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(CNN)November isn't even over, and the US has already seen more new Covid-19 cases than any other month of this entire pandemic.
More than 3 million new cases were reported between November 1 and 22, according to data from Johns Hopkins University. That's about a quarter of all US cases since the beginning of this pandemic.
Yes, testing has increased. But it hasn't kept pace with the rate of new infections.
As of late last week, the number of daily new cases increased 25% compared to the previous week, according to Johns Hopkins data.
But the number of new tests increased only 14.55%, according to the Covid Tracking Project.
And in 44 states, the percentage of positive tests is higher than the recommended 5% threshold.
"If a positivity rate is too high, that may indicate that the state is only testing the sickest patients who seek medical attention, and is not casting a wide enough net to know how much of the virus is spreading within its communities," Johns Hopkins said.
And every surge in new cases leads to more hospitalizations and deaths in the following weeks.
Hospitals are getting overwhelmed
Once again, the US smashed its record for people hospitalized with Covid-19 -- putting enormous strain on the health care system and threatening to reduce care for even those who don't have coronavirus.
At least 83,227 Covid-19 patients were hospitalized Saturday, according to the Covid Tracking Project. That's the 12th straight day that the US has broken its record for Covid-19 hospitalizations.
At least 24 hospital leaders warned the American Hospital Association they're having staffing shortages, said Nancy Foster, the association's vice president for quality and patient safety policy.
Health experts say new infections, hospitalizations and deaths will get worse before they get better, as the upcoming holidays and colder weather trigger more indoor socializing.
"Think about where spread of this virus happens. It is indoors, without masks, over long periods of time. And that's exactly what Thanksgiving is," emergency medicine physician Dr. Megan Ranney said.
"If even 1% of the 50 million people who are traveling for Thanksgiving transmit or catch this virus, we're looking at an extra 500,000 cases across the country," Ranney said.
"This is the year to stay home. If you must see people, do so only outdoors and at that safe distance. Because you just don't know who's infected."
Why infections might be higher than we know
More than 12.2 million people in the US have been infected with coronavirus, and more than 256,000 people have died, according to Johns Hopkins.
But the real case count is likely to be "multitudes" higher because there's not enough testing, said Dr. Esther Choo, professor of emergency medicine at Oregon Health & Science University.
Choo said she's especially concerned by how quickly new cases are accelerating.
"So many states have test positivity rates above 20%, which means that we are vastly lagging behind in our confirmed cases," she said.
For context, the World Health Organization has recommended governments not reopen until they keep their test positivity rate at or below 5% for 14 days.
As of Sunday, only six states -- Vermont, Hawaii, Maine, New York, Massachusetts and New Hampshire -- plus the District of Columbia met that WHO standard, according to Johns Hopkins data.
Of the remaining 44 states, several had test positivity rates of more than 40%: Wyoming, South Dakota, Iowa and Idaho.
States and communities have tried to get the virus under control by implementing new restrictions. Los Angeles County announced Sunday it would halt outdoor dining after the 5-day average of Covid-19 cases surpassed 4,000 cases, according to the county's Department of Public Health.
The order goes into effect Wednesday evening and will remain in place for at least three weeks, officials said. It includes dining at restaurants, breweries, wineries and bars, all of which will be limited to takeout and delivery service.
"Public Health reminds everyone to stay home as much as possible for the next two to three weeks to change the trajectory of surging cases and save lives," the department said in a statement.