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In an unassuming carpark in El Paso, a refrigerated truck sits idly by the medical examiners office.
It'd be an otherwise innocuous sight, if it weren't for one minor detail: there are dead bodies in the back.
Amid a surge in active cases of coronavirus and a mounting backlog of victims, health authorities in the border city have been forced to double their supply of mobile morgues.
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Though harrowing, it is a quandary facing swathes of Texas, where the virus has continued to spread largely unabated.
Some eight months after recording its first confirmed case of COVID-19, the Lone Star State this week became the first jurisdiction to hit one million cases — a symptom of a broader resurgence of the virus across the United States.
With more than 240,000 deaths and over 10 million confirmed cases nationwide, it would seem almost every metric is trending in the wrong direction.
And as daily case numbers continue to hit all-time highs with winter fast approaching, it is yet to be seen if the country can claw back control.
Cases hit 'record highs'
"We are going in the wrong direction," Dr Anthony Fauci warned a fortnight ago, as daily cases threatened to eclipse 100,000.
"If things do not change, if they continue on the course we're on, there's going to be a whole lot of pain in this country with regard to additional cases and hospitalisations, and deaths."
Fauci, the nation's top infectious disease expert, was, of course, correct — in the two weeks to Wednesday (local time), deaths per day soared by more than 40 per cent, from an average of about 790 to more than 1,100.
Health experts have blamed the increase, at least in part, on the onset of cold weather and growing frustration with wearing masks and other health precautions.
But with the deepening crisis threatening to push the nation's hospital system to the brink, authorities are pleading for "evidence-based" action.
"Cases are at record highs across the country, and with the holidays quickly approaching, each of us must do everything possible to reduce the spread of COVID-19," American Medical Association President Susan Bailey said in a statement.
"Failing to do our part will prolong the suffering and disruption to our lives, and inevitably lead to more deaths of our friends, neighbours and loved ones."
Trending up
At the centre of the nation's burgeoning crisis are the Dakotas.
Per capita, North Dakota continues to lead the United States in daily infections, with one in every 83 residents testing positive for the virus in just the past week,.
During the same period, the state averaged more than 1,200 cases per day — an increase of 58 per cent from the average two weeks prior.
Across the border, South Dakota — which has emerged as having the nation's second-worse rate of new infections per capita — experienced a 110 per cent increase in deaths over a two-week period.
Alarmingly, almost 55 per cent of tests conducted during a similar period returned a positive result, despite the state's refusal to implement stay-at-home orders or to adopt a mask mandate (The World Health Organisation has recommended governments ensure rates of positivity remain at 5 per cent or lower for "at least 14 days" before reopening).
While the root cause of the resurgence is complex, a motorcycle rally in Sturgis, South Dakota is believed to be linked to as many as 260,000 new cases since the beginning of August.
But experts point to another more overarching issue: complacency.
"Our low rates in the spring and summer built a sense of complacency, and that it was more of a problem for the rest of the country," Paul Carson, an infectious disease expert at North Dakota State University, told Vox.
"I fear we won't see behavioural changes until people have been personally affected, or can't get medical care because our hospitals are being overrun — which may not be too far off."
Trending down
Despite recording more than three times the total number of coronavirus cases than North Dakota, the Deep South state of Louisiana appears to have avoided the record-breaking wave of infections gripping the United States.
Over the past two weeks, daily case numbers have declined by 3 per cent, while fatalities have decreased by 17 per cent.
Phase three orders — which include a statewide mask mandate, social distancing requirements and gathering limits — were introduced in September, and a bid by House Republican lawmakers to have the restrictions revoked was thrown out by the courts on Thursday.
"This represents our best chance at slowing the spread of COVID in Louisiana and has and will save lives," Governor John Bel Edwards declared, following the ruling.
"I will continue to work with public health experts, scientists and doctors on strategies and mitigation measures to slow the spread of COVID-19 in Louisiana."
While it is unclear how the state has largely bucked the national trend upwards, adherence to mask-wearing, social distancing guidelines and warmer autumn temperatures have been put forward as potential factors.
However, health authorities have warned that "COVID-19 continues to be active in Louisiana with flu season underway, and now is not the time to let down your guard".
Where to from here?
Not long after Texas marked its dire coronavirus milestone, California became the second state in the US to eclipse one million confirmed cases — a national predicament forecast to worsen.
Computer modelling, conducted by the University of Washington's Institute for Health Metrics and Evaluation (IHME), suggests the daily number of COVID-19 deaths in the US will rise to 2,200 in mid-January, with a cumulative 439,000 lives lost by March 1 — nearly double the current toll.
While the production of various vaccines has sparked hopes of a turnaround, with public health officials now gearing up for the "biggest vaccination effort in US history", any prospective solution is likely to be months away.
Until then, experts say, masks, handwashing and social distancing will be imperative to keeping case numbers under control.
"We hope that by the time you get into the second quarter, end of April, early May, May-June — somewhere around that time, the ordinary citizen should be able to get [the vaccine]," Fauci told Good Morning America on Thursday.