As COVID-19 cases rise in all states across the United States, there are now growing concerns that that despite widespread vaccine availability in the county, the pandemic is far from over in the world’s richest nation.

At least 163-million people are now fully vaccinated, accounting for about 49.7% of the entire US population, with the White House warning that this has now become a pandemic of the unvaccinated.

Coupled with this is an uptick in so-called breakthrough infections with the Centres for Disease Control reporting almost 6 000 hospitalisations or deaths among those fully vaccinated.

The country is reporting an average of almost 44 000 new cases per day – about 53% higher than the previous seven-day average after reaching a 15-month low in late June with officials sounding the alarm that the country was heading in the wrong direction.

“The people I feel worst about are the hospital workers, the nurses, ICU staff who are now thinking they were seeing the last of the ICU admissions because a lot of people were vaccinated, not realising that so many young people were defying the vaccines and now because of the Delta variant, they’re coming into intensive care units. And that, I’m sure, is extremely demoralising and even a component of PTSD, I’m sure, associated with that. The tragedy is, almost everyone who’s in a hospital right now from COVID is there by choice. They could have opted to vaccinate. And I think that’s extremely frustrating. So the key now is to really elevate our levels of vaccination. We’re doing pretty well in the Northeast, we’re doing terribly in the South and terribly in the Mountain West and that’s got to pick up.” says Dr Peter Hotez of the National School of Tropical Medicine a Baylor College in Texas.

The virulent Delta variant is far more contagious than the ancestral variant first discovered in Wuhan, even 50% more contagious than the more recent Alpha variant first detected in November last year which again speaks to how viruses, including the coronavirus, mutate over time to evade immune responses while reducing vaccine efficacy.

Driving these mutations in the main are the unvaccinated that represent about 50% of the US population in the face of an extremely efficient mutation that does not only threaten those refusing or unable to get the jab.

“We have a pandemic among the non-vaccinated – those who are not vaccinated. If you are vaccinated, you are safe. If you are vaccinated, you have a 98% chance of never catching the virus at all. If you catch it, the overwhelmingly truth so far is: you’re not going to be hospitalised, you’re not going to be sick, you’re going to probably have no signs if you had it, and you are not going to die. That’s a simple proposition” says US President, Joe Biden.

Health officials say that 99.5% of COVID-19 deaths and 97% of hospitalisations are among unvaccinated Americans.

With Delta now representing more than 83% of the virus circulating in the USA, Dr Rochelle Walensky, Director of the Centres for Disease Control, says: “Compared to the virus we had circulating initially in the United States at the start of the pandemic, the Delta variant is more aggressive and much more transmissible than previously circulating strains. It is one of -the-most infectious respiratory viruses we know of and that I have seen in my 20-year career.”

Current CDC guidance says vaccinated people no longer need to wear masks unless otherwise mandated by local authorities to do so, a matter that could be reviewed given the new mutations at play.

But for now Dr Walesnky affirmed the CDC’s current recommendations. “Overall, the CDC recommendations haven’t changed. Fully vaccinated people are protected from severe illness and we’ve always said that communities and individuals need to make the decisions that are right for them based on what’s going on in their local areas. So if you’re in an area that has a high case rate and low rates of vaccination where Delta cases are rising, you should certainly be wearing a mask if you are unvaccinated. If you are vaccinated, you get exceptional protection from the vaccines but you have the opportunity to make the personal choice to add extra layers of protection if you so choose,” he says.

The states of Florida, Texas and Missouri, all with below average vaccination rates, are accounting for about 40% of all new cases in the country.

Unpacking the latest on COVID-19 in the US with Sherwin Bryce-Pease: