Never has there been a greater need for hospice care than during a deadly pandemic.

But in the U.S., COVID-19 has disrupted almost every aspect of comforting the terminally ill at the end. Even as vaccinations roll out across the country, the system remains under unprecedented strain. As infection rates and hospitalizations plateau and, in some regions, rise after months of improvements, pressures on hospice care are unlikely to ease anytime soon.

"We're preparing for another wave,'' said Melinda Gruber, president of the Caring Circle hospice provider in Michigan, where COVID-19 hospitalizations are climbing again.