The U.S. surpassed 250,000 coronavirus deaths Wednesday, as the pandemic continues a long-predicted autumn surge throughout the nation.

According to data tracked by Johns Hopkins University’s School of Medicine, the U.S. leads the world in the number of cases — 11.4 million — and deaths, with at least 250,029 as of Wednesday evening.

On Wednesday, Georgia’s Department of Public Health reported 8,536 confirmed COVID deaths.

Globally, more than 56 million cases of the coronavirus have been confirmed since the pandemic officially began earlier this year.

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On Wednesday, Pfizer and its German partner, BioNTech, announced more interim results from their ongoing coronavirus vaccine study, which suggests the shots are 95% effective and that the vaccine protects older people most at risk of dying from COVID-19. The announcement, just a week after revealing the first promising preliminary results, comes as the team is preparing within days to formally ask U.S. regulators to allow emergency use of the vaccine.

The deadly rise in COVID-19 cases across the U.S. is forcing state and local officials to adjust their blueprints for fighting the virus, with governors adopting mask mandates and schools scrapping plans to reopen classrooms.

The Centers for Disease Control and Prevention (CDC) made the announcement on Tuesday.

The steps face blowback from those who question the science behind mask wearing and social distancing and fear the new restrictions will kill off more jobs and trample civil liberties.

In Iowa, Gov. Kim Reynolds had pushed back against a mask mandate for months but imposed a limited one Tuesday, becoming the latest GOP holdout to change course on face coverings. At the same time, she claimed “there’s science on both sides” about whether masks reduce the spread of the coronavirus.

With Thanksgiving coming up next week, public health officials are bracing for a holiday-fueled surge. Doctors are urging families to stick to small gatherings.

Governors in Ohio, Maryland and Illinois imposed restrictions on business hours and crowd sizes Tuesday, and their counterparts in Wisconsin and Colorado proposed economic relief packages. Los Angeles County, with a population of 10 million, ordered similar business restrictions.

In its weekly internal report, the White House Coronavirus Task Force warned of an “aggressive, unrelenting” spread of the coronavirus across the country “without evidence of improvement but rather, further deterioration,” a senior administration official said Tuesday. The official, who spoke on condition of anonymity to discuss private deliberations, said the task force concluded existing efforts to slow the spread “are inadequate and must be increased to flatten the curve” and that Thanksgiving travel and gatherings could “amplify transmission considerably.”

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More than 73,000 people — an all-time high — were hospitalized with the virus in the U.S. as of Monday, an increase of more than 3,000 from just a day earlier, according to the COVID Tracking Project. Hospitals are running out of space, and nurses and doctors in Kansas are converting waiting areas to patient rooms and spending upward of eight hours on the phone trying to secure beds at other hospitals.

Since the election, Republican governors in hard-hit Iowa, North Dakota and Utah have reversed course and put in place requirements on masks, and others have extended or expanded earlier orders.

In Utah, dozens of people opposed to a statewide mask mandate protested outside the home of Gov. Gary Herbert. In South Dakota, the state with the highest rate of COVID-19 deaths per capita in November, Gov. Kristi Noem has no plans to issue mask requirements.

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Doctors serving Idaho and eastern Oregon spent hours Tuesday trying to sway health districts, city leaders and the public to do more to stop the spread of the coronavirus, warning that rationed care is looming in Idaho’s future. But in Idaho, they were met with skepticism, as some residents in attendance either denied the existence of the virus or disputed its severity. Idaho is experiencing a severe and unchecked community spread of COVID-19 in much of the state.

A more stringent mask mandate took effect Tuesday in California, where Democratic Gov. Gavin Newsom said residents will be required to cover up outdoors, with limited exceptions.

And in New Orleans, officials took the drastic step of canceling the beloved, but traditionally packed Mardi Gras and Carnival parades that draw visitors from around the world. The city has a 250-person cap on outdoor crowds to limit the virus’ spread.

The Associated Press contributed to this report.