‘A surprising number of deaths’ will soon occur in these American regions due to the increase in Covid-19 cases

By Madeline Holcombe | CNN

As the Delta variant spreads rapidly, US hotspots have seen cases climb – and an expert warns that a “surprising amount” of Covid-19 deaths could soon follow.

The United States averages about 19,455 new cases in the past seven days, a 47% increase from the previous week, according to data from Johns Hopkins University. And a third of them, according to CNN medical analyst Dr. Jonathan Reiner, are from five hot spots: Florida, Louisiana, Arkansas, Missouri and Nevada.

“In places like Missouri where intensive care units are crowded, you’re going to see a startling death toll,” Reiner said Sunday.

At Mercy Hospital in Springfield, Missouri, 91% of intensive care patients are on ventilators and many are in their 20s, 30s and 40s, executive director Erik Frederick told CNN on Saturday. This is of particular concern, he said, because at the peak of last year, there were only 40 to 50 percent of intensive care patients on ventilators.

Typically, increases in Covid-19 death rates follow three to four weeks after peak cases, Reiner said. It takes a week for patients to get sick enough to require hospitalization, and often another two weeks for the infection to become fatal.

“We’re going to start to see an increase in mortality in this country,” Reiner said.

What’s particularly frustrating for many experts, Reiner said, is that the deaths are “completely preventable” now that vaccines are available.

But about a third of those 12 and older in the United States have yet to receive the vaccine, according to CDC data.

“The vaccines we have work very well against this variant. It doesn’t have to be that way, ”Reiner said.

Experts wonder if vaccinations should be mandatory

Much of the increase in cases has been attributed to the now dominant Delta variant, which is said to be more transmissible. And the variant sparked discussions about local immunization mandates.

In the United States, 48% of the population is fully vaccinated, but in some states that number is much lower, according to CDC data. Alabama, Arkansas, Louisiana, Wyoming, and Mississippi all have about 35% or less of their populations fully vaccinated.

Experts say vaccines are essential to manage the spread. With rapidly changing information, it’s important to be smart about how vaccinations are mandatory, said George Washington University School of Medicine professor of medicine Dr Gigi El-Bayoumi.

“In states with high vaccination rates, of 75 or more, it makes sense to relax the restrictions. In places where there are none, such as some southern states, it makes sense “to impose vaccinations, El-Bayoumi said on Sunday.

Dr Anthony Fauci, director of the National Institutes of Allergy and Infectious Disease, told CNN he thought it was a good idea for mandates at the local level.

“We are talking about a life and death situation. We have already lost 600,000 Americans, and we are losing more and more people. There have been 4 million deaths worldwide, ”Fauci said. “This is serious business.”

He added that he expects the hesitation over the vaccine mandate to end when the vaccines are fully approved.

Currently, the available Covid-19 vaccines are being administered under emergency use authorizations, which Fauci says has made some people skeptical about their safety and effectiveness. But the amount of data that supports the importance and safety of vaccines is more than anything experts have seen for an EUA, he said.

“These vaccines are as good as officially approved with all dotted I’s and crossed T’s,” Fauci said.

Pfizer to brief US on boosters

Another concern for many experts as the variants spread is whether people will need boosters for their vaccines.

Pfizer will virtually inform U.S. government officials on Monday evening of the potential need for booster shots of its Covid-19 vaccine, a company spokesperson and two administration officials confirmed to CNN.

The meeting is seen as a courtesy, and federal guidelines on boosters are not expected to change immediately after the meeting, a senior health official said.

Last week, Pfizer / BioNTech reiterated its expectations that people might need boosters for their vaccinations in six months to a year, citing the decline in immunity they are seeing in people who have received their vaccine. The company also said it would seek emergency use authorization for a recall from the United States Food and Drug Administration in August.

But some experts have argued that the data shows boosters aren’t needed yet.