Upticks in new COVID-19 cases and hospitalizations in central southeastern states such as West Virginia and Kentucky are considered signs that the pandemic is on its way out and shifting toward endemicity.

As more people gain immunity to the coronavirus, through either vaccination or infection, the virus has fewer opportunities to spread and mutate into variants that are better at infecting people. The pandemic’s demotion to the endemic level at which the virus circulates globally at manageable levels is likely around the corner, infectious disease experts say, but the delta variant is still ripping through states such as West Virginia and Kentucky, where immunogenicity is low.

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“Delta speeds up that approach to endemicity,” said Dr. Monica Gandhi, an expert in infectious diseases at the University of California, San Francisco. She pointed to California as an example of recently declining case rates due to a steady uptick in vaccinations over the summer as well as natural exposure of unvaccinated people to the virus.

The delta variant “leaves immunity in its wake,” Gandhi said. “So you get all this immunity, then you get it down to a low circulating level, and then that is a way to live.”

By contrast, new daily COVID-19 cases reported in West Virginia and Kentucky increased 20% and 36% over the past two weeks, respectively. They have the second- and third-highest cases per capita in the United States, outstripped only by Alaska. They also lead the U.S. in hospitalizations due to the disease, indicating that too few people in those states have received the vaccines that have been proven highly effective at protecting against severe infections.

Still, epidemiologists caution against viewing these recent upticks as a sign that yet another surge is brewing. Rather, they are part and parcel of the same delta surge recorded earlier this summer.

“What we're seeing in Kentucky and West Virginia is an evolution of what we saw in the South already,” said Dr. David Dowdy, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “The areas that are more highly vaccinated, we haven't seen the same spread to, but this is still the evolution of that same outbreak … like what Missouri, Arkansas, and Louisiana were at the beginning of this surge.”

West Virginia Gov. Jim Justice warned people last week that “we're going to pile the body bags up until we reach a point in time to where we have enough people that have natural immunities and enough people that are vaccinated.”

Daily vaccinations in the state plateaued despite incentives to get the shots, such as a $100 savings bond and a firearm giveaway. To date, only about 40% of West Virginians have been fully vaccinated, the lowest total in the country. In Kentucky, just over half of the population has been fully vaccinated. Vaccinations are still climbing, albeit slowly, and new infections are outpacing state officials’ efforts to get shots to everyone.

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To get to that level means that many more people will become exposed to the virus as long as vaccine holdouts remain firmly against getting the shots.

“The current surge has likely peaked in the United States, but it may be a very slow off-ramp,” Dowdy said. “If the criterion is that we want to be back to where we were in June, that could still be a long way away, and by a long way, I mean it could be months. ... We're going to have to learn to adapt and accept some level of disease ongoing.”

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Tags: Healthcare, News, Coronavirus, West Virginia, Kentucky, FDA, Johnson & Johnson, Vaccination, Pfizer

Original Author: Cassidy Morrison

Original Location: COVID cluster outbreaks could signal pandemic is nearing the end