Out of the Covid-19 pandemic, two Americas are emerging: One protected by vaccines and the other still vulnerable to infection – and experts say progress made across the entire US is being threatened by low-vaccinated regions.
“We’re already starting to see places with low vaccination rates starting to have relatively big spikes from the Delta variant. We’ve seen this in Arkansas, Missouri, Wyoming … those are the places where we’re going to see more hospitalizations and deaths as well, unfortunately,” Dean of the Brown University School of Public Health, Dr. Ashish Jha, told CNN.
“And any time you have large outbreaks, it does become a breeding ground for potentially more variants.”
Parts of the South, Southwest and Midwest are starting to see spikes in cases, and many of those states – like Alabama, Arkansas, Louisiana and Mississippi – are among those with the lowest rates of vaccination, according to the US Centers for Disease Control and Prevention. Recent Covid-19 case rates are an average of three times higher in states that have vaccinated a smaller share of their residents than the United States overall, CDC data shows.
If there is another surge, Dr. Megan Ranney, associate professor of emergency medicine at Brown University, said young unvaccinated adults could be a big part of the problem.
“We’ve already seen that the highest number of infections over the past few months have been in those younger adults,” Ranney said. “These are the people that thought they were invincible.”
But after weeks of declining cases and with a surplus of vaccine doses, there should not be an uptick in infection in the US, CNN Medical Analyst Dr. Leana Wen said Monday.
“We have the ability to stop Covid in its tracks,” Wen said.
Only 47.4% of the US population is fully vaccinated against the virus, according to CDC data. And with so much transmission among those that are hesitant to get vaccinated, Wen said it is a good idea for vaccinated people in high transmission areas to continue wearing masks indoors.
While some experts have held that vaccines provide good enough protection that vaccinated people can forgo face coverings, the transmission rates have made others more cautious.
“If you’re in a low-infection, high-vaccination area, you don’t need to be wearing a mask indoors if you’re fully vaccinated,” Jha told CNN Monday. “If I were in southwest Missouri right now, I’m fully vaccinated but I would be wearing a mask indoors.”
Missouri hospital transfers Covid-19 patients to other facilities due to staffing shortages
One Missouri hospital has been under such strain with cases surging in the region that Covid-19 patients are being transferred to hospitals in different health systems.
The health system, CoxHealth, currently has 94 patients hospitalized for Covid-19, Kaitlyn McConnell, a CoxHealth public relations director, told CNN Monday. At Cox South, a hospital located in Springfield, Missouri, 12 Covid-19 patients were transferred to other facilities in the region between Friday and Monday morning.
“While we have ample supplies and space to care for additional patients, staffing remains a challenge,” McConnell said. “Divert is not a permanent status; we only use it temporarily, it is tied to capacity at a particular moment in time and based on what is best for staff and patients.”
McConnell said the health system had around 170 Covid-19 patients last winter and 280 traveling staff members to help with the response. Now the system is struggling to meet the current demand without the extra help.
“We are aggressively working to have more travelers return – and hire more staff, as we have throughout the pandemic – but it is currently a challenge due to times of year that travelers tend to be available,” said McConnell.
In recent weeks, CoxHealth has transferred patients to facilities in Kansas City, St. Louis and the state of Arkansas.
But Arkansas is beginning to feel the effects of low vaccination rates too, and University of Arkansas for Medical Sciences Chancellor Dr. Cam Patterson warned that if trends in the state continue, it could spell another surge.
CNN Medical Analyst Dr. Johnathan Reiner said, “Arkansas, which has a very low vaccination rate, has seen over a hundred percent rise in daily cases over the last two weeks.”
What could this mean for a return to classes?
Children who are unvaccinated are also at a high risk for infection, Wen said, raising questions for what the new school year will look like for young students.
“These governors that have said that schools no longer need masks indoors, that’s a big mistake,” Wen said.
Considering concerns regarding mental health, educational outcomes and worsening disparities, Wen said she thinks it is necessary to have kids back to school full-time and in-person in the fall.
But even mild cases of the virus could have long-term impacts for children, so mitigation measures would be important for students to return safely, she added.
Those measures include: indoor masking, surveillance testing, and vaccinating adults in the area (be they teachers, staff or parents).
And even vaccinated parents of unvaccinated children may benefit from wearing masks indoors, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious diseases, said last week. It is possible, he said, that people could get experience breakthrough infections and pass them to their children.
“We haven’t formally proven yet how much diminution there is in the likelihood of transmitting it to someone else – including children – and that’s one of the reasons why you’ve got to be careful when you’re dealing with something like the Delta variant,” he said.
The best protection against the Delta variant, experts have said, is to inoculate 70 to 85% of the population against the virus. Ranney has said she hopes vaccines receiving full approval will take away some fear that is left in people who have not yet gotten vaccinated.
“There are some people that hear that ‘emergency’ in ‘emergency use authorization’ and somehow think that the vaccine is risky or hasn’t been fully tested yet,” she said.
CNN’s Deidre McPhillips and Lauren Mascarenhas contributed to this report.
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