Russia’s daily death toll from COVID-19 exceeded 1,000 for the first time as the country faces a sustained wave of rising infections.

The national coronavirus task force on Saturday reported 1,002 deaths in the previous day, up from 999 on Friday, along with 33,208 new confirmed COVID-19 cases, more than 1,000 higher than the day before.

Authorities have tried to speed up the pace of vaccination with lotteries, bonuses and other incentives, but widespread vaccine skepticism and conflicting signals from officials stymied the efforts.

The government said this week that about 43 million Russians, or about 29% of the country’s nearly 146 million people, are fully vaccinated.

Despite the mounting toll, the Kremlin has ruled out a new nationwide lockdown like the one early on in the pandemic that badly hurt the economy, eroding President Vladimir Putin’s popularity. Instead, it has delegated the power to enforce coronavirus restrictions to regional authorities.

Some of Russia’s 85 regions have restricted attendance at large public events and limited access to theaters, restaurants and other venues. However, daily life is going on largely as normal in Moscow, St. Petersburg and many other Russian cities, with businesses operating as usual and mask mandates loosely enforced.

Health Minister Mikhail Murashko acknowledged this week that medical facilities have come under growing strain and said that authorities have offered retired medics who have gotten vaccinated the option of returning to work.

Overall, the coronavirus task force has registered more than 7,958,000 confirmed cases and 222,315 deaths – Europe’s highest death toll. The official record ranks Russia as having the fifth-most pandemic deaths in the world following the United States, Brazil, India and Mexico.

However, state statistics agency Rosstat, which also counts deaths in which the virus wasn’t considered the main cause, has reported a much higher pandemic death toll – about 418,000 people with COVID-19 as of August. Based on that higher number, Russia would rank be the fourth hardest-hit nation in the world, ahead of Mexico.