The United States reported 3,865 Covid-19 deaths on Wednesday, the highest number of deaths reported in a single day since the pandemic began. The nation’s death toll as of Thursday stands at more than 364,600, according to data from Johns Hopkins University, while the number of people who have been infected has topped more than 21. 53 million. The Centers for Disease Control and Prevention’s most recent forecast projected there will be between 405,000 and 438,000 deaths by the end of the month. The previous forecast, published December 30, projected up to 424,000 deaths by January 23. The ongoing spread of the virus and climbing number of deaths come even as the US is working to distribute vital Covid-19 vaccines — a process that has been criticized for being too slow. US Surgeon General Jerome Adams said Thursday that states able to vaccinate beyond phase 1a recommendations — which include health care workers and residents of long-term care facilities — should do so. “States not only can, but SHOULD aggressively expand vaccinations to other phases if current supply exceeds demand in phase 1a,” the surgeon general said on Twitter. The guidance by the CDC’s Advisory Committee on Immunization Practices that identifies prioritized groups for vaccination, Adams said, are “recommendations — not mandates. ” He shared a picture of other groups identified phases 1b and 1c, including frontline essential workers, people age 75 and older and those with high-risk conditions, among others. Adams’ comments were echoed by Kentucky Health Commissioner Dr. Steven Stack, who said Thursday that sticking to guidelines of who should be prioritized for the vaccine “should not stand in the way of” facilities using all the doses they receive. “Sometimes, more than 30% of eligible people decline to receive the vaccine when offered,” Stack said. “There’s a need to be flexible or else we don’t administer the vaccine. ” “A shot in a willing arm is ultimately a higher priority than a shot in only certain arms,” he added. “We’re prioritizing, but focusing on not letting vaccines sit in a freezer, where it helps no one, for extended periods of time. ” In an interview with NPR, Dr. Anthony Fauci said the vaccine rollout still needs a couple weeks to catch up to earlier projections. But if that doesn’t happen, he said, “then we really need to make some changes about what we’re doing.