Tanzanian leader John Magufuli has said citizens should avoid vaccines and the country does not need a lockdown because God will protect his people.
Homespun precautions such as steam inhalation, he said, were better than dangerous foreign vaccines.
The east African country stopped publishing coronavirus data in April last year.
The US embassy did not give figures for the surge in infections but said "limited hospital capacity throughout Tanzania could result in life-threatening delays for emergency medical care".
Magufuli has also rubbished imported Covid-19-19 testing kits, saying they had returned positive results on a goat and a pawpaw fruit. He has promoted traditional remedies, without offering data or scientific evidence.
Reuters