FILE PHOTO: Members of the medical staff, wearing protective face masks, work in the Intensive Care Unit (ICU) for coronavirus disease (COVID-19) patients at the Clinique de l'Estree private hospital in Stains near Paris as the spread of the coronavirus disease continues in France, April 20, 2020. REUTERS/Benoit Tessier

PARIS (Reuters) - The number of people who have died from coronavirus infection in France increased by 544 to 21,340 on Wednesday, the fourth-highest casualty tally in the world, but trailing just a few hundred behind Spain, which has a death toll of 21,717.

The toll increased at a rate of 2.6% on Wednesday, the same as Tuesday, and remained well below the four to five percent rates seen a week ago. In Spain, the increase in the number of deaths has been close to 2% for four days.

The United States has reported 45,241 coronavirus deaths, Italy 25,085, and worldwide more than 178,500 people have died, according to a Reuters tally.

“The virus keeps circulating at high speed. We must remain careful and strictly respect social distancing rules,” Health Ministry director Jerome Salomon said at a daily briefing.

The number of people in French hospitals with COVID-19 fell by 365 or 1.2% to 29,741, the eighth consecutive fall and more than 2,300 patients less than the high of 32,113 set on April 13, health ministry data showed.

The number of patients in intensive care units - the most important metric of a health system’s ability to deal with the epidemic - fell by 215 or 4% to 5,218, the 14th consecutive decline. There are now nearly 2,000 people less in ICUs from the high of 7,148 set on April 8.

The ministry reported 1,827 new confirmed cases of COVID-19, taking the total to 119,151, an increase of 1.6%, slightly slower than the 2.3% seen on Tuesday and 1.8% on Monday.

It also reported a total of 62,222 cases in nursing homes, of which 25,513 were confirmed and 36,709 were possible cases.

In total, France has 155,860 confirmed or possible cases of coronavirus infection, compared to the more than 208,389 reported in Spain.