Covid-19 deaths and cases in the U.S. have climbed back to levels not seen since last winter, erasing months of progress and potentially bolstering President Joe Biden’s argument for his sweeping new vaccination requirements.

The cases — driven by the delta variant combined with resistance among some Americans to getting the vaccine — are concentrated mostly in the South.

While one-time hot spots like Florida and Louisiana are improving, infection rates are soaring in Kentucky, Georgia and Tennessee, fueled by children now back in school, loose mask restrictions and low vaccination levels.

The dire situation in some hospitals is starting to sound like January’s infection peak: Surgeries canceled in hospitals in Washington state and Utah. Severe staff shortages in Kentucky and Alabama. A lack of beds in Tennessee. Intensive care units at or over capacity in Texas.

The deteriorating picture nine months into the nation’s vaccination drive has angered and frustrated medical professionals who see the heartbreak as preventable. The vast majority of the dead and the hospitalized have been unvaccinated, in what has proved to be a hard lesson for some families.

“The problem now is we have been trying to educate based on science, but I think most of the education that is happening now is based on tragedy, personal tragedy,” said Dr. Ryan Stanton, an emergency room physician in Lexington, Kentucky.

In Kentucky, 70 percent of the state’s hospitals – 66 of 96 – are reporting critical staff shortages, the highest level yet during the pandemic, the governor said.

“Our hospitals are at the brink of collapse in many communities,” said Dr. Steven Stack, Kentucky’s public health commissioner.

The U.S. is averaging over 1,800 Covid-19 deaths and 170,000 new cases per day, the highest levels, respectively, since early March and late January. And both figures have been on the rise over the past two weeks.

The country is still well below the terrifying peaks reached in January, when it was averaging about 3,400 deaths and a quarter-million cases per day.

The U.S. is dispensing about 900,000 vaccinations per day, down from a high of 3.4 million a day in mid-April. On Friday, a Food and Drug Administration advisory panel will meet to discuss whether the U.S. should begin giving booster shots of the Pfizer vaccine.

On a positive note, the number of people now in the hospital with Covid-19 appears to be leveling off or even declining at around 90,000, or about where things stood in February.

Last week, President Joe Biden ordered all employees with more than 100 workers to require vaccinations or weekly tests, a measure affecting about 80 million Americans. And the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.