The U.S. on Monday finally reached President Joe Biden's goal of getting at least one covid-19 shot into 70% of American adults -- a month late and amid a fierce surge by the delta variant that is swamping hospitals and leading to new mask rules and mandatory vaccinations around the country.
Biden had set a vaccination goal of 70% by the Fourth of July. That figure was the low end of initial government estimates for what would be necessary to achieve herd immunity in the U.S. But that has been rendered insufficient by the highly contagious delta variant, which has enabled the virus to come storming back.
There was was no celebration at the White House on Monday, nor a setting of a new target, as the administration instead struggles to overcome skepticism and outright hostility to the vaccine, especially in the South and other rural and conservative areas.
The U.S. still has not hit the administration's other goal of fully vaccinating 165 million American adults by July 4. It is about 8.5 million short.
While setting a national vaccination goal may have been useful for trying to drum up enthusiasm for the shots, 70% of Americans getting one shot was never going to be enough to prevent surges among unvaccinated groups. And when he announced the goal, Biden acknowledged it was just a first step.
It's the level of vaccinations in a community -- not a broad national average -- that can slow an outbreak or allow it to flourish.
Vaccination rates in some Southern states are far lower than they are New England. Vermont has fully inoculated nearly 78% of its adult population. Alabama has just cracked 43%.
New cases per day in the U.S. have increased sixfold over the past month to an average of nearly 80,000, a level not seen since mid-February. And deaths per day have climbed over the past two weeks from an average of 259 to 360.
Those are still well below the 3,400 deaths and a quarter-million cases per day seen during the worst of the outbreak in January. But some places around the country are watching caseloads reach their highest levels since the pandemic began. And nearly all deaths and serious illnesses now are in unvaccinated people.
The surge has led states and cities across the U.S. to beat a retreat, just weeks after it looked as if the country was going to see a close-to-normal summer.
In a major retreat in the Deep South, Louisiana ordered nearly everyone, vaccinated or not, to wear masks again in all indoor public settings, including schools and colleges.
Health officials in San Francisco and six other Bay Area counties announced Monday they are reinstating a requirement that everyone -- vaccinated or not -- wear masks in public indoor spaces.
New York Gov. Andrew Cuomo said New York City airport and transit workers will have to get vaccinated or face weekly testing. He stopped short of mandating either masks or inoculations for the general public, saying he lacks legal authority to do so.
Denver's mayor said the city will require police officers, firefighters and certain other municipal employees to get vaccinated, along with workers at schools, nursing homes, hospitals and jails.
Minnesota's public colleges and universities will require masks indoors, regardless of vaccination status. New Jersey said workers at state-run nursing homes, psychiatric hospitals and other such institutions must get the shot or face regular testing.
North Carolina's governor ordered state employees to cover up indoors if they are not fully vaccinated.
White House press secretary Jen Psaki said a nationwide vaccination requirement "is not on the table," but noted that employers have the right to take such a step.
SURGE TEAMS OFFERED
To help prevent the spread of the delta variant, the White House is offering coronavirus surge response teams and other federal resources to governors in all 50 states.
Jeff Zients, head of the White House covid-19 response team, in a letter dated Thursday said the Biden administration is prepared to send additional federal resources wherever they are requested, including supplies from the strategic national stockpile.
Some states experiencing a rise in cases, such as Missouri and Colorado, have already accepted federal help. "Surge response teams" arrived on the ground in both states in recent weeks and have been helping local officials integrate federal resources into their responses.
Those teams often include experts from the Centers for Disease Control and Prevention and the Department of Health and Human Services, who are able to accelerate the delivery of federal resources such as additional staffing for vaccination and testing sites or funding to increase medical personnel when hospitals are reaching capacity.
Zients said the federal government is offering case investigators, epidemiologists and data analysts to assist local governments on the ground as well as the deployment of mobile vaccination clinics, funding and training to combat vaccine hesitancy and the delivery of therapeutics, ventilators, and other supplies.
Some states disproportionately affected by the spread of the delta variant -- including Florida, where 86% of intensive care unit beds are now occupied -- have not requested assistance, but the administration has been in contact with the offices of the governors of Florida and Texas, an administration official said.
In Florida, it took two months last summer for the number of people in the hospital with covid-19 to jump from 2,000 to 10,000. It took only 27 days this summer for Florida hospitals to see that same increase, said Florida Hospital Association President Mary Mayhew.
She noted also that this time, 96% of hospitalized covid-19 patients are unvaccinated and they are far younger, many of them in their 20s and 30s.
"As quickly as we can discharge them, they're coming in, and they're coming in very sick. We started seeing entire families come down," lamented Dr. Sergio Segarra, chief medical officer of Baptist Hospital Miami. The Florida medical-center chain reported an increase of over 140% in the past two weeks in the number of people now hospitalized with the virus.
In Louisiana, the number of hospitalized climbed to 1,984 -- seven times the number of covid-19 patients a month ago. The total number of deaths since the pandemic started in early 2020 surpassed 11,000 in Monday's newest figures.
Dr. Catherine O'Neal, chief medical officer of Our Lady of the Lake Medical Center in Baton Rouge, said the hospital is currently caring for 155 covid-19 patients, one-third of them in intensive care. She said covid patients occupy one-quarter of the facility, while people with chest pains and other medical conditions are forced to sit in the emergency room waiting for an ICU bed. Elective surgeries have been postponed.
"These are the darkest days of this pandemic. We are no longer giving adequate care to patients," she said.
Louisiana has one of the lowest vaccination rates in the country, although the number of people who had received at least one dose rose by more than 46,000 between Thursday and Monday, to nearly 43%. More than 1.72 million, or just under 37%, are fully vaccinated.
SENATOR TESTS POSITIVE
Meanwhile, U.S. Sen. Lindsey Graham of South Carolina tweeted Monday he has tested positive for coronavirus, months after he was vaccinated.
He tweeted he will quarantine for the next 10 days, and, despite his diagnosis, is glad he was vaccinated.
"I was just informed by the House physician I have tested positive for #COVID19 even after being vaccinated. I started having flu-like symptoms Saturday night and went to the doctor this morning," Graham tweeted. "I feel like I have a sinus infection and at present time I have mild symptoms. I will be quarantining for ten days. I am very glad I was vaccinated because without vaccination I am certain I would not feel as well as I do now. My symptoms would be far worse."
Graham's diagnosis is among the rising breakthrough cases reported across the country where vaccinated people are testing positive for the virus as a result of the rise in the delta variant.
As concerns grow over the highly contagious delta variant of the coronavirus, Germany on Monday became the biggest Western country yet to announce that it will offer vaccine booster shots to a wide range of people considered potentially vulnerable, adding to growing momentum in rich nations to give additional shots to fully vaccinated people.
Starting in September, Germany, Europe's largest economy, wants to administer a booster of the Pfizer-BioNTech or Moderna vaccine to older people, residents of care homes and people with compromised immune systems -- and also to anyone who was already fully vaccinated with the two-dose AstraZeneca or single-dose Johnson & Johnson shots, which clinical trials have shown are not as highly protective.
"We will be prepared for the fall," said Klaus Holetschek, the Bavarian Health minister who made the announcement on behalf of all 16 German state health ministers. "I am convinced that a booster shot is important and right based on prevention alone. But I still hope science stays on the ball and generates even more reliable data to help us optimize our vaccination strategy."
The move by Germany came even as a top European Union official criticized the bloc as falling far short of its promises to donate vaccine doses to Africa and Latin America. And with a limited global vaccine supply, health experts say the top priorities should be distributing doses to poor countries that lag far in inoculations, and persuading vaccine-resistant people in wealthy countries to get their first shots.
There is also still no consensus among scientists on the need for booster shots, but as fears rise of more pandemic waves and more costly lockdowns, a growing number of countries either are preparing to give their people booster doses or have already started.
Israel, an early leader in vaccination, began administering boosters to people 60 and older last week. A month ago, Russia made additional shots available to anyone six months after inoculation, and on Sunday, Hungary began offering them four months post-vaccination.
France is offering them only to those with weak immune systems, and plans to give them this fall to those who were the first to be vaccinated early this year -- mostly people older than 75 and those with serious health problems.
In Britain, which remains ahead of the European Union on vaccinations, health officials have been preparing to offer booster doses as early as September, but that plan has not yet been activated by the government. A committee of government advisers recommended in late June that everyone older than 50 should be eligible but said the priority should be getting the shots to people older than 70, health workers, nursing home residents, and younger adults with immune problems or other serious vulnerabilities.
Several other European countries, including Italy and Spain, have said they will probably make boosters available to certain groups this fall. But none have indicated that they would go as far as Germany and include healthier and younger people who have had the shots from AstraZeneca or the one known in Europe under the Janssen Pharmaceuticals name, and in the United States as Johnson & Johnson.
In the United States, Biden administration health officials increasingly think that vulnerable populations may need additional shots even as research continues into how long the vaccines remain effective. Some people have already obtained boosters simply by not revealing previous vaccination.
Information for this article was contributed by Mike Catalini, Kelli Kennedy, Michelle Liu, Gary Robertson and Melinda Deslatte of The Associated Press; by Michael Wilner of McClatchy (TNS); by Andrew Caplan of The State (Columbia, S.C.) (TNS); and by Katrin Bennhold and Benjamin Mueller of The New York Times.