Some experts are voicing concerns about potential upcoming holiday-related COVID-19 surges, citing the rapidly spreading delta variant and pockets of the U.S. reporting particularly low vaccination rates.
Current U.S. trends
New COVID-19 cases are now increasing, a change from previous declines over the last couple of weeks. Nationwide, daily cases have risen 5 percent over the last 14 days, as of July 6, according to The New York Times.
As of July 6, COVID-19 hospitalizations are currently rising in 17 states, according to the Times.
Many surges are emerging in rural areas with low vaccination rates. Younger patients are also accounting for more COVID-19 hospitalizations than previous waves.
As of July 4, 67.1 percent of all American adults have received at least one vaccine dose, while 58.2 percent of American adults are fully vaccinated, reports the CDC.
Current COVID-19 case, hospitalization and death data are not yet able to be connected to holiday activities, with case trends usually lagging at least seven days behind large group gatherings or social activities.
What we know about the rapidly spreading delta variant
The delta coronavirus variant, first identified in India, is now the most commonly circulating strain in the U.S., according to sequencing data.
Unvaccinated individuals infected with delta are twice as likely to be hospitalized as those infected with alpha, the variant first detected in the U.K., according to a study published June 14 in The Lancet. The study analyzed data from all COVID-19 infections reported in Scotland (19,543) between April 1 to June 6, 2021, of which 377 patients were hospitalized. Risk of COVID-19 hospitalization was doubled in those with the delta when compared to alpha, with risk of admission increased in those with five or more relevant comorbidities.
What community leaders are seeing
"My concern is all the patients I'm seeing in my office who are not vaccinated and are not wearing a mask," Cecil Bennett, MD, a family physician in Georgia, told ABC affiliate WSB-TV.
"They're trying to mix in with everyone else and it's a risk to themselves and others who are not wearing a mask," Dr. Bennett said. "That is the greatest risk for spreading the delta variant."
"I'm very concerned," Erik Frederick, chief administrative officer at Springfield, Mo.-based Mercy Hospital, told NPR when asked about the Fourth of July. Mr. Frederick compared this year to last, noting that mask mandates and social distancing measures in place last year no longer exist.
"There are things happening all over the community this weekend," Mr. Frederick said. "Five to seven days is when we'll start to know, you know, what did this weekend bring us?"
Mercy Hospital ran out of ventilators July 4 as cases and hospitalizations spike in southwest parts of the state, said Mr. Frederick.
"We're not post-pandemic," Mr. Frederick told NPR. "What everybody should be thinking about is how do we protect our communities in case someone travels to southwest Missouri and brings this delta variant back with them?"
What authorities are doing
Conflicting advice about masks has confused many, with the World Health Organization urging everyone to wear masks but the CDC standing by its guidance that vaccinated Americans often don't need them. Whether a fully vaccinated person should wear a mask depends on specific personal and community circumstances, most experts have said.
"WHO is providing guidance for the whole world, and in areas where delta is dominant, cases are high, vaccination rates are low, and the vaccines that have been distributed are less effective against delta, it makes sense for vaccinated people to wear masks," Linsey Marr, PhD, professor of civil and environmental engineering at Blacksburg-based Virginia Tech, told The New York Times.
Local authorities may impose more stringent measures to protect unvaccinated individuals, said Rochelle Walensky, MD, director of the CDC.
The White House is launching "surge response" teams to stop the spread of the variant in COVID-19 hot spots. The teams include both virtual and in-person support, helping deploy additional supplies as needed.
The rising prevalence of the delta variant in the U.K. is the "primary reason" the U.S. hasn't eased travel restrictions there, a senior health official told CNN.
Implications of not meeting Biden's 70% vaccination goal
President Joe Biden hoped 70 percent of American adults would have received at least one dose by July 4. The U.S. did not hit that mark, and most American adults who plan to get vaccinated have already done so, according to a recent Kaiser Family Foundation poll.
"Looking state by state and county by county, it is clear that communities where people remain unvaccinated are communities that remain vulnerable," Dr. Walensky said.
What can Americans do to offset the spread of COVID-19?
Consider the circumstances when choosing to wear a mask (or not). "At this point, thinking about wearing a mask is a little like dressing for the weather," Dr. Marr told The Times. "You need to consider the caseload and vaccination rates wherever you're going, what activity you'll be doing and your own health."
Get vaccinated — fully. Both Johnson & Johnson and Moderna have released data showing promise that their vaccines are effective protecting against delta. However, almost 15 million people have missed their second COVID-19 vaccine dose, according to CDC data cited by The Washington Post. The CDC considers a second dose missed if more than 42 days passed since the first dose. Experts say getting both doses of an mRNA vaccine will be critical to combat the delta variant.