who initially bristled at the idea of the government imposing social restrictions have changed tune as the virus has spread.

In South Dakota, about 2% of residents currently have COVID-19, according to state data. The city of Sioux Falls voted to institute a mask mandate on Tuesday night, a week after Mayor Paul TenHaken voted the mandate down. TenHaken shifted to supporting the ordinance after the South Dakota State Medical Association urged the city council to mandate masks. State Governor Kristi Noem, a Republican, has continued to oppose government restrictions to curb COVID-19.

White House spokeswoman Kayleigh McEnany on Wednesday called the wave of new restrictions an overreach by state and local officials.

“The American people know how to protect their health,” she told Fox News in an interview. “We don’t lose our freedom in this country. We make responsible health decisions as individuals.”

(Reporting by Gabriella Borter in New York and Anurag Maan in Bengaluru; additional reporting by Susan Heavey and Maria Caspani; Editing by Rosalba O’Brien)