The U.S. continues approaching 200,000 reported coronavirus cases per day, as national health officials continue warning Americans not to let their guard down during this latest, long-predicted fall pandemic surge.

As of Monday morning, the U.S. continues to lead the world in the number of cases — 14.7 million — and deaths, with more than 282,000, according to the Johns Hopkins University School of Medicine.

On Sunday, Health and Human Services Secretary Alex Azar told Fox News people are “not minding the three W’s. “Our advice is always the same. Wash your hands, watch your distance, wear face coverings.”

As of Sunday, the U.S. had averaged a record-high 196,233 new cases during the last week, according to a CNN analysis of Johns Hopkins data. Also Sunday, 101,487 patients were in the hospital with the virus, the fifth straight day the U.S. surpassed 100,000 hospitalizations, also according to a CNN analysis.

On Thursday, a Food and Drug Administration advisory panel is scheduled to take up a request to authorize emergency use of Pfizer’s coronavirus vaccine. Vaccinations could begin just days later, though initial supplies will be rationed, and shots are not expected to become widely available until the spring.

At CDC, Pence says COVID-19 vaccine approval could be ‘a week and a half away’

Deaths per day have surged to an average of more than 2,160, a level last seen during April, when the outbreak was centered around New York. The number of Americans in the hospital with the coronavirus topped 100,000 for the first time during the last few days.

Dr. Scott Gottlieb, a former FDA commissioner, warned on CBS’ “Face the Nation” the U.S. death toll could approach 400,000 by the end of January. “As bad as things are right now,” he said, “they’re going to get a lot worse.”

Azar also told ABC’s George Stephanopoulos the holiday season might have more devastation in store.

“We’re worried about people and the behaviors coming up with Christmas,” he said. “We want to make sure everyone’s loved ones are there next Christmas, especially when we have so much hope of vaccines.”

The Centers for Disease Control and Prevention is recommending that health care workers and nursing home patients get priority when the first shots become available.

Both Pfizer’s vaccine and a Moderna vaccine that will also be reviewed by the FDA later this month require two doses a few weeks apart. Current estimates project that a combined total of no more than 40 million doses will be available by the end of the year. The plan is to use those to fully vaccinate 20 million people.

Pfizer says its COVID-19 vaccine is 90% effective in early analysis

Dr. Moncef Slaoui, head of Operation Warp Speed, the government’s vaccine development program, suggested on CBS that using those 40 million doses more broadly to reach 40 million people right away would be too risky, because of the possibility of manufacturing delays that could hold up the necessary second doses.

“It would be inappropriate to partially immunize large numbers of people and not complete their immunization,” he said.

But Gottlieb said he would push out as many doses as possible, taking “a little bit of a risk” that the supply would catch up in time for people to get a second dose.