Where and Why COVID-19 Cases Are Surging in the United States

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Experts say low vaccination rates and a lack of mask wearing have fueled the latest surge in COVID-19 cases. Mood Board/Getty Images

• Researchers say COVID-19 cases are surging in places like Arkansas and Los Angeles County due to low vaccination rates.
• Most of the increase in cases is associated with the delta variant.
• Experts say more people need to be vaccinated, and mask mandates need to be reinstated to reduce cases again.

A “runaway train” and a “raging forest fire that will continue to grow in size and strength.”

That’s how public health researchers are describing the current COVID-19 surge in Arkansas.

The latest forecast from officials at the University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health projects an average of 1,039 new cases per day in the state over the next week.

They also predict an average of 169 new cases per day in children under the age of 17.

The researchers warn that those numbers may already be out of date because the coronavirus is moving so rapidly in this region of the country.

Why? The researchers point to Arkansas’ vaccination rate of 35 percent, one of the lowest in the country.

Arkansas has one of the highest rates of new COVID-19 cases per capita, but it has plenty of company amid this latest nationwide surge.

In overall numbers, the Centers for Disease and Control and Prevention (CDC) reports that Florida had the most new cases the past week. Florida also had the most COVID-19 deaths the past week.

“It’s more heartbreaking than surprising,” Dr. Rajiv Bahl, an emergency medicine physician in central Florida, told Healthline. “If we could get more people vaccinated, we could start to see the numbers plateau, even decrease.”

Outbreaks in unexpected places

A preprint study reports that the viral load in the delta variant is more than 1,000 times higher than that of the original coronavirus variant.

That makes it much easier to be transmitted from person to person.

Driven by the delta variant, even states such as California are seeing a spike in new cases and hospitalizations. That comes despite the fact the number of fully vaccinated people in the state is 61 percent.

The rise is most dramatic in Los Angeles County, the largest U.S. county with a population of 11 million.

On June 15, when the state reopened, Los Angeles County reported 210 cases. This past Sunday, the caseload was 1,635. It was the 10th straight day of more than 1,000 new cases.

“What’s happening is that there are just not enough people vaccinated there,” Dr. George Rutherford III, a professor of epidemiology at the University of California, San Francisco, told Healthline.

“When you look at a map of the county, there are large swaths where vaccination rates are low and there wasn’t enough natural acquired immunity, especially in the face of the delta variant,” he said.

There are reports of positive test results in people who are fully vaccinated. A White House staff member and a senior aide to House Speaker Nancy Pelosi both tested positive, but they reportedly have only mild symptoms.

Experts say that shows the vaccines are working.

“Those who are getting COVID-19 despite the vaccine are only experiencing very mild symptoms,” Bahl said. “The point of the vaccine was to prevent severe and life threatening illness. That’s exactly what it’s doing even with the delta variant.”

What’s the outlook?

One expert said combining a highly transmissible virus variant with low vaccination rates and doing away with COVID-19 restrictions is a recipe for trouble.

“Pretending the pandemic is over is going to cost lives,” said Dr. Gregory Poland, a professor of medicine and infectious diseases at the Mayo Clinic in Minnesota, and director of the Mayo Vaccine research group.

“We are going to see these so-called hot spots, no question about it,” he told Heathline. “We will see outbreaks and a major surge in the later part of the summer and fall, particularly as kids go back to school. That wasn’t an issue with the original virus but will be a major issue with the delta variant.”

“The message has to be vaccines and masks, not one or the other,” Poland said. “Get the vaccine, and when you’re in a crowd, when you’re indoors, wear a mask. That’s what I do, what my medical colleagues do. It’s the safest course if we want to beat this thing back. Otherwise, we’re going to be in a cycle and people will needlessly die.”

Los Angeles County has already put its indoor mask mandate back in place. Other California counties are strongly urging people to wear a mask indoors but aren’t requiring it.

Chicago announced it was putting travel restrictions back in place. Unvaccinated travelers from Arkansas and Missouri, two states considered hot spots, will have to either quarantine for 10 days or present a negative COVID-19 test result.

Amid the resurgence of cases, officials at Apple Inc. are reportedly pushing back the date for workers to return to the office until at least October. The company has also recommended that workers in its retail stores wear masks.