Coronavirus infections are surging in places with low vaccination rates. Covid-19 is continuing to mutate, with researchers confirming the delta variant is far more transmissible than earlier strains. And although the vaccines remain effective, the virus has bountiful opportunities to find ways to evade immunity.
And so the end of the pandemic remains somewhere over the horizon.
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"We're getting further away from the end than we should be. We're in a bad place right now globally," said Maria Van Kerkhove, a World Health Organization epidemiologist.
Similarly dismayed is Francis Collins, director of the National Institutes of Health. Last summer, he watched cases in the U.S. spike after what he felt was a premature end to spring restrictions. This summer, he said, he is not surprised by the rise in infections across a country where many people haven't gotten their shots and have returned to pre-pandemic behavior.
"It's like we've been to this movie several times in the last year and a half, and it doesn't end well. Somehow, we're running the tape again. It's all predictable," Collins said.
Coronavirus infections in the U.S. rose nearly 70% in a single week, officials reported Friday, and hospitalizations and deaths rose 36% and 26%, respectively. Almost every state has experienced a rise in cases. Florida, which is populous and not highly vaccinated, is seeing a surge in cases. In hot spots such as Arkansas and Missouri, covid wards are opening up again in hospitals.
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Thursday night's prime-time baseball game between the New York Yankees and Boston Red Sox was canceled when six Yankees players -- most of them vaccinated -- tested positive for the virus.
Many cases involving vaccinated people, known as breakthrough infections, will produce no symptoms. The Centers for Disease Control and Prevention decided in May to track only breakthrough infections leading to hospitalization.
The vaccines, though effective, do not form an impenetrable shield against the virus. They work as advertised, meaning they usually prevent severe illness and death, but they do not deliver what is known as "sterilizing immunity."
MISSOURI CASES
In Missouri, Gov. Mike Parson said the state will "probably" provide funding for a site to help handle the overflow of covid-19 patients in Springfield, where hospitals are struggling to keep up with a surge driven by the delta variant and vaccine hesitancy.
The Republican governor suggested that federal stimulus money could help pay for the alternative care site that health leaders in the city requested. Parson, who was in Springfield on Thursday for an unrelated bill signing, told the Springfield News-Leader that the state will "for the most part probably" fulfill the request.
"We're in the process of kind of going through that right now to see what we can deliver and what we can't," he said. "Those are things we've done before, so I think we'll be able to do [the funding]."
The fast-spreading delta variant has led to a surge in hospitalizations throughout southwest Missouri. Springfield's hospitals are already seeing patient counts topping the previous peak in mid-winter. As of Friday, 228 people with covid-19 were hospitalized there. Three weeks ago, the daily average patient count was fewer than 120.
CoxHealth, which operates six hospitals in southwest Missouri, was treating 170 patients during the winter surge of the virus, CEO Steve Edwards said in an interview. It has surpassed that now, and Edwards expects at least 240 daily covid-19 patients within two weeks -- if there's room.
There's a difference this time around compared with January.
"Younger, sicker, quicker is the way I characterize it," Edwards said. "We have many, many younger patients. Pediatric patients hospitalized. Many in their 20s. A good number of pregnant women that we've had to do emergency C-sections to save the baby and to save mom."
Katie Towns, the interim director of the Springfield-Greene County Health Department, said the alternative care site would provide transitional care for patients stabilized enough to be released from hospitals. She said options include places such as dorms and hotels.
The governor also told the News-Leader that the CDC halted the state's plan to implement an incentive program to encourage vaccinations. Only 45.8% of Missourians have initiated vaccination, which is 10 percentage points below the national average.
"The CDC didn't accept our plan, which is just totally ridiculous that they would turn us down with Missouri in the situation we're in right now. So I think it's just another obvious problem with the CDC," Parson said.
Parson's spokeswoman, Kelli Jones, said Friday that the CDC wanted to limit funding incentives to $25 per vaccinated person, "and we do not feel this figure will be enough to significantly increase vaccine uptake in Missouri."
The agency reviewed the plan and returned it to the state because it didn't meet the CDC's guidelines for use of the specific federal funds the state wanted to draw from for the project, a CDC official said.
Covid-19 cases are rising sharply across Missouri. The state health department on Friday reported 1,834 newly confirmed cases and seven additional deaths. Hospitalizations continued to rise, reaching 1,357, including 425 people who were in intensive care units.
TEXAS LAWMAKERS
Elsewhere, three Democratic state lawmakers who fled Texas to stymie a Republican-backed effort to impose broad voting restrictions have tested positive for covid-19 and are quarantined, the Texas House's Democratic Caucus director said Saturday.
One lawmaker tested positive Friday and the other two Saturday, according to caucus director Phillip Martin. All three were fully vaccinated against the disease, according to Martin, who declined to release their names or conditions to "respect the privacy of Members and their personal health."
More than 50 Texas lawmakers arrived in Washington on Monday after leaving their home state on a private charter flight. They received criticism from Republicans and others after a photo showed them maskless on the plane, though federal pandemic guidelines don't require masks to be worn on private aircraft.
Rep. Chris Turner, the caucus chairman, said in a statement that the caucus was conferring with health experts in Texas for additional guidance.
"This is a sober reminder that COVID is still with us, and though vaccinations offer tremendous protection, we still must take necessary precautions," Turner said.
The Democrats left the state to deny the Republican-controlled Legislature the necessary quorum to pass a bill that would place new restrictions on voting in Texas.
Members of the caucus met with Vice President Kamala Harris, including two of the three lawmakers who tested positive, Harris spokesperson Symone Sanders said in a statement on Twitter.
"Based on the timeline of these positive tests, it was determined the Vice President and her staff present at the meeting were not at risk of exposure because they were not in close contact with those who tested positive and therefore do not need to be tested or quarantined," Sanders wrote.
"The Vice President and her staff are fully vaccinated," according to Sanders.
TRIBE'S MANDATE
The Choctaw Nation of Oklahoma has reinstated a mask requirement for visitors at tribal health facilities.
The Choctaw Nation Health Services Authority announced Friday on Facebook that all visitors must wear masks, and it placed limits on the number of visitors a patient is allowed.
"Due to the increasing number of positive COVID-19 cases in ... Oklahoma, it has become necessary to reinstate some of the previous visitor restrictions to ensure the safety of our patients and staff," according to the statement.
A spokesperson for the tribe did not immediately respond to requests for comment Saturday.
The seven-day rolling average of new cases in Oklahoma increased from 224.7 per day on July 1 to 560.7 Thursday, according to data from Johns Hopkins University, ranking Oklahoma ninth in the nation with 155.3 new cases per 100,000 residents.
State health officials have pleaded for Oklahomans to get vaccinated, saying the delta variant is likely moving into Oklahoma from Arkansas and Missouri, which rank first and second in the nation in new cases per capita.
The CDC reports that 46% of the state's population has received at least one vaccine dose and that 39.4% is fully vaccinated.
ANTI-VACCINE RHETORIC
In Utah, the state's Republican governor on Thursday decried "propaganda" spread against coronavirus vaccines, warning that those discouraging immunization are "killing people."
"We have these -- these talking heads who have gotten the vaccine and are telling other people not to get the vaccine," Gov. Spencer Cox said in response to a reporter's question about anti-vaccine rhetoric coming in large part from the political right. "That kind of stuff is just, it's ridiculous. It's dangerous, it's damaging, and it's killing people. I mean, it's literally killing their supporters. And that makes no sense to me."
Cox's sharp words came as some Republican members of Congress have derided "door-to-door" outreach. A host at the conservative network Newsmax recently declared vaccines "against nature," and audience members at a conservative conference cheered last weekend when a speaker said the U.S. missed its immunization goals.
Most covid-19 deaths now occur among the unvaccinated, something Cox underscored as true for Utah. Yet recent polling shows that 29% of Americans say they are unlikely to get their shots, with most of those people saying they definitely will not. That's a slight uptick from three months earlier when 24% said they were unlikely to get vaccinated.
Cox said he sees the coronavirus vaccines as a key accomplishment of the Trump administration.
"I don't think we can take credit for getting the vaccine and then tell people that there's something wrong with the vaccine," Cox said Thursday.
Cox is not the only Republican official to express frustration over vaccine messaging from the right. Sen. Mitt Romney, R-Utah, last week said that "politicizing vaccinations is moronic" and asked aloud why supporters of former President Donald Trump are resistant.
"President Trump and his supporters take credit for developing the vaccine," he said, according to the Deseret News. "Why the heck won't they take advantage of the vaccine they received plaudits for having developed?"
Surgeon General Vivek Murthy highlighted the threat of misinformation on covid-19 at a White House news briefing last week, where he said he has lost 10 family members to the disease. He accused tech companies of allowing falsehoods to "poison our information environment with little accountability to their users."
President Joe Biden doubled down on that Friday. "They're killing people," he said of the social media platforms that spread misinformation.
Facebook spokesperson Dani Lever said the tech giant is "helping save lives" and that "more than 2 billion people have viewed authoritative information about COVID-19 and vaccines on Facebook, which is more than any other place on the internet."
Utah has seen its coronavirus cases, deaths and hospitalizations drop significantly with vaccination but tick up in recent weeks, according to data tracked by The Washington Post.
With at least one dose for 66.5% of adults, Utah is slightly behind the country as a whole, according to the newspaper's tracking.
Information for this article was contributed by Joel Achenbach and Hannah Knowles of The Washington Post and by Darlene Superville and Ken Miller of The Associated Press.