COVID-19 deaths and cases in the US have climbed back to levels not seen since last winter, eroding months of progress and potentially reinforcing President Joe Biden’s argument for his sweeping new vaccination requirements. are.

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Cases driven by the delta variant combined with resistance to receiving the vaccine among some Americans – mostly concentrated in the South.

While one-time hot spots like Florida and Louisiana are improving, infection rates are rising in Kentucky, Georgia and Tennessee, fueled by children now in school, loosened mask restrictions and low vaccination levels.

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The dire situation in some hospitals is beginning to look like the peak of January’s infections: surgeries were canceled in hospitals in Washington state and Utah. Serious staff shortages in Kentucky and Alabama. Lack of beds in Tennessee. Intensive care units at or above capacity in Texas.

The deteriorating picture nine months into the country’s vaccination campaign has angered and dismayed medical professionals, who believe heartbreak is preventable. Most of the dead and hospitalized have not been vaccinated, which has proved a hard lesson for some families.

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“The problem now is that we are trying to educate based on science, but I think the education that is happening now is based on tragedy, personal tragedy,” said Dr. Ryan Stanton said.

The governor said that in Kentucky, 70% of the state’s hospitals – 66 of the 96 – are reporting critical staff shortages, the highest level yet during the pandemic.

“Our hospitals are on the verge of collapse in many communities,” said Kentucky Public Health Commissioner Dr. Steven Stack.

The US averages more than 1,800 COVID-19 deaths and 170,000 new cases per day, the highest levels since early March and late January, respectively. And both figures have been rising over the past two weeks.

The country is still well below the dire peaks it reached in January, when it averaged about 3,400 deaths and a quarter million cases per day.

The US is immunizing about 900,000 per day, down from a high of 3.4 million per day in mid-April. On Friday, a Food and Drug Administration advisory panel will meet to discuss whether the US should start giving booster shots of the Pfizer vaccine.

On a positive note, the number of people in hospital with COVID-19 now appears to be around 90,000, or even declining to the level of where things stood in February.

Last week, the president ordered all employers with more than 100 workers to require vaccinations or weekly tests, a measure that affects nearly 80 million Americans. And the nearly 17 million workers in health facilities that receive federal Medicare or Medicaid must also be fully vaccinated.

“We read and hear about it and we see stories of people hospitalized, people who have died without vaccinations in the past few weeks,” Biden said in announcing the rules. “This is an epidemic of the uneducated.”

The requirements have been met with resistance and threats from Republican lawsuits.

Arizona reported 117 deaths on Tuesday, the most in a single day since last February. Tennessee now ranks first in the US in new cases per capita. Hundreds of students there have been forced to quarantine. Some schools have closed due to staff shortage. Others have asked to switch to distance learning.

But measures aimed at containing the virus have gone into protest. Last week, a Tennessee high school student who spoke at a school board meeting in favor of a masked mandate was harassed by adults while they talked about their grandmother dying of the virus.

Stanton, an ER doctor in Kentucky, said he has admitted families where the delta variant has been flowing for generations, especially if older members are unrelated.

“Now in Kentucky, a third of new cases are under the age of 18,” he said. Some kids brought it home from summer camp and spread it to the rest of the family, and now, “between day care and schools and school activities, and friends getting together, there’s just so much exposure.”

In Alabama, hundreds of COVID-19 patients fill intensive care units, and one hospital contacted 43 others in three states to find a specialized cardiac ICU bed for Ray Martin Demonia. It was not soon enough. The 73-year-old died on 1 September.

“In honor of Ray, if you haven’t done so in an effort to free up resources for non-COVID related emergencies, please get vaccinated,” his family requested in his obituary.

In Hidalgo County, Texas, along the Mexican border, about 50 patients were in hospital with COVID-19 on a given day in July. By early August, that number had grown to over 600.

“Back in July we were almost celebrating. We knew very little,” said Hidalgo County public health authority Ivan Melendez. Melendez said the situation had improved, with just under 300 people in hospital as of Monday, but the ICU is still more than 90%.

Lynsey Marr, a professor of civil and environmental engineering at Virginia Tech, said the biggest jump in the summer occurred in states that had lower vaccination rates, especially in the South, where many people rely on air conditioning and breathing air. Huh. He said further northward states could see an uptick as the onset of cold weather sends people indoors.

Vaccination rates aren’t as low in some northern states, but “there are still a lot of unvaccinated people out there. Delta is going to find them,” Marr said.

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Associated Press Writers Ken Sweet, Kimberly Krusei, Adrian Sainz and Tali Arbel contributed to this report.