The daily toll of Covid-19 deaths in Russia exceeded 500 for the first time as the rise in infections across the country puts increasing strain on hospitals and medical staff complain about a lack of medicines and protective gear. There were 507 deaths and 23,675 new cases in the past 24 hours, the government’s virus response center said Wednesday. The seven-day average number of Covid-19 deaths has reached 450, the highest so far, compared to less than 400 a week ago.

Russia has the fifth-most cases globally, approaching 2.2 milion, after the U.S., Brazil, India and France. Federal authorities have refrained from locking down during the second wave of the pandemic, instead introducing limited restrictions in hard-hit regions in order to contain the economic fallout. So far, only one of Russia’s 85 regions has imposed a lockdown.

President Vladimir Putin told officials last week that the situation wasn’t easy and described the rising mortality rate as the “most alarming” trend.

The authorities have placed their hopes on vaccines that are still in trials. On Tuesday, the developers of Russia’s Sputnik V said initial testing showed it was 91.4% effective in preventing infections, although it has not yet published final results in a peer-reviewed journal.

Still, inoculating everyone who wants a vaccination could take as long as a year, according to Alexander Gintsburg, the director of the Gamaleya Research Institute of Epidemiology and Microbiology that developed the inoculation.