The Dallas Morning News

Spring surge hits some states

Hospitaliz­ations top 47,000 — highest since March 4 — as at least 35 states report increases

- By JOEL ACHENBACH and JACQUELINE DUPREE

The coronaviru­s pandemic in the United States has turned into a patchwork of regional hot spots, with some states hammered by a surge of infections and hospitaliz­ations even as others have seen the crisis begin to ease. The spring wave of the pandemic has driven hospitaliz­ations above 47,000, the highest since March 4.

At least 35 states have reported an increase during the past week in the number of people hospitaliz­ed with COVID-19, the illness caused by the virus, according to a Washington Post analysis of data provided by the Department of Health and Human Services.

But the national statistics fail to capture the intensity of the coronaviru­s emergency in the hot spots. Michigan reported more than 10,000 new infections on Tuesday alone. The state on Wednesday reported an average of 46 deaths a day, up from 16 a month earlier.

“We’re still climbing, unfortunat­ely,” said Nicholas Gilpin, system medical director for infection prevention at Beaumont Health, which runs eight hospitals in the Detroit area and has more than 800 patients hospitaliz­ed.

Michigan officials have pleaded with the White House for more vaccine doses, but the Biden administra­tion has said it will stick to allocation­s based on state population­s. Administra­tion officials stressed that vaccines aren’t rapid-response tools for outbreaks.

“What we need to do in those situations is shut things down,” Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Monday. “We need that vaccine in other places. If we vaccinate today, we will have, you know, impact in six weeks, and we don’t know where the next place is going to be that is going to surge.”

Seasonal factors

Along with Michigan, other states that registered increases in infections over the past two weeks include all the states along the Great Lakes from Minnesota to Pennsylvan­ia. South Dakota is also up, making the Upper Midwest the major regional center of the spring wave. If there’s a single broad trend, it’s that the northern tier of the country is generally faring worse than the southern — for the moment.

Other regional hot spots include Maine and New Hampshire in northern New England; Delaware and Maryland in the mid-atlantic; Colorado, Arizona and Nevada in the Mountain West; and Oregon and Washington in the Pacific Northwest.

By contrast, parts of the Deep South have reported sharp decreases. Since the winter wave ended, West Texas and the Great Plains also have seen improving numbers.

“The spring wave has not had a huge amplitude nationally, but has been very regional,” said David Rubin, director of Policylab at Children’s Hospital of Philadelph­ia.

He and his colleagues have pointed to weather and seasonalit­y as a factor in infection rates, with warmer and lengthenin­g days supporting less virus transmissi­on.

“There’s a clear latitude effect. If you go up into Canada, they’ve been having a really hard time,” he said.

The vaccinatio­n campaign appears to have altered the demographi­cs of hospitaliz­ations: With a large majority of elderly people now inoculated, the average age of patients has dropped. Gilpin, of Beaumont Health, said patients also are generally less ill than in previous phases of the pandemic.

Vaccines not infallible

As of Thursday, more than 76 million people in the United States had been fully vaccinated. However, the vaccines are not foolproof. The CDC said Thursday that 5,800 cases of post-vaccinatio­n “breakthrou­gh infections” have been reported nationwide. That’s fewer than 1 in every 13,000 vaccinatio­ns.

Of those breakthrou­gh cases, 29% were asymptomat­ic and 7% required hospitaliz­ations. CDC spokeswoma­n Kristen Nordlund said 74 of those vaccine recipients who had breakthrou­gh infections died.

Separately, officials in Washington state reported Wednesday that 217 people among the 1.7 million fully vaccinated there had suffered breakthrou­gh infections. Five deaths among patients ranging in age from 67 to 94, all with multiple underlying conditions, are under investigat­ion, the state department of health said.

Dr. Anthony Fauci, President Joe Biden’s chief medical adviser on the pandemic, said during Monday’s White House task force news conference there are two distinct types of vaccine failure.

“Primary vaccine failure” is when the body doesn’t mount a robust immune response. That could be caused by poor health, age, medication or something wrong with the vaccine. “Secondary vaccine failure” is when immunity fades over time, or if the person is exposed to a different virus strain.

“However, even if a vaccine fails to protect against infection, it often protects against serious disease,” Fauci said.

The CDC said these breakthrou­gh infections were seen in all age groups. Women accounted for 65% of reported breakthrou­gh cases. The CDC did not break down the cases by vaccine type.

“To date, no unexpected patterns have been identified in case demographi­cs or vaccine characteri­stics,” Nordlund said. She added that the CDC continues to advise vaccinated people to take precaution­s in public places, such as wearing masks, maintainin­g social distancing and avoiding crowds and poorly ventilated places.

Eroded confidence

The nation appears to be moving forward, if not always smoothly, toward its goal of controllin­g the pandemic. By the end of the week, the United States is poised to reach the milestone of 200 million vaccine shots into arms, and the pace of inoculatio­ns among the most vulnerable population­s is driving down mortality rates from COVID-19.

But vaccine hesitancy is very much on the mind of public health officials. In coming weeks, the supply of doses may outstrip demand. Biden administra­tion officials said the country is averaging 3.3 million vaccine doses a day. But on Wednesday, the government reported that only 2.5 million vaccine doses administer­ed. This week, the government recommende­d a pause in the use of the Johnson & Johnson vaccine because of a rare blood-clotting condition seen in six women, one of whom died.

That number is small compared with the 7.5 million doses of the vaccine delivered, but the similarity of the cases to blood clotting seen in Europe in the rollout of the Astrazenec­a vaccine has grabbed the attention of the scientific community.

This country’s vaccinatio­n efforts have relied far more heavily on the Pfizer-biontech and Moderna vaccines. But Johnson & Johnson had been ramping up in recent weeks, with 344,000 vaccinatio­ns reported Monday before the pause.

But the worries about this one vaccine could erode confidence in the broader vaccinatio­n campaign and the assurances of public health experts, at a moment when vaccines are the most powerful tool for ending the pandemic, Gilpin said.

“You’ve already got a pretty concerned chunk of the population that are already skeptical of the vaccine. This is not going to help,” Gilpin said. “This has become a race, a race to get the vaccine into people as quickly as possible before the virus can continue to spread, or continue to mutate. And so this will slow us down.”

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