Forty percent of all new cases this week have been recorded in Florida, Texas and Missouri, White House pandemic response coordinator Jeff Zients revealed at a press briefingThursday.
Florida alone accounts for 20 percent of all new cases nationally, Zients pointed out, a trend that has stretched into its second week.
Zients added that “virtually all” hospitalizations and deaths — a full 97 percent — are among unvaccinated people. “The threat is now predominantly only to the unvaccinated,” he said. A few vaccinated people do experience so-called breakthrough infections, but they tend to experience only mild COVID-19 illness, or no illness at all.
Encouragingly, Zients said the five states that have experienced the most significant rise in infections — Arkansas, Louisiana, Florida, Nevada and Missouri — all also saw vaccination rates beat the national average for a second week in a row. But because immunity takes two weeks to develop, and the Delta variant spreads so rapidly, the benefits of the increased uptake of vaccinations may not be evident right away.
Singling out the three states where infections are now spiking could have the effect of putting pressure on elected officials there to do more to encourage vaccinations.
Florida’s governor, Ron DeSantis, is a Donald Trump loyalist who is widely expected to seek the presidency in 2024. His handling of the pandemic is coming under new scrutiny with the recent rise in cases.
As the pandemic has surged back in parts of the country, other Republicans have deviated from that approach. The governor of Arkansas, Asa Hutchinson — a Republican who, like DeSantis and Abbott, is rumored to have presidential ambitions of his own — has recently pushed for more vaccinations in his state.
There were 46,318 new cases of the coronavirus reported nationwide on Tuesday, Centers for Disease Control and Prevention Director Rochelle Walensky said at Thursday’s briefing. That is a marked increase from the lows of late May and early June. Hospitalizations and deaths are also rising, after plummeting earlier this summer.
“If you are not vaccinated,” Walensky said, “please take the Delta variant seriously.”
With every passing day, the United States appears more likely to be on the cusp of a dreaded fourth wave of COVID-19 infections, even as the percentage of fully vaccinated Americans inches toward 50%. In the past two weeks, the number of average new daily cases has more than doubled, from 13,200 on July 4 to more than 32,300 on July 18, a surge that harbors grim reminders of the fronts of the second and third waves in the summer and fall of 2020.
But on closer inspection, this surge looks significantly different than those we have seen in the past—and may very well be worse than it looks on the page.
The coronavirus pandemic has never, even in its worst heights last winter, struck the U.S. uniformly. Instead, it has wandered from eruptions in specific urban areas to suburban and rural counties and then back again, like a persistent hurricane. Now, as the gap between states’ completed vaccination rates widens—Alabama has vaccinated just 33.7% of residents, compared to nearly 70% in Vermont—the per capita rate of new cases has clustered in a handful of regions where a majority of adults remain unvaccinated even as reopening continues apace.
To draw on my amateur oceanography, the current crest resembles less a wave than a rip tide, with surges of current inundating several hotspots while the remainder of the country remains blissfully unaware (or unwilling to admit) that the pandemic is not remotely over. The upshot is that local data, rather than state- or nationwide-level figures, now paint the most accurate picture of the current state of the outbreak.
“State-wide cases don’t tell the entire story. We need a finer-toothed comb,” says Jennifer Nuzzo, the lead epidemiologist for the Johns Hopkins University Testing Insights Initiative.
As Nuzzo notes, the most recent documented outbreaks are more concentrated in rural areas than those of the worst spikes over the past 16 months (though the virus didn’t spare any corner of the country). What appears to be different now, even within more rural regions, is a blossoming of outbreaks that are at the moment highly clustered, particularly along the border between Arkansas and Missouri as well as northeast Florida and southeast Georgia.
But any such observation comes with the same caveat that we on the Numbers Beat have been striving to communicate since the beginning: The number of cases is contingent on the number of people being tested for the virus, a figure that can only underestimate the true picture, not exaggerate it.
“I don’t worry that we are missing the severe cases,” including when a patient is hospitalized, Nuzzo says. “It’s everybody else I worry about. We have turned our telescope to a different part of the sky.”
Murray Côté, an associate professor of health policy and management at Texas A&M University, agrees. “I still think we’re missing a chunk” of positive cases, he says. “It’s a confluence of things. We don’t have the testing facilities we used to have [earlier in the pandemic].” That chunk, both Côté and Nuzzo say, is likely made up of people who are experiencing mild or no symptoms, but can still be part of a transmission chain.
I last spoke with Côté in June 2020 when unwinding Pence’s claim that the summer surge was a product of more testing. Our conversation this time felt both reversed, as we were discussing a possible under-calculation of reality, as well as strangely familiar, because a year ago, we were seeing a new surge amid a widespread relaxation of safety measures—not unlike the freedom from safety measures like maskless dining we currently enjoy.
“We’re behaving exactly the same way as we did last year,” Côté says. To refresh your memory: Around this time in 2020, the U.S. had a brief moment where cases began to drop. Some Americans started to ease their social distancing and mask wearing, and it led to both a summer surge and, after another lull, the massive winter spike that turned out to be the worst stretch of the global outbreak to hit any country in the world. What’s different now is that this time we have highly effective vaccines—but, while inoculation can protect individuals, vaccination rates in many communities across the U.S. remain too low to prevent fresh outbreaks.
In the heady days of spring, 2021, many states began reducing the frequency of their reports on new cases to every few days or once a week. That was a foolish mistake when, even with a massive reduction in testing, the seven-day rolling average of new cases never dipped below 10,000 at the national level. Given that the best-case scenario—even before the emergence of the Delta variant—was a reduction of cases and deaths to endemic levels for years to come, states must pair their desperate attempts to vaccinate more individuals with a renewed focus on surveillance and contact tracing.
For now, the best way to prevent the current spikes from becoming a proper fourth wave is vaccination (which, even if cases continue to rise, can help prevent hospitalizations and deaths), increased surveillance, and a return to mitigation measures. Indeed, Los Angeles County on Sunday reinstituted mandatory mask-wearing in businesses and public areas, a major rollback after the U.S. Centers for Disease Control and Prevention said on May 13 that fully vaccinated individuals could shed their masks in many scenarios. Unless states can rapidly revive widespread and easily available testing, L.A. will be far from the last county to ask residents to mask up once again.
The delta variant of the coronavirus is sweeping through the United States, raising the average number of cases to 30,000-per-day, crowding hospitals in areas with large number of unvaccinated people and spurring questions about the nation’s recovery from the pandemic.
Stocks tanked on Monday, with the Dow Jones Industrial average dropping 725 points after being down more than 900 points at one time.
It was the worst one-day performance in the Dow since last October, and followed losses in markets around the world as investor fears about how the delta virus might slow both the health and economic recovery took hold.
Health officials have described the latest stage of the coronavirus as a pandemic of the unvaccinated while emphasizing that those who have had their shots are relatively safe.
Yet Los Angeles County on Saturday reinstated a mask mandate for indoor public settings, a sign that local communities may decide to reimpose restrictions as a safety measure.
An Olympic gymnast and an Olympic women’s basketball player both announced they had tested positive as they prepared for the Games, which is being held in a state of emergency in Tokyo where the rate of vaccinations is behind the United States.
Canada had also been well behind the U.S. in its vaccination rate but surpassed its southern neighbor on Monday, a sign of how much more slowly the vaccination rate now is in the United States. A big reason is that many people who are unvaccinated do not want to get the vaccine, something the Biden administration has increasingly blamed on social media and some conservative media outlets.
While the 30,000 cases per day on average is more than double the 13,000 average at the end of June, that rate is still well below highs from last fall and earlier this year.
Still, deaths are also ticking back up, at around 240 per day.
Because vaccinated people are still overwhelmingly protected, especially from severe outcomes, case and death numbers are likely to stay well below the worst of last winter’s surges, before vaccines were widely available.
But unvaccinated people are at increasing risk, especially given the rise of the highly transmissible delta variant, and the vaccination campaign is hitting a wall, leaving more than 30 percent of adults without any shots and exposed to the full dangers of the virus.
States with lower vaccination rates are seeing the worst outbreaks. Arkansas, Missouri, Florida and Louisiana are the four states with the highest per capita new cases per day, according to data from the Covid Act Now tracking site. The percentage of the population with at least one shot in those states is 44 percent, 47 percent, 56 percent, and 40 percent, respectively.
In contrast, Vermont and Massachusetts, where the vaccination rate is over 70 percent, are faring much better.
Vaccine resistance among some leading conservative commentators and lawmakers is raising fears that many of the remaining unvaccinated may never get the shots.
Sten Vermund, a professor at the Yale School of Public Health, said he is “not particularly worried” about COVID-19 for himself, because he is fully vaccinated.
“What worries me is my fellow Americans who for a variety of reasons choose not to get vaccinated; they continue to be in harm’s way,” Vermund said.
In the rare instances where vaccinated people do get COVID-19 cases, symptoms are likely to be much milder.
CDC Director Rochelle Walensky said Friday that 97 percent of people entering the hospital with COVID-19 are unvaccinated, part of why she said it “is becoming a pandemic of the unvaccinated.”
Conservative resistance to vaccination is stiffening. A Washington Post-ABC News poll released earlier this month found that 47 percent of Republicans said they were unlikely to get vaccinated, compared to just six percent of Democrats. Among Republicans, 38 percent said they definitely would not get the shots.
Former President Trump has previously encouraged people to get vaccinated, though he has not made a forceful push, for example by recording a public service announcement or getting his own shots in public.
On Sunday, though, Trump appeared to justify people not taking the vaccine, blaming President Biden.
“He’s way behind schedule, and people are refusing to take the Vaccine because they don’t trust his Administration, they don’t trust the Election results, and they certainly don’t trust the Fake News, which is refusing to tell the Truth,” Trump said in a statement.
Asked if Biden would request Trump film a public service announcement on vaccination, White House press secretary Jen Psaki said “we don’t believe that requires an embroidered invitation to be a part of.”
“Certainly any role of anyone who has a platform where they can provide information to the public that the vaccine is safe, it is effective, we don’t see this as a political issue,” Psaki said. “We’d certainly welcome that engagement.”
She also emphasized, though, that the administration is focusing on local doctors and community leaders to try to boost vaccination rates, not national officials.
The effort is hitting its limits, though. The pace of vaccinations has fallen to around 500,000 per day, down from over 3 million at the peak in April, according to Our World in Data.
“I’m not that hopeful that we’re going to get to people who have refused to be vaccinated,” said Preeti Malani, an infectious disease expert at the University of Michigan.
Experts increasingly say the best remaining hopes of reaching the remaining unvaccinated are school and employer mandates for their workers or students to get vaccinated.
France is experiencing a surge in vaccinations after President Emmanuel Macron announced this month that proof of vaccination, or a negative test, would be required for everyday activities like going to restaurants. The Biden administration has repeatedly ruled out a national vaccine passport in the U.S., though, and Republicans have rebelled against the idea.
Full approval of the vaccines from the Food and Drug Administration, as opposed to the current emergency authorization, could also help assuage some people’s fears, and some experts have called on the FDA to move faster on issuing a full approval.
The Biden administration has stepped up its calls for Facebook and other technology companies to do more to fight vaccine misinformation on their platforms.
Biden on Friday said social media companies are “killing people” with misinformation. On Monday, though, he dialed the criticism back down, instead pointing to 12 people responsible for much of the disinformation.
“Facebook isn’t killing people, these 12 people are out there giving misinformation,” Biden said.
“My hope is that Facebook, instead of taking it personally, that somehow I’m saying Facebook is killing people, that they would do something about the misinformation, the outrageous misinformation about the vaccine,” Biden added. “That’s what I meant.”
For its part, Facebook said over the weekend, before Biden’s walk-back, that the administration was “finger pointing” and the company was not the reason the president’s goal of getting 70 percent of adults at least one shot by July 4 was missed.
Los Angeles County’s move to return to an an indoor mask mandate, even for vaccinated people,
got mixed reviews from experts, but either way, it is unlikely to be replicated in places that are the hardest hit, given that places that are resistant to vaccines tend to also be resistant to masks.
“Vaccines are really the only way out,” Malani said. “We can’t live in masks forever.”
Trinity Health is the latest—and now the largest—U.S. provider organization to roll out a COVID-19 vaccination requirement for all of its employees.
Announced Thursday and effective immediately, the nonprofit, Catholic healthcare system said the policy will extend across its entire workforce of more than 117,000 employees, including clinical staff, remote employees, contractors and “those conducting business in its healthcare facilities.”
Trinity said it will approve exemptions for religious or health reasons that are formally requested and documented. Others who don’t meet the criteria for exemption and fail to provide proof of vaccination “will face termination of employment,” according to the announcement.
Trinity said an estimated 75% of its employees have already received at least one dose of a COVID-19 vaccine, and it hopes the new policy will bring that number closer to 100%.
“Safety is one of our core values. We feel it is important that we take every step available to us to stop the spread and protect those around us—especially the most vulnerable in our communities who cannot be vaccinated including young children and the more than 10 million people who are immunocompromised,” Trinity Health President and CEO Mike Slubowski said in a statement.
“Over the last year, Trinity Health has counted our own colleagues and patients in the too-high coronavirus death toll. Now that we have a proven way to prevent COVID-19 deaths, we are not hesitating to do our part,” he said.
Livonia, Michigan-based Trinity operates 91 hospitals and 113 continuing care locations serving more than 30 million people across 22 states. The system reports $19.4 billion in annual operating revenues and is on track to top that number having recently reported $15.1 billion in operating revenues for the nine-month period between July 2020 and March 2021.
Trinity said that most of its locations will be requiring employees to submit their proof of vaccination by Sept. 21. Should it be determined that COVID-19 vaccine boosters will be necessary down the line, the hospital said that it would similarly require employees to submit proof of their receipt “as needed.”
“The science has shown us that the COVID-19 vaccine is the single most effective tool in slowing, and even stopping, the spread of the virus,” Dan Roth, M.D., Trinity Health executive vice president and chief clinical officer, said in a statement. “As a Catholic Health Ministry—even if we work remotely or do not regularly encounter patients—we view ourselves as caregivers, and it’s important that we do everything we can to end the pandemic and save lives.”
But perhaps the best known of the bunch has been Houston Methodist, which drew a line in the sand on June 8 and has since cut loose 153 employees who did not comply with the vaccine mandate.
That policy led to protests from the dissenting employees as well as a lawsuit that argued the system was “forcing its employees to be human ‘guinea pigs’ as a condition for continued employment.” The case was dismissed by a U.S. district judge and quickly appealed by the employees.
Other organizations such as Mass General Brigham have signaled support for a mandatory COVID-19 vaccination policy but said that they would not enforce the requirement until a COVID-19 vaccine receives formal approval from the FDA.
Earlier this year, the U.S. Equal Employment Opportunity Commission paved the way for employer-mandated COVID-19 vaccine policies with guidance permitting the requirements “so long as employers comply with the reasonable accommodation provisions of the [Americans with Disabilities Act] and Title VII of the Civil Rights Act of 1964 and other [Equal Employment Opportunity] considerations.”
COVID-19 cases are up by nearly 70% over the past seven days due to huge spikes of cases in low vaccinated areas, Biden administration officials said Friday.
“This is becoming a pandemicof the unvaccinated,” said Rochelle Walensky, M.D., director of the Centers for Disease Control and Prevention, during a briefing Friday. “We are seeing outbreaks of cases in parts of the country that have low vaccination coverage because unvaccinated people are at risk. Communities that are fully vaccinated are generally faring well.”
The seven-day average of cases was 26,300 per day, an increase of nearly 70% from the last seven-day average, Walensky said.
Hospitalizations are also up to 2,790 per day, an increase of 36% from the previous seven-day period.
Deaths, a metric that has declined since prior surges earlier in the year, have also started to increase. The seven-day average increased by 26% to 211 per day, Walensky said.
“Our biggest concern is we are going to see preventable cases, hospitalizations and, sadly, deaths among the unvaccinated,” she said.
A major driver of the increases has been the highly transmissible Delta variant of COVID-19, but Walensky said that 97% of the patients hospitalized right now with the virus are unvaccinated.
The Biden administration is ramping up efforts to increase vaccinations in areas that have stubbornly low rates. The administration is sending more than 100 people to states to help enhance vaccine access and boost outreach efforts, said Jeff Zients, the White House coronavirus response coordinator, during the briefing.
States with the highest cases are starting to see their vaccination rates go up, Zients said.
“In the past week, the five states with the highest case rates had a higher rate of people getting newly vaccinated compared to the national average,” he added.
He added that so far the CDC and the Food and Drug Administration have not recommended a booster shot for the fully vaccinated.
Infectious disease expert Anthony Fauci, MD, said Friday that the federal government is looking into evidence accumulated on a daily basis on the need for a booster.
“At this particular time right now, we don’t recommend that there be boosters for people,” Fauci said.
The number of new coronavirus cases is increasing in every state, setting off a growing sense of concern from health officials who are warning that the pandemic in the United States is far from over, even though the national outlook is far better than during previous upticks.
The 160 million people across the country who are fully vaccinated are largely protected from the virus, including the highly contagious delta variant, scientists say. In the Upper Midwest, the Northeast and on the West Coast — including in Chicago, Boston and San Francisco — coronavirus infections remain relatively low.
But the picture is different in pockets of the country where residents are vaccinated at lower rates. Hot spots have emerged in recent weeks in parts of Missouri, Arkansas and Nevada, among other states, leaving hospital workers strained as they care for an influx of coronavirus patients. Less than a month after reports of new cases nationally bottomed out at around 11,000 a day, virus cases overall are increasing again, with about 26,000 new cases a day, and hospitalizations are on the rise.
The country is at an inflection point, and experts said it was uncertain what would come next. While nationwide cases and hospitalization numbers remain relatively low, more local hot spots are appearing and the national trends are moving in the wrong direction. Many of the oldest, most vulnerable Americans are already inoculated, but the vaccine campaign has sputtered in recent weeks.
“This will definitely be a surge,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It won’t be as big as what happened in January. But we still have 100 million people in the United States who are susceptible to COVID-19.”
Intensive care beds in hospitals have become scarce in parts of Missouri, where officials in Springfield on Wednesday asked for an alternative care site. In Mississippi, where cases are up 70% over the past two weeks, health officials have urged older adults to avoid large indoor gatherings even if they have been vaccinated. And in Los Angeles County, officials said Thursday that masks would once again be required indoors, regardless of vaccination status, because of the spread of the delta variant.
The slowdown of the vaccination effort has amplified concerns. About 530,000 people are now receiving a vaccine each day, a sharp decrease from 3.3 million shots a day in April. Less than half of the United States population has been fully vaccinated.
Still, the country’s prognosis remains better than at previous points in the pandemic. The vaccines are widely available, cases and hospitalizations remain at a tiny fraction of their peaks and deaths are occurring at some of the lowest levels since the early days of the pandemic.
Yet daily case numbers have increased in all 50 states, including 19 states that are reporting at least twice as many new cases a day.
Mayor Quinton Lucas of Kansas City, Missouri, where cases are increasing but remain far below levels in other parts of the state, said he worried that the outbreak in southwestern Missouri would keep spreading, given low vaccination rates there. He said strong recommendations for mask wearing — or even new mandates — may become necessary if his city’s outlook continued to worsen.
“I think when you start to see Springfield-level hospitalizations here in the Kansas City metro, then we’ll have to very seriously consider whether it’s time to return to previous restrictions,” Lucas said.
In a string of news conferences this week, public health officials pleaded with people who have not gotten shots to change their minds, urging them to consider that coronavirus vaccines are safe, free and available to anyone ages 12 and older.
“To any who have been hesitating about being vaccinated, please, I implore you to hesitate no longer,” Dr. Kiran Joshi, the senior medical officer for the Cook County Department of Public Health, which serves suburban Chicago, said Thursday.
Even in places in the United States that have not yet seen a significant uptick in infections, governors and public health officials worried that their states were vulnerable to an outbreak.
“I hope and pray that it doesn’t come to West Virginia and just absolutely runs across our state like wild,” said Gov. Jim Justice, whose state has recorded relatively few cases recently but has a low vaccination rate. “But the odds are it will.”
Few places are more worrisome than in Missouri, where a surge among unvaccinated people has left hospitals scrambling to keep up.
Just two months ago, when there were only 15 active coronavirus cases in his southwestern Missouri county, Larry Bergner, the director of the Newton County Health Department, had hoped the end of the pandemic might be in sight.
That has not happened.
As the delta variant has spread across the country, it has sent case totals spiking in Newton County, where less than 20% of residents are fully vaccinated. Bergner’s county now has a higher rate of recent cases than any state.
“It does give, I guess, some depression to think that we thought we were coming out of it, now here we go again, how high are we going to get,” Bergner said.
In Milwaukee County, where 48% of residents are fully vaccinated, the health department has tried to push the number higher by setting up a vaccine site outside the Fiserv Forum, where the Milwaukee Bucks are playing in the NBA Finals. Fewer than two dozen people have received a vaccine each day the site was in place, said Dr. Ben Weston, the director of medical services for the Milwaukee County Office of Emergency Management.
“In March, people flooded to our vaccination sites — all we had to do was open a door,” Weston said. “Now we have to go out and find people.”
As case numbers slowly rise, a sense of worry has begun to creep in for some Americans, even those who are fully vaccinated.
Vince Palmieri, 89, who gets around Los Angeles on public transportation, said he worried when he saw fellow riders not wearing masks as required. Though per capita case rates remain relatively low in Los Angeles County, they have grown sharply in recent weeks. The county is averaging about 1,000 new cases a day, up from fewer than 200 a day in mid-June.
“Once you get on a bus or a train you’re in no man’s land,” said Palmieri, who continues to wear a mask. “Their sneeze could take somebody out, but I’m frightened to talk up about the disease because people get ugly.”
Debora Weems, 63, who lives in New York City, has been following the case numbers closely. Her anxiety about the virus has risen alongside cases. New York City, which averaged fewer than 200 new cases a day in late June and early July, is now averaging more than 400 a day, far below past peaks.
“I’m just afraid we’re going to have to shut down again,” Weems said. Both she and her mother, who is 85, are vaccinated, but now she worries that their protection is not enough.
When the case numbers were at their lowest, she moved through the city more freely, with less thought about whether people nearby were vaccinated. But now she is trying to avoid leaving her neighborhood, and recently put up a new sign on her apartment door with a request: She and her mother are not receiving visitors because of COVID-19.
The largest union for registered nurses in the U.S. called on the Centers for Disease Control and Prevention (CDC) to bring back recommendations for universal masking in public regardless of people’s vaccination status.
The National Nurses Union (NNU) in a Monday letter to CDC Director Rochelle Walensky requested that the agency reinstitute guidelines for all people to wear masks in public and in close proximity to those outside their household.
NNU Executive Director Bonnie Castillo pointed to a 16 percent uptick in U.S. COVID-19 cases from last week, according to CDC data, as well as rises in case counts in more than 40 states and hospitalizations in more than 25 states as reasons to return to previous, stricter guidelines.
“NNU strongly urges the CDC to reinstate universal masking, irrespective of vaccination status, to help reduce the spread of the virus, especially from infected individuals who do not have any symptoms,” Castillo wrote in the letter. “Our suggestions are based on science and the precautionary principle and are made in order to protect nurses, other essential workers, patients, and the public from Covid-19.”
The union also cited the World Health Organization’s (WHO) call for vaccinated people to continue wearing masks in public amid the spread of the highly transmissible delta variant. Several U.S. officials and experts have said the WHO’s guidance reflects the state of the pandemic worldwide, which overall has seen lower vaccination rates than the U.S.
Castillo acknowledged that COVID-19 vaccines are effective at preventing severe illness and death but noted “no vaccine is 100 percent effective, and the emergence and spread of variants of concern may reduce vaccine effectiveness.”
The NNU in its letter also appeals for the CDC to update its guidance to “fully recognize aerosol transmission,” mandate tracking and reporting of cases among health care and essential workers, and keep records of cases, including mild and asymptomatic infections, among fully vaccinated people to measure the shots’ effectiveness.
The CDC did not immediately return a request for comment on the letter, but officials have consistently defended the updated mask guidance, saying fully vaccinated individuals are protected against the virus.
The NNU vocally opposed the CDC’s current mask guidance updated in May to permit fully vaccinated individuals to go maskless in virtually all settings. The union has argued that the change in recommendations endangered patients, front-line workers and nurses as the pandemic continues.
In the Monday letter, the union wrote that the CDC’s relaxation of mask guidance “failed to account for” the possibility of fully vaccinated people contracting and spreading the virus. It also said the agency’s guidelines do not protect people, including children, who cannot get the vaccine.
The NNU sent the letter days after the CDC urged schools to reopen for full in-person learning in the fall, saying that fully vaccinated teachers and students do not need to wear masks.
It also comes after Los Angeles County and St. Louis County recommended their residents to wear masks in public indoors.
The average number of new daily COVID-19 cases has increased 94 percent over the past two weeks, according to data from The New York Times, as worries over outbreaks climb nationwide.
The U.S. recorded a seven-day average of more than 23,000 daily cases on Monday, almost doubling from the average two weeks ago, as less than half of the total population is fully vaccinated.
Monday’s count of 32,105 newly confirmed cases pushed the seven-day average up from its Sunday level of more than 19,000 new cases — a 60 percent increase from two weeks prior.
All but four states — West Virginia, Maine, South Dakota and Iowa — have seen increased daily averages in the past 14 days, and the average in 16 states at least doubled in that period.
This comes as the highly transmissible delta variant was declared the dominant strain in the U.S. last week.
At the same time, vaccinations have stalled, with the daily rate reaching its lowest point during President Biden’s tenure on Sunday at slightly more than 506,000. Monday saw a small uptick in the average rate to more than 527,000 per day, according to Our World in Data.
The rise in case counts comes as the Centers for Disease Control and Prevention says just 48 percent of the total population is fully vaccinated. Officials have said fully vaccinated people are protected from the virus, while unvaccinated people are at much higher risk for serious illness and death.
This leaves a majority of Americans still vulnerable to the virus, particularly children under 12 years old, who are not authorized to get the vaccine. More than 56 percent of the eligible population aged 12 and older is fully vaccinated.
The Biden administration has strived to boost vaccination numbers over the past few months and signaled a new strategy focused on grassroots campaigning to promote the vaccine last week. The country fell short of the president’s goal to get 70 percent of adults at least one dose by the Fourth of July.
Increases in COVID-19 cases have previously signaled during the pandemic an upcoming rise in hospitalizations and deaths. The Times data shows that average deaths are still decreasing, but average daily hospitalizations are climbing, with a 16 percent increase from two weeks ago.
Still, case counts are much lower than the devastating peak that hit the U.S. in January, and experts say the country will not reach that level of infection again, as vulnerable populations have gotten vaccinated. Seventy-nine percent of those aged 65 and older are considered fully vaccinated.
The coronavirus has killed nearly 4 million people since it first emerged in Wuhan, China, in 2019, according to data compiled by Johns Hopkins University.
New confirmed cases of covid-19, the disease caused by the virus, remain high, and the world struggles with unequal vaccine rollouts and new threats posed by fast-spreading variants.
“The pandemic is a long way far from over,” World Health Organization Director General Tedros Adhanom Ghebreyesus warned in May. “It will not be over anywhere until it’s over everywhere.”
Some countries have already found that the spread of the virus is outpacing their vaccination plans, especially in the face of proliferating variants. In India, new daily cases topped 400,000 in early May — a global record but probably an undercount.
China now leads the world in the number of vaccine doses given out, though some other nations have vaccinated far more of their population. The vaccines were developed and rolled out at record speed, and studies show most have impressive efficacy.
More than a billion doses have been administered around the world, far more than the number of confirmed cases of the coronavirus since the start of the pandemic — though a large number of cases were likely never recorded, experts caution.
But the vaccine rollout has been persistently unequal, with problems with global supply and pockets of opposition in many nations. Covax, a program to distribute vaccines fairly backed by the World Health Organization, only belatedly began distributing doses to low-income nations.
“I can’t say it’s surprising,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations. “In every previous pandemic where we have our global health crisis, where there has been limited supplies of medical intervention, wealthy nations have hoarded.”
The United States, which continues to have the highest cumulative number of confirmed cases and deaths globally. More than 590,000 deaths from covid-19 have been recorded across the country.
Though cases dipped after January, a new wave began only a few months later, prompting President Biden to urge governors to reinstate mask mandates and other virus-related restrictions. “This is deadly serious,” Biden said in March.
Behind the United States, India, Brazil, France and Turkey have the largest number of cases.
India’s record-setting surge this spring meant the country accounted for about 1 in 3 of all new confirmed cases. The spike, which has been blamed on complacency and the lifting of restrictions, along with the spread of variants, has seen the country’s health-care system overwhelmed amid widespread oxygen shortages.
Even after the spike in new cases subsided in mid-May, India still set records for the number of new daily deaths with more than 4,500 deaths from covid-19 reported in a single 24-hour period.
In India, as in Britain and Brazil before it, some of the spread of the virus has been blamed on fast-spreading variants rampant in the country.
The variant widespread in India, known by the name B.1.617.2, has spread far beyond its borders. In May, British officials warned that it would likely become dominant across Britain unless more was done to control its spread.
Sharon Peacock, director of the U.K.’s Covid-19 Genomics Consortium, told reporters that a fast-spreading variant such as B.1.617.2 had “a biological passport for international travel and global spread” — making its spread difficult, if not impossible, to fully contain.
Some countries have seen success at controlling the virus.
In New Zealand, which closed its borders and ordered people to stay home as a first wave hit in the spring of 2020, confirmed infections went down to zero for a time. Taiwan and Singapore have kept their outbreaks far smaller than those in other parts of the world, which some experts attribute to their early responses and sophisticated tracking and tracing.
China, the early epicenter of the crisis, has seen much of daily life return to normal. In the early months of the outbreak, it reported more cases than any other country. Its tally of new infections peaked in mid-February of 2020 and approached zero by mid-March, although questions surround the accuracy of its data.
Wuhan, the virus’s initial epicenter, ground to a standstill in January 2020 as the coronavirus spiraled out of control. But after months without a confirmed case of domestic transmission, about 1.4 million children in the city returned to classrooms at the start of September, and crowded events have resumed.
Countries that have successfully rolled out vaccines are also seeing important gains. Britain, one of the hardest-hit countries in terms of cases and deaths, has excelled in the distribution of coronavirus vaccines. It was the first country to roll out a fully tested vaccine to the general public in December, when it began distributing the vaccine developed by Pfizer and Moderna.
Data released by Public Health England in March suggested that vaccinations had saved over 6,000 lives among people over 70, if not more.
Israel, which has seen several waves of the virus, had raced ahead of other nations and given the first doses of Pfizer’s two-dose vaccine to more than a third of its population by the end of January. Data from Israel indicated that the Pfizer vaccine was around 94 percent effective at stopping asymptomatic infection.
Early signs from the country suggest that the large scale of vaccinations has had an impact on the spread of the virus.
But global health experts have cautioned that despite the success of vaccines, the virus remains a potent threat and returning to normal life too early could ultimately extend the length of the pandemic and lead to fresh new cases.
Though wealthy countries have taken some steps to ensure vaccines are shared around the world, such as by donating through Covax or supporting waivers on intellectual property such as the Biden administration has done, experts say they are worried by the ongoing level of spread.
“Sadly, unless we act now, we face a situation in which rich countries vaccinate the majority of their people and open their economies, while the virus continues to cause deep suffering by circling and mutating in the poorest countries,” United Nations Secretary General António Guterres said at a meeting of the World Health Assembly on May 24.