More people in Florida are catching the coronavirus, being hospitalized and dying of Covid-19 now than at any previous point in the pandemic, underscoring the perils of limiting public health measures as the Delta variant rips through the state.
This week, 227 virus deaths were being reported each day in Florida, on average, as of Tuesday, a record for the state and by far the most in the United States right now. The average for new known cases reached 23,314 a day on the weekend, 30 percent higher than the state’s previous peak in January, according to a New York Times database. Across the country, new deaths have climbed to more than 1,000 a day, on average.
And hospitalizations in Florida have almost tripled in the past month, according to federal data, stretching many hospitals to the breaking point. The surge prompted the mayor of Orlando to ask residents to conserve water in order to limit the strain on the city’s supply of liquid oxygen, which is needed both to purify drinking water and to treat Covid-19 patients.
Even as cases continue to surge, with more than 17,200 people hospitalized with the virus across Florida, Gov. Ron DeSantis, a Republican, has held firm on banning vaccine and mask mandates. Several school districts have gone ahead with mask mandates anyway.
Overall, 52 percent of Floridians are fully vaccinated, but the figure is less than 30 percent in some of the state’s hardest-hit counties.
On Monday, dozens of doctors and hospital employees in Palm Beach County gathered for an early morning news conference to beseech the unvaccinated to get shots, emphasizing that the surge was overwhelming the health care system and destroying lives.
“We are exhausted,” said Dr. Rupesh Dharia, an internal medicine specialist. “Our patience and resources are running low.”
A growing proportion of the people inundating hospitals and dying in Florida now are coming from younger segments of the population, particularly those ages 40 to 59, which were less vulnerable in earlier waves of the pandemic. The Delta variant is spreading among younger people, many who thought they were healthy and did not get vaccinated.
Dr. Chirag Patel, the assistant chief medical officer of UF Health Jacksonville, a hospital system in Northeast Florida, said the patients hospitalized with the virus during this latest surge tend to be younger and have fewer other health issues, but are nearly all unvaccinated. Of those who have died, including patients ranging in age from their 20s to their 40s, more than 90 percent were not inoculated, Dr. Patel said.
“We’ve had more patients this time around that have passed away at a younger age with very few if any medical problems,” he said. “They simply come in with Covid, and they don’t make it out of the hospital.”
Two months ago, the number of Covid-19 patients admitted at the system’s two University of Florida hospitals in Jacksonville was down to 14. On Tuesday morning, 188 coronavirus patients were in the hospitals, including 56 in the intensive care units.
One of the hardest parts of his job, Dr. Patel said, is having to tell family members that their unvaccinated loved one had succumbed to the virus. “It’s just such a senseless and preventable way of ultimately dying,” he said.
Lisa Waananen, Alison Saldanha and Sarah Cahalan contributed reporting.
Pfizer and BioNTech said on Wednesday they were now applying to the Food and Drug Administration for supplemental approval of a coronavirus vaccine booster shot for those aged 16 and up, and will submit all their supporting data by the end of this week. The move came as the companies said that a third shot of the vaccine sharply increased the levels of antibodies against the virus.
The companies conducted a study of 306 volunteers who received a booster shot about five to eight months after their second shot. Researchers found that the level of antibodies that block the coronavirus jumped more than three times higher than the level after the second dose.
The side effects of a third injection were about the same as after the initial two doses, the companies said. The underlying data was not included in the news release, nor were the dates or location of the study specified. The companies said they were preparing a scientific publication describing the research.
The news of Pfizer and BioNTech’s booster application came two days after the F.D.A. fully approved their two-dose vaccine for those 16 and older, making it the first to move beyond emergency use status.
Over the past few weeks, federal regulators have been racing to collect and evaluate data on booster shots. If the F.D.A. decides additional shots are safe and effective, the Biden administration has said it wants adults to get a third injection eight months after their second shot of the Pfizer or Moderna vaccines, starting the week of Sept. 20.
Federal health officials said last week that they believe that the potency of the Pfizer-BioNTech and Moderna vaccines wanes over time, raising the risk of infection from the highly contagious Delta variant. While data indicate that the vaccines continue to offer robust protection against hospitalization and severe disease, the officials said they fear that the situation could change without booster shots.
Some public health experts have challenged the plan as premature, saying the available data shows that the vaccines are holding up well against severe disease and hospitalization, including against the Delta variant. Extra shots would be warranted only if the vaccines failed to meet that standard, some have said.
Pfizer executives presented an early look at their booster data on July 23, during their second-quarter earnings call. In a smaller study, they found that antibody levels dropped markedly in the months following a second dose. But those levels jumped back up after a third dose. When researchers expanded their focus to a larger group of subjects, they continued to find a strong effect from the boosters.
Antibodies that can neutralize the coronavirus are only one kind of defense our immune systems use to fight it. The new study did not include details about other defenses provoked by the vaccine, such as immune cells trained to kill infected cells.
The participants in the new booster study were between the ages of 18 and 55. It was not immediately clear why the study did not include older people. Volunteers were followed for a median period of 2.6 months.
Pfizer and BioNTech said that in addition to the F.D.A., they plan to submit their data to regulatory authorities in Europe and other countries.
The administration’s booster plan does not as yet include recipients of Johnson & Johnson’s one-shot vaccine. Johnson & Johnson announced earlier on Wednesday that unlike the studies of Moderna’s and Pfizer’s vaccines, a study of 17 volunteers showed little change in their antibody levels over the course of six months.
But the study also showed that when the volunteers were given a second shot six months after their first, their antibodies against the coronavirus jumped nine times higher than the level after the first dose. Company officials said they are looking forward to discussing a potential booster strategy for their vaccine with federal health officials.
While Pfizer-BioNTech vaccine was fully approved as a two-shot regimen for those 16 and older, adolescents aged 12 to 15 can continue to be vaccinated under the vaccine’s emergency use authorization. Regulators have only authorized a third shot for some people with weakened immune systems.
A booster shot of the Johnson & Johnson vaccine dramatically raises the levels of antibodies against the coronavirus, the company reported on Wednesday.
Johnson & Johnson will submit the data to the Food and Drug Administration, which is evaluating similar studies from Pfizer and Moderna. If authorized by the agency, the Biden administration wants to provide booster shots eight months after vaccination.
The Johnson & Johnson vaccine was absent from the government’s initial booster plan, announced last week. But with the new data, the company hopes to be part of the initial distribution of additional shots, which could happen as early as September.
“We look forward to discussing with public health officials a potential strategy for our Johnson & Johnson Covid-19 vaccine, boosting eight months or longer after the primary single-dose vaccination,” Dr. Mathai Mammen, the global head of Janssen Research & Development at Johnson & Johnson, said in a statement.
In February, the F.D.A. gave emergency authorization to Johnson & Johnson for its one-shot vaccine. A clinical trial carried out last fall and winter showed that a single shot had a 72 percent efficacy in preventing symptomatic Covid-19 among U.S. participants. In the trial, none of the vaccinated volunteers were hospitalized or died.
Johnson & Johnson carried out its clinical trial before the Delta variant became widespread, leaving open the question of how well the vaccine worked against the highly contagious form of the virus. But in a study released earlier this month, South African researchers found that a single shot of the Johnson & Johnson vaccine was up to 95 percent effective against death from the Delta variant, and reduced the risk of hospitalization by 71 percent.
In its new study, Johnson & Johnson tracked 17 volunteers from last year’s clinical trial. Six months after vaccination, their level of antibodies had changed little.
That’s different than the pattern seen with the Moderna and Pfizer-BioNTech vaccines. Those shots initially produce higher levels of antibodies, but their levels then drop over several months.
When volunteers in the Johnson & Johnson trial were given a booster shot at six months, their antibodies against the coronavirus jumped nine times as high as after the first dose.
Studies on the Moderna and Pfizer-BioNTech vaccines found a comparable jump in antibody levels. Because the three vaccines were not tested in a head-to-head comparison, it’s not possible to determine which one provides the biggest boost.
Johnson & Johnson said that it had submitted a manuscript describing the research to the website Medrxiv. It has not been posted there yet.
Noah Weiland contributed reporting.
To help address unequal access to Covid-19 vaccines around the world — an issue that “remains the Achilles’ heel” of the pandemic fight — the World Health Organization is starting a program to manufacture vaccines in Latin America and the Caribbean, Dr. Carissa Etienne, the director of the Pan American Health Organization, said Wednesday.
“Much of today’s vaccine supply remains in the hands of wealthy nations around the world,” she said. “We must expand regional pharmaceutical production so we can be in the driver’s seat.”
She said her organization, which is part of the W.H.O., was analyzing about 30 proposals to manufacture messenger RNA vaccines — the same type as the Pfizer-BioNTech and Moderna shots — and expects to decide next month which ones to implement.
The “most feasible proposals,” including those that already have guaranteed investment backing, will get priority in an effort to expedite the project, according to Dr. Jarbas Barbosa, the pan-American agency’s assistant director.
The mRNA “vaccines are some of the most effective vaccines against Covid-19, and the technology is highly adaptable, so it has enormous potential to be used against other viruses,” Dr. Etienne said.
Vaccines produced by the program are to be distributed to countries in Latin America and the Caribbean, a region where an average of only 23 percent of the population has been fully vaccinated so far. “In many countries coverage is much lower,” Dr. Etienne said. “Just over 3 percent of people have been vaccinated in Guatemala, and a little over 4 percent in Jamaica.”
Many islands in the Caribbean, including Jamaica, are reporting steep surges in new cases and Haiti’s health system is struggling to care for survivors of the devastating Aug. 14 earthquake that killed more than 2,200 people.
“Logistics and security challenges continue to limit the delivery of supplies, the deployment of personnel to affected areas and the transfer of patients to other hospitals,” Dr. Etienne said.
The Episcopal Diocese of Maine will mandate coronavirus vaccines for all clergy and staff members, becoming one of the first religious authorities in the country to require inoculations.
“We needed to join the public health leaders in giving a religious voice to what is a very pressing moral issue right now,” said Bishop Thomas J. Brown on Wednesday. “To lead in the public square, and to join other organizations, corporations and institutions with similar mandates is to say that we are all about loving God and loving our neighbors.”
Bishop Brown issued the directive on Monday and said it will apply to about 240 clergy and 14 employees, who will have until Sept. 30th to get fully vaccinated, unless they have a medical exemption from a physician. So far, all 170 religious who have responded have told him they are already inoculated. If any of the remaining 70 decline to get shots, he said the consequences would depend on their role.
The bishop said he issued the directive in an effort to safeguard the public well beyond the reach of the diocese, which includes more than 10,000 parishioners. “What it ultimately means is, we can say to people in Maine who are not in our churches that we stand on the side of public health.”
Some faith leaders in the United States have sought to tread carefully on issues like vaccines and masks, creating a patchwork of policies as they seek to reopen houses of worship after more than a year of restrictions. A smaller group of religious denominations and leaders have opposed public health rules and questioned inoculations.
The Episcopal Church, though, has been supportive of vaccinations long before this pandemic, Bishop Brown said. In 2019, the Executive Council of the Episcopal Church issued a resolution stating: “The proper and responsible use of vaccines is a duty not only to our own selves and families but to our communities. Choosing to not vaccinate, when it is medically safe, threatens the lives of others.”
Maine has fared relatively well amid the nation’s recent surge in cases and deaths driven by the Delta variant, with a seven-day average of 161 new cases per day and two deaths reported on Tuesday, according to a New York Times database. More than 70 percent of Maine residents have received at least one dose of the vaccines and 65 percent are fully vaccinated.
At the emergency department of Hilo Medical Center on the island of Hawaii Wednesday, patients lay on beds in the hallway as staff members scrambled to find space in other parts of the hospital.
“Today is the fullest we’ve been in over 15 years — maybe even ever,” said Elena Cabatu, director of public affairs at the hospital. Nurses “are almost beside themselves at this point,” she said.
Across the islands of Hawaii, hospitals are facing an acute shortage of beds and medical staff as the Delta variant causes a surge far worse than any the state experienced during earlier waves of the pandemic.
By virtue of its geographical isolation and stringent government restrictions, Hawaii maintains its position as the state with the lowest rates of Covid cases and deaths. But in recent months, as restrictions have loosened and travel has resumed, case numbers have skyrocketed.
On July 1, the state’s seven-day average was 40 new cases daily. By Aug. 19, the new case reports had peaked at 729 a day, according to a New York Times database, more than double the state’s previous high in September.
And, with just 55 percent of the state’s population fully vaccinated, according to a New York Times database, health care providers worry that the worst is yet to come.
Models show that the state could reach a daily average of 1,500 Covid hospitalizations by the end of September, said Hilton Raethel, president of the Healthcare Association of Hawaii. The state normally maintains just 2,000 staffed hospital beds across the islands.
“The numbers don’t work, obviously,” said Mr. Raethel. Options for obtaining additional beds are limited. “It’s not like New York where you can truck people or beds in from New Jersey. We’re a five-hour flight away from the mainland.”
Over 200 health care workers have been dispatched from the mainland to assist the strapped hospitals. Three hundred more will be on the way next week.
At the same time, officials are rushing to reinstate restrictions to temper the surge. On Monday, Mayor Rick Blangiardi of Honolulu prohibited indoor gatherings of more than 10 people and outdoor gatherings of more than 25 people for at least 28 days.
And at a news conference Monday, Gov. David Ige discouraged tourists from coming.
“It’s not a good time to travel to the islands,” he said. “The visitors who choose to come to the island will not have the typical kind of holiday that they expect to get when they visit Hawaii.”
The Pfizer-BioNTech Covid-19 vaccine is associated with an increased risk of myocarditis, an inflammation of the heart muscle, a large new study from Israel confirms. But the side effect remains rare, and Covid-19 is more likely to cause myocarditis than the vaccine is, scientists reported on Wednesday.
The research, which is based on the electronic health records of about two million people who are 16 or older, provides a comprehensive look at the real-world incidence of various adverse events after both vaccination and infection with the coronavirus.
In addition to myocarditis, the Pfizer vaccine was also associated with an increased risk of swollen lymph nodes, appendicitis and shingles, although all three side effects remained uncommon in the study. Coronavirus infection was not associated with these side effects, but it did increase the odds of several potentially serious cardiovascular problems, including heart attacks and blood clots.
“Coronavirus is very dangerous, and it’s very dangerous to the human body in many ways,” said Ben Reis, a co-author of the new study and the director of the predictive medicine group at the Boston Children’s Hospital Computational Health Informatics Program.
He added, “If the reason that someone so far has been hesitating to get the vaccine is fear of this very rare and usually not very serious adverse event called myocarditis, well, this study shows that that very same adverse event is actually associated with a higher risk if you’re not vaccinated and you get infected.”
The data arrived in the middle of an intense discussion among federal regulators about the risks of myocarditis and pericarditis, which is inflammation of the lining around the heart, in younger recipients of both the Pfizer-BioNTech and the Moderna vaccines.
Emily Anthes and