Americans went to the polls Tuesday under the shadow of a resurging pandemic, with the number of people hospitalized with COVID-19 reaching record highs in a growing number of states. Some are already facing bed and mask shortages. 

While daily infections were rising in all but three states, the surge was most pronounced in the Midwest and Southwest, The Guardian reported. 

Missouri, Oklahoma, Iowa, Indiana, Nebraska, North Dakota, and New Mexico all reported record high hospitalizations this week. Nebraska’s largest hospitals started limiting elective surgeries and looked to bring in nurses from other states to cope with the surge, Omaha CBS affiliate KMTV reported.

Hospital officials in Iowa and Missouri also warned bed capacity could soon be overwhelmed.

The virus has left more than 232,000 people dead in the U.S. and total confirmed COVID-19 cases have surpassed 9 million. As hospitalizations have climbed, so have deaths. The seven-day rolling average for deaths from COVID-19 has risen over the past two weeks from about 58,424 on Oct. 19 to 83,805 on Monday, according to Johns Hopkins University.

As the infection rate continues to rise, N95 masks and other protective gear are becoming scarce once again. Many hospitals and other health care facilities continue to reuse masks, even as manufacturers have raised production.

Nearly 90% of New Mexico hospitals are reusing N95 masks under emergency guidelines as new cases rise at an alarming rate, The Wall Street Journal reported. Wyoming’s health department also said its hospitals could revert to emergency reuse of N95 masks if hospitalizations rise further.

Jeff Wagner, supply chain manager for several major Michigan healthcare facilities, explained, “We would really like to beef up our stockpiles, but volume is high for everyone, so you can’t. The N95s are really the most challenging.”

The National Institute for Occupational Safety and Health certified 20 new mask makers. However, potential new producers wait a long time to earn the certification needed to produce N95 masks. The long wait has scared off some prospective manufacturers.

Brian Wolin, CEO of Protective Health Gear, told WSJ, “It’s a daunting task.” Protective Health Gear recently started making more than one million N95 masks a month in N.J.

Will Mijangos, operating manager at Pandmedic Solutions Inc., added that N95 mask orders have risen about 40% over the past two weeks. A typical order has increased from around 30,000 to as many as 100,000 masks, he said.

3M's strong sales of N95 masks were offset by weakness in transportation and some other businesses 3M's strong sales of N95 masks were offset by weakness in transportation and some other businesses Photo: AFP / AHMAD YUSNI