Medical professionals look after a COVID-19 patient in the intensive care unit in Salt Lake City, Utah, US. AP

US fatalities from COVID-19 surpassed 700,000 on Friday, according to figures from Johns Hopkins University — a number greater than the population of Boston.

It’s a milestone that by all accounts didn’t have to happen this soon.

The last 100,000 deaths occurred during a time when vaccines — which overwhelmingly prevent deaths, hospitalizations and serious illness — were available to any American over the age of 12.

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After a heavily criticised early response to the pandemic, the United States organised an effective vaccine roll-out — only to see a significant portion of Americans still refusing to get the shots.

A nurse inoculates a person with a COVID-19 vaccine at a clinic in Orange, California. AP

The milestone is deeply frustrating to doctors, public health officials and the American public, who watched a pandemic that had been easing earlier in the summer take a dark turn. Tens of millions of Americans have refused to get vaccinated, allowing the highly contagious Delta variant to tear through the country and send the death toll from 600,000 to 700,000 in 3 1/2 months.

Florida suffered by far the most death of any state during that period, with the virus killing about 17,000 residents since the middle of June. Texas was second with 13,000 deaths. The two states account for 15% of the country's population, but more than 30% of the nation's deaths since the nation crossed the 600,000 threshold.

In Washington, hundreds of thousands of white flags fluttered on the grass on the National Mall, not far from the White House, as sombre reminders of those who have died of Covid in the United States.