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Dr. Fauci Warns That COVID-19 Cases Are Headed In The Wrong Direction

NOEL KING, HOST:

COVID cases are rising in the U.S. because of the delta variant, and we will have to adapt. The CDC is thinking about changing its guidance on masks for people who are vaccinated. And some local officials aren't even waiting for the CDC. St. Louis is one example. A new mask mandate goes into effect there today. NPR's Allison Aubrey has been following this one. Good morning, Allison.

ALLISON AUBREY, BYLINE: Good morning, Noel.

KING: So cases are going up. We have lived through surges before. How does this one compare?

AUBREY: Sure, well, there were more than 64,000 cases reported on Friday. New cases have doubled over the last two weeks. Just to put this in perspective, the U.S. is nowhere near the 200,000 or so cases a day seen last winter. But surges now are concentrated in areas where vaccination rates remain low. Just looking at data from Florida here, some counties are reporting positivity rates in the 25% range, which means about 1 in 4 tests is positive. There's also an increase in Texas. I spoke to Marc Boom. He's the CEO of Houston Methodist Hospital, where the number of COVID patients has climbed quickly. He says the tragedy is that this was preventable.

MARC BOOM: Nine in 10 people in our hospital right now are unvaccinated. So if they had been vaccinated, the vast, vast majority, if not all of them, wouldn't be sick. But furthermore, the other 10% who are here who are vaccinated probably wouldn't be sick, either, because we wouldn't have this rate of virus spreading throughout the community. So we owe it to them to help them.

AUBREY: He says the best way is for everyone to get vaccinated now. Now, unfortunately, new models point to continued increases in hospitalizations and deaths through the fall.

KING: OK. Are there - is there any evidence that the surge is motivating people who don't have the vaccine yet to get it?

AUBREY: You know, more people are getting vaccinated in recent days, but it's really slow going, Noel. About 30% of adults in the U.S. remain unvaccinated, but more leaders in states with low vaccination rates are speaking up more forcefully. This includes Florida's Republican governor, Ron DeSantis, telling Floridians that vaccines are saving lives; GOP Governor Kay Ivey of Alabama, who said it's time to blame unvaccinated people as she discussed the rise in cases; and Arkansas Governor Asa Hutchinson, also a Republican, who told people in his state that they're losing ground to the delta variant. They're all trying to nudge people to get vaccinated. But a new AP poll found that 80% of people who have yet to be vaccinated say they probably won't get the shots. Still, Dr. Anthony Fauci stated again yesterday on CNN, vaccination is the best defense.

(SOUNDBITE OF CNN BROADCAST)

ANTHONY FAUCI: If you are vaccinated, the vaccine is highly protective against the delta variant, particularly against severe disease leading to hospitalization.

AUBREY: You know, it's still possible to get infected with the virus after you're vaccinated, but it's much more likely to be a mild case. In fact, recent evidence from the U.K. found an mRNA vaccine to be 96% effective against hospitalization and death.

KING: And still, in the past couple days, we keep hearing about breakthrough cases, where people have the vaccine but get COVID anyway. Some of them are getting a lot of attention 'cause it's, like, at the White House, Olympic athletes. How worrying are the breakthrough cases to public health officials?

AUBREY: You know, there is such a big difference, Noel, between testing positive, as we've seen with these Olympic athletes, and ending up sick or hospitalized. I spoke to virologist Angela Rasmussen of the University of Saskatchewan. She says the vaccines are doing exactly what they're supposed to do, significantly reducing the risk of serious illness. But they're not 100% effective. And it wasn't realistic to expect that the virus would just simply disappear.

ANGELA RASMUSSEN: So if you are vaccinated, you can still become infected. That doesn't mean that you're going to get sick, though, because the way that the vaccines work is they are able to muster a very potent, very powerful immune response as soon as you are exposed to that virus. So even if you do get infected, that infection is going to be contained and rapidly cleared before it can make you sick. That's how the vaccines work.

AUBREY: Out of 163 million people who've been fully vaccinated in the U.S., in fact, the CDC has received about 5,500 reports of breakthrough infections that have led to hospitalization or death.

KING: OK, so that is pretty rare. But what kinds of people end up in the hospital or end up dying, even, because of breakthrough cases?

AUBREY: Sure, yeah. I mean, the CDC has found 75% of these patients are over the age of 65. Most have complications - for instance, transplant patients, cancer patients, people with weakened immune systems. Dr. Fauci spoke about this yesterday on CNN, too, saying immune-compromised people may benefit from a booster shot. He said data from Israel suggests immunity can begin to wane six months or so after vaccination.

(SOUNDBITE OF CNN BROADCAST)

FAUCI: The data that's evolving from Israel and from Pfizer indicates that it looks like there might be some diminution in protection. And when you have that, the most vulnerable people who have suppressed immune system, those who are transplant patients, cancer chemotherapy, autoimmune diseases - those are the kind of individuals that if there's going to be a third boost, which might likely happen, will be among first the vulnerable.

AUBREY: He says more should be known about a booster strategy soon.

KING: And in the meantime, some places are reinstituting the mask mandate for people who have the vaccine. St. Louis is doing it today. We know that la did it last week, I think. Do you believe we'll see more of this?

AUBREY: You know, I think there will be more of this. And more importantly, many public health officials say even if there's not a mandate in your area, masking in crowded indoor spaces makes sense, I mean, especially if you live in an area where cases are on the rise significantly. And as a new school year approaches, even though CDC guidance is that vaccinating students don't need to be masked, pediatricians say there is a strong case for uniform mandatory masking. I spoke to Judy Guzman-Cottrill - she's a pediatric infectious disease doctor at Oregon Health and Science University - about this.

JUDY GUZMAN-COTTRILL: When I talk to leaders of schools, they say that they don't have the capacity to effectively monitor who's vaccinated, who's not. And I worry that some students will be singled out for wearing masks at school. And this can lead to bullying and peer pressure to unmask even when it's not safe to do so.

AUBREY: That's because the vaccines aren't yet authorized for kids under 12, and many teens have yet to be vaccinated.

KING: Sure. NPR's Allison Aubrey. Thanks, Allison.

AUBREY: Thank you. Transcript provided by NPR, Copyright NPR.