Kentucky’s largest cities continue to be hit hard by a surge of coronavirus infections.

The governor initially announced 114 new cases and six new deaths Tuesday. He later added a seventh death from Campbell County mid-conference.

According to the Kentucky Department of Public Health’s official COVID-19 website, Kentucky now has 591 confirmed cases of coronavirus with 13 deaths.

The continuing surge of the new cases comes as the U.S. death toll surpasses that of 9/11 and Pearl Harbor.