As the delta variant takes over in the U.S., new, localized outbreaks are emerging. Those surges are likely driven by pockets of dangerously low vaccination rates.



A new analysis done by NPR and Johns Hopkins shows that COVID cases are again surging in the U.S., now specifically in places with low vaccination rates. Meanwhile, the very contagious delta variant is now the dominant strain in this country. NPR health correspondent Rob Stein has been following this one. Hey, Rob.

ROB STEIN, BYLINE: Good morning, Noel.

KING: We were doing pretty good as a country. Cases, deaths, hospitalizations were all going down. What happened?

STEIN: Well, you know, Noel, the vaccination campaign essentially stalled just as the country reopened and the delta variant took over. So all that progress the country was making hit a wall, and infections may have even started rising again nationally. And if you drill down to a state level, you can really see what's going on. In the past week, the number of people catching the virus has started climbing again in about half of states, and that increase has been going on for at least two weeks in 15 states. You know, we've heard a lot about Missouri but also in places like Texas, Illinois, the Carolinas. I talked about this with Jennifer Nuzzo at Johns Hopkins.

JENNIFER NUZZO: It's an early trend, and so my hope is that it won't last. But unfortunately, looking at what's happening in individual states, I do worry that we will continue to see national numbers increase.

STEIN: In fact, the number of people getting so sick they're ending up in a hospital started rising again in about nine states, including Florida, Nebraska, Arkansas.

KING: Nine states - and I know you also looked at the county level.

STEIN: Yeah. That's right. The CDC lists hot spots by county, but that fluctuates a lot, with cases up one week and then down the next. So NPR and Johns Hopkins looked at what's been happening over a longer period, over a month. When you do that, you can really see the places that look like they're in trouble, where it isn't just a blip. And in most of those hotspot counties, it's a sustained increase. Most are rural counties in the Midwest, West and South. Newton County, Mo., has seen a 182% increase, for example. In Ottawa County in Oklahoma, infections soared 828%.

KING: I know as a science reporter, you're very careful about percentages, but those are striking.

STEIN: Yeah. I mean, the numbers are small, but, still, these are big increases. And it's happening in lots of places. And Jennifer Nuzzo says those hot spot counties - they are everywhere, even in suburban and urban places.

NUZZO: Most of the counties are in states that are also reporting state-level increases, but not all are. In fact, we are seeing counties in states that we haven't really been worrying much about - California and Washington state, for instance.

KING: So what is going on in those specific counties?

STEIN: Well, you know, everyone's been saying how important it is to get vaccinated, and our analysis with Johns Hopkins illustrates that pretty dramatically. Most of the counties experiencing sustained outbreaks, 92%, have vaccination rates below the national average. You know, Oklahoma's Ottawa County has only vaccinated 23%. In Missouri's Newton County, it's only 16%. And even states that have high vaccination rates are seeing outbreaks in counties that haven't vaccinated enough people.

NUZZO: It raises the prospect that we could see case increases elsewhere in these states, potentially also in other states that haven't yet seen case increases. Things that we keep forgetting about this pandemic is that something that happens in one state is not isolated from something that will happen in another state, and so as long as we see case increases in any part of the country, it remains a national crisis.

KING: So what does this mean, Rob, for the next six months or so?

STEIN: Well, you know, Noel, it's not good. The country may be on the cusp of yet another national surge that could put us in a bad place in the fall, when more people will be heading indoors because of the cold weather. Now, you know, no one is predicting things will get anywhere as bad as last winter, but it's just heartbreaking to see people still dying when COVID has become preventable. Here's Jennifer Nuzzo one more time.

NUZZO: I think it's such an utter tragedy that when we have on hand ample supplies of vaccines that can prevent people from getting infected, prevent people from winding up in the hospital and dying, for anybody to develop severe illness - just a complete and utter tragedy.

STEIN: So Nuzzo and others are hoping these early hot spots will be kind of a wake-up call to people to finally get vaccinated.

KING: And then lastly, Rob, what's going on with this news that people who got the Pfizer vaccine could be able to get a booster shot soon?

STEIN: Yeah, yeah, yeah. The company says a third shot of its vaccine can boost protection and plans to ask the FDA for authorization for that soon. The company says that should help guard against the delta variant, and the company is also updating its vaccine to specifically target delta. But it's important to note that the FDA and the CDC are both saying at the moment, no one who's fully vaccinated needs a booster.

KING: Ah, OK. NPR health correspondent Rob Stein - thank you for this, Rob.

STEIN: You bet, Noel. Transcript provided by NPR, Copyright NPR.