The delta-fueled surge in COVID-19 cases among unvaccinated Americans continues to overwhelm states and health care systems across the country, with Florida and Louisiana experiencing some of the worst tolls.
Nearly one in five new cases reported in the US each day is in the state of Florida—the third-most populous state in the country and one with below-average vaccination rates. On Friday, the Sunshine State reported 21,683 new cases to the Centers for Disease Control and Prevention. It is the state’s highest daily total of new cases in the course of the entire pandemic (aside from a reporting anomaly on January 2). And the state is now nearing its all-time record for current hospitalizations. As of Monday, at least 10,682 people in Florida are hospitalized with COVID-19. The counties with some of the highest rates of infection have some of the lowest rates of vaccination, including Baker county with just 21 percent of residents fully vaccinated.
Louisiana, meanwhile, is claiming the title for the state with the highest rates of infection in the country. The Pelican State, which is a little over a quarter of the size of Florida, has a case rate of 89 new daily cases per 100,000 statewide. That’s above Florida’s current average rate of 74 new cases a day per 100,000. Louisiana is reporting an average of around 4,000 cases per day currently. Every county in the state is considered to have a high rate of transmission by the CDC’s definition. Louisiana overall has one of the lowest vaccination rates in the country overall, with just 37 percent of the state fully vaccinated. Some of the counties with the highest case rates have vaccination rates as low as 26 percent.
On Monday, Louisiana’s Democratic Gov. John Bel Edwards reinstated a statewide mask mandate, requiring everyone ages five and above to wear a mask indoors. “It has been clear that current recommendations on their own haven’t worked,” Gov. Edwards said a press conference today.
Meanwhile, Florida’s Republican Gov. Ron DeSantis took the opposite approach and signed an executive order Friday that barred school districts from forcing students to wear masks in schools.
In a late-afternoon press briefing Monday, US health officials re-emphasized that vaccines and masks are effective against the current surge, which is largely among the unvaccinated.
Get vaccinated and mask up
“This remains a pandemic of the unvaccinated,” CDC Director Rochelle Walensky said during the briefing. Even in the face of the hypertransmissible delta variant, the vaccines are highly effective against severe disease, hospitalization, and death. Mild infections are still possible, but your risk of getting a so-called breakthrough infection is very low, Dr. Walensky emphasized.
Last week, the CDC updated its masking guidance in light of new data related to breakthrough infections among fully vaccinated people. Central to the new data was a large outbreak in Provincetown, Massachusetts, which resulted in a total of 934 cases of COVID-19 in July, with 73 percent of those infections occurring in people who were fully vaccinated, Walensky said Monday.
Many of the cases were linked to indoor, maskless spread. Moreover, the outbreak showed spread of the delta variant from vaccinated people to other vaccinated people—something not seen with previous variants. Taken together, the data convinced the CDC to reverse its mask guidance. The agency now recommends indoor masking in many settings, including schools and areas with high or substantial transmission, which is most of the country.
But Walensky and top infectious disease expert Anthony Fauci stressed that breakthrough infections, while concerning, still only affect a small proportion of those fully vaccinated. Those infections, Walensky and Fauci emphasize, are almost always asymptomatic or mild. Among the 934 cases in the Provincetown, only seven resulted in hospitalizations. None resulted in death.
As of July 26, the CDC had recorded 6,587 breakthrough infections that resulted in hospitalization or death among 163 million fully vaccinated people, Dr. Fauci noted. That works out to just 0.004 percent of fully vaccinated people getting a severe breakthrough infection.
Rare and rarely
Data from Virginia, the District of Columbia, and other locations found the rate of any breakthrough infection among fully vaccinated people ranged from 0.26 percent to 0.03 percent, Fauci said in the press briefing. “The bottom line is: [breakthrough infections] are rare and they rarely result—not rarely, but unusually result—in hospitalization or death,” Fauci said.
In the past, Fauci and Walensky have noted that unvaccinated people account for 97 percent of COVID-19 hospitalizations and over 99 percent of COVID-19 deaths in the country.
With new fears of delta and its wildfire spread, vaccinations are up nationwide, including in many of the most hard-hit states. However, because it takes up to six weeks for people to become fully vaccinated, the vaccination surge alone is unlikely to thwart the current wave of cases.