More than 40 million cases of the coronavirus have been recorded in the United States, according to a New York Times database.
The total number of known infections, more than the population of California, the nation’s most populous state, is a testament to the spread of the coronavirus, especially lately the highly contagious Delta variant, and the United States’ patchwork efforts to rein it in.
Vaccines are effective in preventing severe disease and death, but about 47 percent of Americans are not fully vaccinated, allowing the Delta variant more than enough opportunity to inflict suffering and disrupt daily life. Health officials say that most of the patients who are being hospitalized and dying are not vaccinated, and that it is those unvaccinated people who are driving the current surge and burdening the health care system.
Over the past week, new virus cases have averaged more than 161,000 a day, as of Sunday. New deaths are up to 1,560 a day, and hospitalizations are averaging more than 102,000 a day. Those numbers, while very high, remain lower than last winter’s peaks.
Before July 4, President Biden said he hoped for “a summer of freedom.” Instead, the Delta variant became the dominant form of the virus, ravaging unvaccinated populations and filling I.C.U.s in some states.
In an appearance last Wednesday, Gov. Brad Little of Idaho, a Republican, pleaded with people to get vaccinated: “I wish everyone could have seen what I saw in the I.C.U. last night.”
On Tuesday Idaho’s Department of Health and Welfare said it has activated crisis standards of care, emergency measures put in place when there are insufficient health care resources available, in the northern part of the state. Hospitals will implement the standards as needed, according to a news release from the department.
“When crisis standards of care are in effect, people who need medical care may experience care that is different from what they expect,” the department said. “For example, patients admitted to the hospital may find that hospital beds are not available or are in repurposed rooms (such as a conference room).”
Dave Jeppesen, director of the department, said “This is a decision I was fervently hoping to avoid.”
Gov. Jim Justice of West Virginia said at a news conference on Monday that the virus had flooded many of his state’s hospitals and closed schools there.
“We’ve got a really big time, big time situation in West Virginia, as it is all across this nation,” said Mr. Justice, a Republican.
After reading a list of people who died in his state from causes related to the disease since Friday, Mr. Justice pleaded with the unvaccinated people of West Virginia to get inoculated.
Understand Vaccine and Mask Mandates in the U.S.
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- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
“We’ve got to get vaccinated for all, not just for you but for everybody — we’ve got to do this,” he said. “We can stop a lot of this terrible, terrible, terrible carnage.”
No U.S. state has more than 70 percent of its population fully vaccinated, according to federal data, and while the average pace of vaccinations ticked upward this summer, it remains far lower than when it peaked in the spring.
