Coronavirus updates: State reports over 49,000 new cases, 468 new deaths

There were at least 4,279 deaths recorded between 5 p.m. Wednesday and 5 p.m. Thursday, marking the first time the U.S. has surpassed 4,000 daily COVID deaths since the pandemic began, according to a count by ABC News.

In the first week of 2021, the U.S. reported more cases of COVID-19 than at any point in the pandemic so far, the second-highest number of deaths, and the most people hospitalized with the disease, according to the COVID Tracking Project.

In the U.S., more than 21.5 million people have been diagnosed with COVID-19, with at least 364,218 deaths.

The coronavirus pandemic has now killed more than 1.89 million people worldwide. Over 87.7 million people across the globe have been diagnosed with COVID-19, according to Johns Hopkins University.

Vice President Mike Pence received a second dose of the Pfizer vaccine at his home Thursday, his press secretary, Devin O’Malley, told ABC News.

Second lady Karen Pence also received a second dose of the Pfizer vaccine, her Director of Communications, Kara Brooks, told ABC News.

ABC News' Ben Gittleson and Elizabeth Thomas contributed to this report.

Massachusetts is escalating all hospitals to Tier 4 status, the "highest level of concern," which indicates active, ongoing constraints warranting Department of Health intervention, Gov. Charlie Baker announced Thursday.

The number of people in hospitals has jumped by 145% and intensive care unit admissions leapt by 111% over the last six weeks, Baker said.

Hospitals were 65% full on Thanksgiving but are now 84% full, he said. ICU capacity went up from 50% at Thanksgiving to 75%.

“Our hospital capacity limits are being stretched to their limit,” Health and Human Services Secretary Marylou Sudders said.

Hospitals with severe capacity constraints may begin on Thursday to request a temporary exemption from the mandated nurse-to-patient ratios in the ICU, Baker said. 

A hospital system may exercise this exemption only if it has capacity of less than 20% across its system for more than seven days, and if the chief executive officer has attested in writing that all nonessential invasive procedures have stopped.

The governor also said he’s extending the state’s restrictions around gatherings and businesses through Jan. 24. Gatherings are limited to 10 people indoors and most businesses, including restaurants, are limited to 25% capacity.

ABC News' Arielle Mitropoulos contributed to this report.

Daily cases may double in most New York City boroughs within the next four weeks, while in the Washington, D.C. area, case numbers are expected to grow well into January, models from PolicyLab at Children’s Hospital of Philadelphia predict.

PolicyLab’s latest forecast shows cases doubling in the Atlanta area in January. Across Georgia, ventilator use has been up 60% since Christmas, PolicyLab said.

In Texas, “projections for Dallas, Houston, San Antonio and Austin show no signs of slowing in the coming weeks,” PolicyLab said. “These forecasts come as Texas climbs to 45% COVID ICU occupancy and 200 deaths a day.”

In the Pacific Northwest, “concerns are growing,” PolicyLab said, “as some of the highest transmission rates in the country were observed in the state of Washington this past week.”

The Seattle area could see cases double over the next few weeks, PolicyLab said.

Hard-hit Los Angeles is “near its peak,” according to PolicyLab’s model. 

ABC News' Brian Hartman contributed to this report.