INDIANAPOLIS (AP) — Indiana faces a longer stretch of COVID-19 illnesses and deaths while the governor and top state health official on Wednesday pinned improvement on personal responsibility and the looming first arrival of vaccines rather than reinstating more statewide precautions.

Nearly all of Indiana remained in the greatest-risk categories for coronavirus spread in a state health department update that also showed a new high for average daily COVID-19 deaths for the state.

Health officials across the state are worried about hospitals being overwhelmed by the growing number of severely ill patients and a possible new surge tied to Thanksgiving gatherings in the past week.

“We know that we’re kind of bracing for the next few weeks to unfold and those lagging indicators that come off of holidays when people are traveling, when people are getting together with folks that they haven’t been around,” Gov. Eric Holcomb said during his weekly coronavirus briefing.

Indiana hospitals were treating more than 3,400 COVID-19 patients as of Tuesday — about a 350% increase since late September when the state’s steep increase in hospitalizations and deaths began.

Sixteen of the state’s 92 counties were listed in the most dangerous red category in the health department’s weekly tracking map. All but one other county was assigned the next riskiest orange rating.

Those overall county ratings have not improved over the past three weeks as Indiana’s number of COVID-19 deaths and hospitalizations have continued increases to surpass the state’s peaks during the initial coronavirus surge during the spring.

State Health Commissioner Dr. Kristina Box said it was possible that Indiana could receive enough of the initial vaccines nearing federal authorization to cover front-line health care workers and nursing home residents by the end of December, followed by wider distribution next year.

“I hope it gives every Hoosiers hope that we will get to the other side of this pandemic,” Box said.

Health officials on Wednesday added 91 confirmed recent COVID-19 deaths and 19 deaths of people with probable coronavirus infections to the statewide toll. The confirmed deaths for November now total 1,477 — surpassing the previous monthly peak during April by nearly 400 and about double October’s total.

The state’s seven-day rolling average of COVID-19 deaths has reached 60 per day after that average was below 10 a day during July.

Indiana’s current surge in COVID-19 infections, hospitalizations and deaths began in September about the time Holcomb lifted nearly all business and crowd size restrictions before reinstating some crowd limits in mid-November while continuing the statewide face mask order.

Holcomb, who completed a two-week quarantine Tuesday after a COVID-19 exposure, said Wednesday no states have found a “magic wand” of actions to stop the coronavirus spread and that individuals needed to accept the short-term inconvenience of precautions such as mask wearing and limiting contact with others.

“We’ll continue to appeal and make sure that folks have the information as COVID-19 continues to ravage our communities and families and make sure folks are equipped to make the right, safe decisions,” Holcomb said.