When Jonathan Johnson was in the hospital battling COVID-19, his nurses said his outlook wasn't always good.

"He was as sick as you could be without passing away," said Amy Waldstein, critical care nurse at Methodist Jennie Edmunson in Iowa.

But they said he was a fighter throughout the journey.

"It was admirable about how he fought the whole time, he did every possible thing he needed to do to get past COVID," Waldstein said.

Johnathan finally got off the ventilator and his condition improved, but before he left the hospital, he had another goal in mind.

"When I finally woke up from being on the ventilator for three and a half weeks, and I was feeling a little better, and was able to breathe, I thought to myself, you know, I want to marry this one," Jonathan said.

He wanted to surprise his fiancé Mariah, so Jonathan and his nurses started planning.

Critical care nurse Jenna Harvey said it was a little unorthodox.

"There was no flower girl. However, I did throw some petals here and there for them," Harvey said.

The couple had been engaged for more than a year and Mariah says when she went to the hospital, she had no idea what was in store for her.

"We get in there, he told me, and I was completely blown back," Mariah said.

Harvey said the couple needed to celebrate after Jonathan's long battle.

"It's something they both deserve after going through such a tragic time in their relationship," Harvey said.

While it wasn't the wedding the couple had planned.

"She wanted to do a Halloween theme wedding, but I didn't know how long I was gonna be in the hospital," Jonathan said.

Jonathan says surviving his battle gave him some new perspective.

"I didn't want to have any regrets because after coming off the ventilator, you view a lot of things differently in life," Jonathan said.

Watch the full story in the video above.

KANSAS CITY, Mo. —

The Kansas City Zoo announced via press release that one of their western lowland gorillas recently had the delta variant of COVID-19.

The other five gorillas that make up the zoo’s troop, are presumed to also be positive. The zoo has yet to receive official test results.

While all the gorillas have shown symptoms of the virus, some have already returned to normal. The zoo says the rest of the troop continue to respond to treatment and are improving.

The gorillas’ care specialists first noticed that Charlie the gorilla did not appear to be feeling well on Sept. 22 and then began coughing on Sept. 25.

The zoo says the veterinary health team immediately began treatment but within the next several days other gorillas began showing symptoms. Coughing and a lack of appetite are among many outward symptoms the animals began displaying.

Related video: COVID-19 spreads through gorillas at zoo in Atlanta

All of the gorillas are scheduled for the Zoetis vaccine, which was specifically developed for use with animals. The zoo says research has shown the vaccine to be safe.

"As always, the top priority of the Kansas City Zoo is the health and safety of our animals, guests, and staff. As the COVID-19 pandemic progressed, the zoo implemented protocols to keep susceptible animals and their caregivers safe," The KC Zoo said in their press release.

The zoo doesn't know how the gorillas came down with virus. They also say that visitors to the KC Zoo are not at risk of contracting COVID-19, due to the viewing distance and design of their gorilla habitat.

Video above: Johns Hopkins experts cautiously optimistic amid downward COVID-19 trendsIt’s a milestone that by all accounts didn’t have to happen this soon.The U.S. death toll from COVID-19 eclipsed 700,000 late Friday — a number greater than the population of Boston. The last 100,000 deaths occurred during a time when vaccines — which overwhelmingly prevent deaths, hospitalizations and serious illness — were available to any American over the age of 12.The milestone is deeply frustrating to doctors, public health officials and the American public, who watched a pandemic that had been easing earlier in the summer take a dark turn. Tens of millions of Americans have refused to get vaccinated, allowing the highly contagious delta variant to tear through the country and send the death toll from 600,000 to 700,000 in 3 1/2 months.Florida suffered by far the most death of any state during that period, with the virus killing about 17,000 residents since the middle of June. Texas was second with 13,000 deaths. The two states account for 15% of the country's population, but more than 30% of the nation's deaths since the nation crossed the 600,000 threshold.Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health who has analyzed publicly reported state data, said it's safe to say at least 70,000 of the last 100,000 deaths were in unvaccinated people. And of those vaccinated people who died with breakthrough infections, most caught the virus from an unvaccinated person, he said.“If we had been more effective in our vaccination, then I think it’s fair to say, we could have prevented 90% of those deaths,” since mid-June, Dowdy said.“It’s not just a number on a screen,” Dowdy said. “It’s tens of thousands of these tragic stories of people whose families have lost someone who means the world to them."Danny Baker is one of them.The 28-year-old seed hauler from Riley, Kansas, contracted COVID-19 over the summer, spent more than a month in the hospital and died Sept. 14. He left behind a wife and a 7-month-old baby girl.“This thing has taken a grown man, 28-year-old young man, 6′2″, 300-pound man, and took him down like it was nothing,” said his father, 56-year-old J.D. Baker, of Milford, Kansas. “And so if young people think that they’re still ... protected because of their youth and their strength, it’s not there anymore.”In the early days of the pandemic, Danny Baker, who was a championship trap shooter in high school and loved hunting and fishing, insisted he would be first in line for a vaccine, recalled his mother.But just as vaccinations opened up to his age group, the U.S. recommended a pause in use of the Johnson & Johnson vaccine to investigate reports of rare but potentially dangerous blood clots. The news frightened him, as did information swirling online that the vaccine could harm fertility, though medical experts say there’s no biological reason the shots would affect fertility.His wife also was breastfeeding, so they decided to wait. Health experts now say breastfeeding mothers should get the vaccine for their own protection and that it may even provide some protection for their babies through antibodies passed along in breastmilk.“There’s just a lot of miscommunication about the vaccine,” said his wife, 27-year-old Aubrea Baker, a labor and delivery nurse, adding that her husband's death inspired a Facebook page and at least 100 people to get vaccinated. “It’s not that we weren’t going to get it. We just hadn’t gotten it yet.”When deaths surpassed 600,000 in mid-June, vaccinations already were driving down caseloads, restrictions were being lifted and people looked forward to life returning to normal over the summer. Deaths per day in the U.S. had plummeted to an average of around 340, from a high of over 3,000 in mid-January. Soon afterward, health officials declared it a pandemic of the unvaccinated.But as the delta variant swept the country, caseloads and deaths soared — especially among the unvaccinated and younger people, with hospitals around the country reporting dramatic increases in admissions and deaths among people under 65. They also reported breakthrough infections and deaths, though at far lower rates, prompting efforts to provide booster shots to vulnerable Americans.Now, daily deaths are averaging about 1,900 a day. Cases have started to fall from their highs in September but there is fear that the situation could worsen in the winter months when colder weather drives people inside.Almost 65% of Americans have had at least one dose of vaccine, while about 56% are fully vaccinated, according to the Centers for Disease Control and Prevention.But millions are either refusing or still on the fence because of fear, misinformation and political beliefs. Health care workers report being threatened by patients and community members who don't believe COVID-19 is real.The first known deaths from the virus in the U.S. were in early February 2020. It took four months to reach the first 100,000 deaths. During the most lethal phase of the disaster, in the winter of 2020-21, it took just over a month to go from 300,000 to 400,000 deaths.The U.S. reached 500,000 deaths in mid-February, when the country was still in the midst of the winter surge and vaccines were only available to a limited number of people. The death toll stood about 570,000 in April when every adult American became eligible for shots.“I remember when we broke that 100,000-death mark, people just shook their heads and said ‘Oh, my god,’” said Dr. Georges Benjamin, executive director of the American Public Health Association. “Then we said, ‘Are we going to get to 200,000?’ Then we kept looking at 100,000-death marks,” and finally surpassed the estimated 675,000 American deaths from the 1918-19 flu pandemic.“And we’re not done yet,” Benjamin said.The deaths during the delta surge have been unrelenting in hotspots in the South. Almost 79 people out of every 100,000 people in Florida have died of COVID since mid-June, the highest rate in the nation.Amanda Alexander, a COVID-19 ICU nurse at Georgia’s Augusta University Medical Center, said Thursday that she'd had a patient die on each of her previous three shifts.“I’ve watched a 20-year-old die. I’ve watched 30-year-olds, 40-year-olds,” with no pre-existing conditions that would have put them at greater risk, she said. “Ninety-nine percent of our patients are unvaccinated. And it’s just so frustrating because the facts just don’t lie and we’re seeing it every day.”___Associated Press Medical Writer Carla K. Johnson and data journalist Justin Myers contributed to this story.

A mother is back home in Texas after a long battle with COVID-19 in an Oklahoma City intensive care unit.

Devisha Long credits her nurses for getting her home. But, she said, it has been a long journey.

She was flown by helicopter from Dallas to OKC. She was placed in a medically-induced coma at Integris Baptist Medical Center and was in this condition for nearly a month. She became a mother during her hospital stay.

“I surprised them. Oh, man, they were so excited,” she said. “You know, everybody was happy.”

Long survived COVID-19 thanks to the innovative extracorporeal membrane oxygenation treatment. This week, she finally returned home to her family in Dallas. Her nurses watched the tender moment while huddled around an iPhone.

“It was freaking awesome! I got chills. I cried, and I don’t cry. It was a breath of fresh air,” the nurses said.

Their former patient hugged her sweet daughters for the first time in months.

While Long was in a coma, Nurse Manager Rebecca Mitchell said she was very sick and was pregnant.

“And then they had to do an emergency C-section before she came to us,” Mitchell said.

“When I finally woke up, the only way I knew I wasn't pregnant is because one of the nurses from the other hospital had made a collage of the baby, and I seen him line up on the wall, and I looked and I was like, That's my baby,” Long said.

She eventually woke up from her coma, holding her baby girl.

“When I first held her and I was like, I can't believe, you know, this is you,” she said.

For the nurse team at Integris, they’ve been running nonstop, experiencing tragedy treating COVID-19 patients.

“It truly has been a hellacious year. I've seen more death. This just this past year than I have in the 10 years I've been a nurse,” Mitchell said.

But this brief moment offered a change from the sad realities of the COVID-19 pandemic.

“We all cried. I think we all teared up, because just that those are those moments that you, you need to kind of help rebuild to remind you why we do what we do,” she said.

They remember why they continue their work.

“Thank you for your positivity, thank you for encouraging me. You really helped me to remain strong,” Long said. “Even in the dark times of me being alone, y'all really did an amazing job and I just want to tell you how to continue to do the same because you're touching lives and making a difference."

Long is still recovering from COVID-19, going to appointments in Dallas. As for her newborn, she’s at a Dallas hospital until she can come home.

COVINGTON, Ky. — Michael Tudor is fully vaccinated against COVID-19 but routinely gets tested every two weeks. As the delta variant surges across the region, though, he's finding he has to wait in longer and longer lines to get swabbed, and as the Labor Day holiday weekend approached, those lines got even longer still.

"We've been trying to do it pretty regularly just to make sure we're not passive carriers," the Ludlow, Kentucky, resident said. "I'm glad people are getting tested."

The swell in demand for COVID-19 testing was prompted not just by the recent spike in cases across the region, but also the start of the school year and holiday and seasonal travel.

It's had Tony Remington, CEO of Covington-based Gravity Diagnostics, and his team running ragged, sometimes testing as many as 1,000 patients a day.

"We're burned out," he told WCPO Friday. "We don't want to do testing anymore. We don't want to set up drive-thrus, but it's the culmination of things."

For much of the pandemic, Gravity has operated five free drive-thru testing sites — subsidized by state funds — across the commonwealth and in Indiana, with 15 more sites planned to pop up over the next two weeks. One of those sites, located on a surface parking lot near the now decommissioned IRS building along Covington's Fourth Street corridor near the Clay Wade Bailey Bridge, lately has seen those drive-thru lines back up out onto the street.

"We're close to saying, 'Sorry, we can't set that up for you anymore,'" he said. "But we're not there yet."

Kiana Martinez, a mother of six, said she needs to get tested but is finding it difficult to find appointments. She tried an area Walgreens, where she was told they didn't have any tests available. Some stores have run out of take-home tests. CVS on Wednesday had to work with a new supplier to try to keep up with their national demand.

"We don't want to see one person who wants testing not get testing and a fast result," Remington said.

It's why he said his crews are working seven days a week, some pulling 18-hour shifts to make sure their clinics get rapid results for as many as they can.

Health departments across the Tri-State are warning that the number of COVID-19 cases in children is rising. Officials at the region’s largest pediatric hospital, Cincinnati Children’s Hospital Medical Center, said Wednesday the number of young patients admitted with complications due to the virus is also increasing weekly.

The spread is spilling into the broader healthcare community, doctors said. Outside a Hyde Park urgent care clinic, patients formed a line out the door Wednesday morning.

“We’re all waiting long, side by side, not feeling good,” said Seante Bullock, who was at the clinic.

Inside the clinic, all chairs appeared taken.

“They ran out of chairs,” Bullock said. “Everybody's waiting in the same air-space or outside. There's someone coughing almost next to me, and I’m just like freaking out.”

One of Cincinnati’s leading pediatric doctors, Dr. Patty Manning-Courtney, is chief of staff at Children’s Hospital. She joined Hamilton County Health Commissioner Greg Kesterman Wednesday to warn of this impact. Manning-Courtney traces it back to what she said is the rising number of children contracting the virus along with other respiratory illnesses spreading from children, families and neighbors.

“Our entire pediatric healthcare system is under stress and strain right now,” she said. “By that I mean: Our emergency rooms, our urgent cares, our primary care practices, our community physicians are seeing some of the highest volumes of patients that they have ever seen.”

Dr. Amy Mechley works at Integrated Family Care of Cincinnati in East Walnut Hills. She said her office is seeing the same.

“COVID cases now are getting younger and maybe a little bit more personal,” she said. “We’re seeing more people coming in asking questions. Our vaccine appointments are now getting full, which is great.”

Public health data show Hamilton County has had the most pediatric cases in the Tri-State since the pandemic began and has the third-highest number in the state of Ohio.

Manning-Courtney said there have been 500 children who tested positive in the last seven days who were not hospitalized. The week before that, 300 children tested positive. They also were not ill enough to be admitted to the hospital.

The number of patients in Children's Hospital due to COVID-19 has not been released because of child-parent privacy, she said.

Other counties across the viewing area said they are experiencing similar trends.

The Northern Kentucky Health Department breaks the number of active cases down by age. However, a spokesperson for St. Elizabeth Healthcare said no patients under 18 were admitted due to COVID-19 in that system's hospitals as of Wednesday evening.

The Butler County General Health District's promotion director, Erin Smiley, said doctors there have seen an increase in the number of childhood hospitalizations related to other respiratory infections — specifically, respiratory syncytial virus (RSV) infections.

Ohio lists data for COVID-19 and children under the age of 19 here, and Indiana's dashboard breaks cases down by county, here.

Meanwhile, back in the Hyde Park clinic line, patients said they can feel the strain. Some question close quarters and level of patient care.

“It gives me anxiety a little bit,” said Bullock. “Most of these people, including myself, are getting COVID testing. So, if everybody has some type of symptoms, and we're all sitting around so close to each other, it kind of doesn’t make sense.”

Video above: San Francisco businesses check for vaccination

For a moment in late spring and early summer, it seemed that restaurant operators were starting to see the light at the end of the tunnel.

The COVID-19 vaccines were publicly available, and more Americans were getting the shot. States and cities eased their pandemic restrictions, including mask mandates and capacity limitations for indoor dining. People started making more reservations, and sales spiked.

But that moment has passed. Now, with COVID-19 cases surging once again as the delta variant of the coronavirus rampages largely through the unvaccinated, restaurants are wondering what's ahead.

So far, the sector is still looking good, but growth is softening. According to the Census Bureau sales at bars and restaurants grew 1.7% from June to July. That growth is slower than from May to June when sales grew 2.4%.

Some restaurant owners are starting to see disruptions in the form of slowing sales, no-shows, nervous guests and supply chain hiccups. Some wonder when they can start to go back to normal, how bad things will get, and if they'll be able to pull through.

Sales drop and people mask up

Nya Marshall's Detroit restaurant, Ivy Kitchen, had been open about six months when COVID-19 hit. After a rough year, she finally felt like the situation was starting to look up in the spring.

"Things were improving," she said. "People were coming back out." Marshall was finally able to start seeing momentum around the restaurant. The local community was "really embracing who we are," she said.

But about six weeks ago, things took a turn, she said. Ivy Kitchen's sales are down about 24% since that time, she said.

"The delta variant is unnerving to people," she said. She's noticed that customers are once again wearing masks indoors, even though fully vaccinated people are not currently required by law to do so in Michigan. Some patrons have also asked to remain socially distant.

Marshall is worried about the possibility of another shutdown. "I have fear of a shutdown every single day," she said. "I'm pretty sure we will not survive another shutdown," she said. "We barely survived this last one."

More no-shows and requests for outdoor dining

Laurie Thomas, executive director of the Golden Gate Restaurant Association and owner of San Francisco restaurants Rose's Cafe and Terzo, said that she's noticed a rise in no-shows, or customers who make reservations but don't show up or cancel.

During the first weekend in August, after San Francisco reinstated its mask mandate due to rising infections, "we were running like 15% to 20% no-shows, which is very disappointing," she said. Typically, that figure is about 5% to 10%.

And "we started to see reservations shift drastically to outside," she added.

Soon after California lifted its mask mandate for vaccinated individuals in June, reservations "switched back to inside because unfortunately, our summer in San Francisco was cold and foggy," Thomas said. But in the first two weeks of August, "we started to see ... a marked shift outside again."

Ideally, "we want people to sit everywhere," she said. "Because in order for a restaurant to survive, we need to be fully booked."

New requirements started in the city on Friday. Now, people who want to eat indoors must show proof that they are fully vaccinated.

Thomas is supportive of the vaccine mandate. If customers are not vaccinated, "it's not as safe for our employees," she said. But, she added, "I'm very worried that we're going to have [customers] that ... are going to be surprised" by the rule. "And that's not what we want."

Reopening plans on hold and supply chain complications

Steve Sarver owns a small chain of soup and salad spots called Ladle & Leaf. Going into the pandemic, he had eight locations open in downtown San Francisco, which primarily catered to the office crowd. But now, with a growing number of companies putting off return-to-work plans, only two of those locations are open for business, and one is closed permanently.

A month or so ago, Sarver had hoped to open the remaining five in September. Now, he's not sure. "It's very hard for me to predict what our opening plan will be," he said. "It's hard to predict when people will want to return to the financial district."

Dick's Drive-In, a small Seattle chain of quick-service restaurants, is in a different situation. Dick's mostly serves customers who take their orders to-go. But the surge in COVID-19 infections is still having an impact on Dick's because it's disrupting the company's supply chain.

Watch video above: Indoor vaccine mandate begins in NYC

"This week it's straws, last week it was salt, a couple weeks ago it was mustard," president Jasmine Donovan said in a recent interview.

Each disruption poses a unique challenge. On one occasion, Donovan said, a major distributor shut down while quarantining employees after someone tested positive. Donovan's team had to send a van to pick up the products. Sometimes items are slow to come because of labor shortages along the supply chain.

"It's just a mad scramble every day to make sure we have what we need to serve our customers," she said. "Our people are under a lot of stress. And we just really appreciate everyone's patience and understanding."

GROESBECK, Ohio — Back in March, before the COVID-19 vaccines became available to the general public, Ned Heeger-Brehm was providing an in-demand product for free from the drive-thru window of his branch of the Public Library of Cincinnati and Hamilton County: at-home COVID tests.

"We were giving out quite a bit of it," he said. "Then it kind of slowed down."

But now, with the virus' new delta variant surging through the region, Heeger-Brehm said demand has begun to spike again. And with thousands of children — many of whom are not eligible for vaccination — heading back to their classrooms, Heeger-Brehm said he's almost out of stock.

"There's been a recent uptick in the last couple of weeks, and it just went crazy this past week," he said, recounting that hundreds of the at-home test kits have flown off his supply shelf.

"I've had some people say that it's like kids going back to school; they figure they're going to have to get tests for when there's an exposure in school," he said. "I think it is a lot of people going back to work and people visiting people in nursing homes, things like that."

Erlene Robinson was in line Wednesday, waiting to stock up on some at-home tests. She said they're for her grandchildren.

"The test is just ... precautionary to make sure that they're not going to be, you know, affecting other people," she said.

The at-home tests are generally easy to use, according to nurse practitioner and director of health services at Northern Kentucky University Rose Tempel.

"You know, you just go up into the nose (with the swab) about an inch, so it's not painful," she said.

But are they effective in detecting the virus?

Tempel said they're "pretty effective," but mostly when someone is experiencing COVID-like symptoms.

"The effectiveness of people with symptoms is about 95% of picking up a true positive case of COVID," she said, but noted that it's probably not worth administering unless symptoms are present.

But she added that the delta variant has a wider range of symptoms than earlier strains, some that are also common among other illnesses.

"So now, headache, nasal congestion and sore throat seem to be more common of what we see presenting with the delta variant, versus initially (when) it was fever, cough, things like that," she said.

An additional note about at-home tests: Some require the self-swab along with the ability to teleconference with a practitioner over a computer, to guide you through the rest of the testing process.

In addition to the Groesbeck branch, these other branches are offering drive-thru access to at-home tests:

• Anderson
• Covedale
• Delhi Township
• Downtown
• Reading
• Symmes Township

Due to increased demand, library officials recommend calling your local branch first to ensure they still have some in stock.

Anyone not comfortable administering a self-test can also consult their local pharmacy.

Related video above: US hiring surges in July, unemployment rate drops

Apple, Google and other big companies around the world are continuing to add to their massive piles of cash, a sign that corporations are increasingly nervous about how the highly contagious delta variant of COVID-19 could damage the global economy.

The world's largest nonfinancial companies had a record $6.85 trillion in cash on their balance sheets as of the end of the second quarter, according to data from S&P Global Ratings. (Banks and other financial firms are usually excluded from corporate cash lists because they are required to hold a lot of money in cash due to the nature of their daily business operations.)

The second-quarter totals are up slightly from the end of 2020. Gareth Williams, global head of corporate research for S&P Global Ratings, estimates the cash level could hit $7.1 trillion by year's end.

Tech giants in particular are hoarding cash. Apple, Microsoft and Google owner Alphabet have a combined $460 billion in cash on their balance sheets. Amazon has nearly $90 billion. Facebook has more than $64 billion, too.

It's not just the tech titans who are stockpiling cash.

Warren Buffett's Berkshire Hathaway has a giant mountain of cash that is growing even bigger as the company struggles to find more investing opportunities. Berkshire Hathaway had $144.1 billion on its balance sheet as of the end of June, up from $138.3 billion in December.

Companies have also been taking advantage of low-interest rates to borrow more money, which has helped boost both cash — and debt levels — for blue-chip firms.

The fact that many of these companies are building their cash reserves is partly because of jitters about the state of the markets and economy.

Time for businesses to start spending again?

But many firms are also looking to use their cash to invest for the future.

"We'd thought earlier this year that by this time, companies would be starting to draw down cash," said Christopher Harvey, head of equity strategy at Wells Fargo.

"But companies are spending on buybacks, dividends and mergers. The capital markets are wide open," Harvey added. "The cost of funding is incredibly cheap so companies are issuing debt and cash is still accumulating."

According to another report by S&P, companies outside of the struggling energy and materials sectors will spend $2.8 trillion on capital expenditures this year. That would be an increase of 15% to an all-time high, with tech firms and utilities leading the way.

But now that the Federal Reserve is widely expected to begin cutting back its bond purchase program later this year and potentially raise short-term interest rates in 2022, there is a sense that companies may stop using cash to borrow even more money.

Debt would become more expensive in a higher rate environment. That means companies may start putting their cash to work in other ways, such as increased investments and potentially more pay raises for employees. That's despite growing concerns about the delta variant.

Companies had built up an "unusual buttress" of cash, said Richard Lane, senior vice president at Moody's. That was due to concerns about liquidity during the worst of the COVID-19 crisis. But it might finally be time to unwind some of the cash instead of just parking it on the balance sheet.

"What happened during the pandemic is that large investment-grade companies were aggressive in refinancing debt or raising new money," Lane said. "As we go through this year, I would expect that cash levels will come down a little bit."

COVID-19 hospitalizations have doubled over the past three weeks, with 83,693 people hospitalized this week, according to data from the U.S. Department of Health and Human Services.

There are no ICU beds are left in the entire state of Alabama, Dr. Don Williamson, president of Alabama Hospital Association, told Birmingham sister station WVTM-TV.

"We have never been here before. We are truly in uncharted territory," Williamson told the TV station.

Earlier Tuesday, Alabama was down to just two ICU beds. The Alabama Hospital Association issued a statement:

"We represent health care providers who have seen far too many of our fellow citizens become ill and die because of this disease, including children," the AHA and several other health care organizations said.

"We join all of you in wanting this to go away, but for that to happen it's going to take all of us. We respectfully request that those currently unvaccinated reconsider their decision. The benefits of getting vaccinated FAR outweigh any potential risk."

Alabama has 1,562 staffed intensive care unit beds and 1,560 patients in need of ICU care, AHA Executive Vice President Rosemary Blackmon told CNN. The Alabama Department of Public Health said 2,631 people are hospitalized with COVID-19 complications.

In Tennessee, "We are prepared to deploy additional medical personnel from the Tennessee National Guard to our hospitals in greatest need of assistance," the state health department wrote in a letter Monday.

In Kentucky, hospitals are starting to cancel or postpone surgeries that would require post-operative admission to the hospital, state Public Health Commissioner Dr. Steven Stack said.

"ICU and ventilator data — it is a vertical climb," Stack said Tuesday. "There's no sign it is abating. We are already just shy of our all-time record. Another day or two, we'll be past that record for ICUs."

Thousands more students are forced to stay home

More than 3,000 students and employees have been quarantined in the New Orleans Public School District due to COVID-19 cases in the past week, according to the district's latest tally.

That represents 5.89% of all students and teachers in the school district.

In Florida, 5,599 students and 316 employees in in Hillsborough County Public Schools were in isolation or quarantine as of Monday morning due to COVID-19 cases, according to the school district.

At least 577 students and 352 employees have tested positive this month, according to the district's COVID-19 tracker.

The Hillsborough County School Board said it will have an emergency meeting Wednesday to discuss COVID-19 mitigation strategies — which may include "mandatory face coverings for all students and staff."

Florida Gov. Ron DeSantis' office has said the state could withhold salaries of officials who impose mask mandates in schools.

But most Americans — 69% — support local school districts requiring everyone to wear masks when inside schools, according to Axios-Ipsos poll results published Tuesday.

A majority, 77%, oppose state governments withholding funding from school districts or local governments that implement mask mandates.

The poll, which was conducted Aug. 13 to 16 and made up of a nationally representative sample of 1,041 U.S. adults, also found that 64% of Americans support state and local governments requiring masks in all public places.

The US is 'flying blind' on the full extent of COVID-19 and kids

Doctors say one way to help students stay in classrooms is to have students — particularly those who are not vaccinated — wear masks in school, health experts say.

"It shouldn't be for months. It shouldn't be forever. But right now, when people are coming back in, masking is a reasonable public health step," said Dr. Brett Giroir, former assistant secretary for health in the Trump administration.

"I support it and encourage parents to encourage their children to do it."

During this delta variant surge, COVID-19 hospitalizations have soared among children. But the total number of severe pediatric cases is unknown.

"Only 23 states and New York City actually report the number of children in hospitals," said Giroir, a pediatrician. He said Texas and Florida are among the states where the total number of child COVID-19 hospitalizations are unknown.

"Talking about flying blind, relative to children," Giroir said. "We need better data, and that's got to be the basis for action."

Giroir said it's important to remember the risk of long COVID for some who get COVID-19 — "meaning for months they'll be in pain, they'll be fatigued, they'll have brain fog, because their memory centers in their brain shrink."

Because COVID-19 vaccination is only available for Americans ages 12 and up, face masks play a key role in helping children avoid the Delta variant — and keeping students in school instead of quarantine, CNN medical analyst Dr. Leana Wen said.

If students are going to be in a room before they can all be vaccinated, it is crucial to have proper testing, ventilation and masking, Wen said.

"Why wouldn't we want every single tool at our disposal to help to keep our children safe at this point?" she said.

'The delta variant ... is because of unvaccinated reservoirs'

About 50.9% of Americans have been fully vaccinated against COVID-19, according to the U.S. Centers for Disease Control and Prevention.

That leaves plenty of chances for the highly contagious delta variant to spread, send more people to hospitals and prevent more students from learning in classrooms.

"The delta variant that we're dealing with is because of unvaccinated reservoirs," said Dr. Chris T. Pernell, fellow at the American College of Preventive Medicine.

"When we have a significant portion of the population (unvaccinated) ... the virus runs amok. It has free course to mutate and to try to get ahead of the interventions and immune system."

Booster shots might be available in the coming months

Fully vaccinated people might be able to get more protection against COVID-19 in the form of a booster shot in the coming months.

On Monday, Pfizer and BioNTech said they submitted initial data to the U.S. Food and Drug Administration to support the use of a booster dose of the COVID-19 vaccine.

The dose elicited a significantly higher antibody response against the initial strain of coronavirus and the Delta and Beta variants compared to what was seen among people who got two doses, they said.

The booster dose seemed to be equally protective against the Delta and Beta variants as against the original strain of novel coronavirus.

But "that's actually ... not answering the key question we have remaining right now," Wen said. "The key question is: How quickly does immunity wane after the first two doses?"

With the more transmissible Delta variant spreading, top officials in the Biden administration are coming to an agreement that most Americans should get a booster shot eight months after being fully vaccinated, according to sources familiar with the discussions.

The Biden administration's plan, which is still being developed, would involve administering third shots beginning in mid- to late September, one source told CNN, pending authorization from the FDA.

Because health care workers and nursing home patients were first to receive their shots, the administration expects they'll be first to receive boosters as well.

Last week, the FDA authorized third doses for some people who are immunocompromised. The CDC almost immediately recommended giving those doses.

Hospitals feeling the weight of the increase

Forty states are seeing a surge in the average number of new cases compared to the week before, according to data from Johns Hopkins University. And the impact can be seen in strained health care systems.

Cases in Mississippi have continued to rise, with the latest data from the state department of health showing 7,839 new cases and 52 new deaths in the three days to August 15.

In response to the record number of COVID-19 hospitalizations, the University of Mississippi Medical Center said a second field hospital is being constructed in one of its parking garages.

The field hospital will have critical care capacity and care for up to 32 patients at a time, the medical center said.

In Texas, following a review of the rise in fatalities, the Department of State Health Services submitted a request for five mortuary trailers as "a normal part of preparedness to have these available to support local jurisdictions in case they need them," DSHS Press Officer Douglas Loveday said.

Like the governor of Florida, Texas Gov. Greg Abbott issued an executive order banning school districts from requiring masks.

Texas and Florida lead the nation in pediatric hospitalizations.

As of Monday, 239 Texas children were hospitalized with COVID-19, according to HHS data. Texas had 170 children hospitalized with COVID-19.

COVINGTON, Ky. — As the COVID-19 delta variant spreads, a Northern Kentucky business is doing its part to help the country stay healthy and safe.

Gravity Diagnostics used to have 45 employees and a 7,000-square-foot lab, and they handled about 15 COVID-19 samples a day. Now they have over 400 employees and a 70,000-square-foot lab and they process about 27,000 samples a day, according to CEO Anthony Remington.

Out of those employees, Remington said six full-time employees in the lab have PhDs, and they have been helpful to track and monitor the spread of the delta variant of COVID-19.

"They've been kind of surprised to see how quickly delta has taken over," he said. "So it is definitely a surge in delta. That is definitely real."

Remington also said he wants his company to be a service to the community, and the focus has always been on ICU patients and those in nursing homes.

"If you have 100 people in your hospital and you don't know who has COVID and who doesn't, if you can find out the same day or the next day, it helps make better decisions quicker, and that's always been our focus," he said. "Testing and getting results the day we get the sample has a value."

Gravity Diagnostics offers free drive-thru COVID-19 testing in the parking lot of 302 W. 4th St. in Covington from 6 a.m. to 1p.m. The company plans to extend these hours from 6 a.m. to 6 p.m. within the next week.

Cases of COVID-19 are again climbing across Ohio, Kentucky and Indiana, fueled by the delta variant. Below are the latest statistics, updated daily, via each state's health department. OHIO (Data as of Thursday, Aug. 12)NEW CASES: 3,272TOTAL CASES: 1,152,590NEW HOSPITALIZATIONS: 130NEW CONFIRMED DEATHS: 0 new deaths, 20,580 total* * The state now updates deaths only after death certificates have been processed, typically twice weekly. KENTUCKY (Data as of Thursday, Aug. 12)NEW CASES: 2,713TOTAL CASES: 508,310NEW CONFIRMED DEATHS: 6 new deaths, 7,414 total 11.57% positivity rateINDIANA (Data as of Thursday, Aug. 12)NEW CASES: 3,186TOTAL CASES: 794,077NEW CONFIRMED DEATHS: 6 new deaths, 13,686 total COVID-19 Vaccine Data: + Where Can I Register for a COVID-19 Vaccine?+ Get the Facts on the Vax: Your Vaccine Questions AnsweredFrequently Asked Questions:Where can I find state COVID-19 information?Ohio's website | Kentucky's website | Indiana's websiteAre facial coverings or masks required in Ohio, Kentucky or Indiana?In most settings, masks are no longer required in Ohio, Kentucky and Indiana. But don't throw away your mask just yet. Businesses are permitted to impose their own requirements. In Kentucky, masks are still required on public transportation, schools, long-term care facilities and other locations that serve the “most vulnerable,” Gov. Andy Beshear said.What does it mean to be "fully vaccinated?"According to the CDC, people are considered fully vaccinated two weeks after their second dose in a 2-dose series, such as Pfizer or Moderna vaccines, or two weeks after a single-dose vaccine, such as Johnson & Johnson's Janssen vaccine. If you do not meet those requirements, regardless of age, you are not fully vaccinated.These plastic holders will keep your COVID-19 vaccination card safe | Keep your COVID-19 vaccine card safe in a stylish sleeveI'm not vaccinated. What activities should I and should I not partake in?Outdoor Activities:Safest: Walk, run, wheelchair roll, or bike outdoors with members of your household. Attend a small, outdoor gathering with fully vaccinated family and friends. While masked, attend a small, outdoor gathering with fully vaccinated and unvaccinated people, particularly in areas of substantial to high transmission.Less Safe: While masked, dine at an outdoor restaurant with friends from multiple households.Least Safe: While masked, attend a crowded, outdoor event, like a live performance, parade, or sports event.Indoor Activities:Less Safe: While masked, visit a barber or hair salon, go to an uncrowded, indoor shopping center or museum, attend a small, indoor gathering of fully vaccinated and unvaccinated people from multiple households.Least Safe: While masked, go to an indoor movie theater, attend a full-capacity worship service, sing in an indoor choir, eat at an indoor restaurant or bar, participate in an indoor, high-intensity exercise class.

Video above: Do's and Don'ts for people looking to dodge delta COVID-19 variant

COVID-19 hospitalizations are reaching all-time highs in parts of the South, with some patients unable to get the care they would normally receive.

Susan Walker has been calling out-of-state hospitals trying to get help for her husband, who did not get vaccinated against COVID-19 and is now in a medically induced coma.

"He is on a ventilator and in dire need of an ECMO treatment, which is not available at the hospital that he is in," the Florida mother said Sunday.

"All the beds are taken up by COVID victims also getting ECMO."

An ECMO treatment uses external machinery that can function as the heart and lungs. It's been used with some severely ill COVID-19 patients, including young adults.

"We have searched every hospital from the south of Florida to the north part of Florida" trying to find availability, Walker said.

"To transfer him to a hospital in Florida is next to impossible."

Across the country, states are struggling to fend off the delta variant — the most contagious strain of coronavirus yet.

But the situation in particularly worrisome in several Southern states.

Louisiana set a new record for COVID-19 hospitalizations last week.

Florida's hospitalizations recently jumped 13% above the state's previous peak on July 23, 2020, according to a survey by the Florida Hospital Association.

The FHA said it expects 60% of the state's hospitals to face a "critical staffing shortage" by this week.

And at Houston's United Memorial Medical Center, "We have no beds. The emergency department is full of patients just waiting to be able to get into the hospital," Chief of Staff Dr. Joseph Varon said Sunday morning.

"Over the last 12 hours, we have lost more patients than ... in the last five to six weeks."

According to data published Sunday by the U.S. Centers for Disease Control and Prevention, 50.1% of the total U.S. population is now fully vaccinated — more than 166 million people.

As of Sunday, Mississippi has fully vaccinated 35.2% of its residents. That makes Alabama — with 34.8% of its residents fully vaccinated — the only state in the U.S. to have fully vaccinated less than 35% of its residents.

The seven-day average of doses administered each day is now 706,323 doses, per the CDC data, and an average of 449,000 people are initiating vaccination each day.

More hospitalizations and deaths expected

The U.S. now is averaging more than 100,000 new COVID-19 cases every day — the highest in almost six months, according to data from Johns Hopkins University.

Because it can take days or weeks for some COVID-19 cases to lead to hospitalization or death, doctors are bracing for an ugly repeat of scenes from 2020.

"It's bad. For me, this is a deja vu of what we had last year," Varon said.

"And the worst part about this is this was foreseeable. And this was preventable. So not only are (we) exhausted, we're annoyed. And we're annoyed because people are not doing the right thing."

The vast majority of those getting hospitalized with or dying from COVID-19 are not fully vaccinated, Dr. Rochelle Walensky, the director of the CDC, said last week.

And Americans who have already had COVID-19 shouldn't assume they don't need a shot.

For adults previously infected with COVID-19, vaccines give better protection against reinfection than natural immunity on its own, according to a CDC study published Friday.

The study suggests people who got COVID-19 in 2020 and didn't get vaccinated were more than twice as likely to be reinfected in May or June 2021, compared with people who also had COVID-19 but were later fully vaccinated.

"If you have had COVID-19 before, please still get vaccinated," Walensky said Friday.

There is no minimum time to wait between recovering from COVID-19 and getting vaccinated, the CDC said.

"Getting the vaccine is the best way to protect yourself and others around you," Walensky said, "especially as the more contagious delta variant spreads around the country."

Steve Witschel is a New Orleans musician diagnosed with COVID-19.

Witschel, who was not vaccinated, said he hopes his story inspires others to take this virus seriously and get the shot.

"A week ago today I didn't know if I was going to live,” Witschel said. “I didn't know if I was going to make it through the week. I seriously was laying here thinking there's no way I'm going to make it through the week. I'm going to die."

Witschel said his passion is music. He performs in the French Quarter.

He is in a COVID-19 unit after contracting the virus.

He works with The Beasts of Bourbon band and Cover Band Central.

"I want to educate, entertain, and inform and inspire,” Witschel said.

For the past six days, Witschel has been at the hospital.

Last month, he started to feel ill and tested positive.

He said he thought he could ride it out, but, eventually, his fever and oxygen levels got worse.

Witschel said he was curled in a ball with a fever shivering and made the decision to call 911 for an ambulance.

Witschel said doctors also found blood clots in his lungs and pneumonia.

“Wear your mask, take the vaccine if you can. I didn't. I should have. I didn't make it a priority,” Witschel said.

To help Witschel with medical expenses click here.

Watch the video above for the full story.

Businesses large and small, from McDonald’s and Home Depot to local yoga studios, are reinstituting mask mandates as U.S. coronavirus cases rise. Bars, gyms and restaurants across the country are requiring vaccines to get inside.

After a largely mask-free summer, it's a reversal no one wanted to see, brought on by the fast-spreading delta variant and new guidance from the U.S. Centers for Disease Control. But business owners and workers say they will do what they can to keep their doors open and not slow the economic gains of the last few months.

“We’ve already been through the worst of the challenges when we shut down the indoors last year,” said Brack May, the chef and owner of Cowbell, a New Orleans burger joint. “Let’s just get ahead of the curve here.”

May recently began requiring customers to show their vaccine cards for indoor dining. He said he wants to protect his workers, who are required to be vaccinated but have young children at home, as well as his neighborhood, where some musicians recently contracted the coronavirus.

May expects that eventually, vaccine rules like his will be commonplace. Next month, New York City will start requiring vaccinations to enter restaurants, gyms and theaters.

But for now, customers are far more likely to encounter mask mandates. After lifting mask recommendations for fully vaccinated people in May, the CDC reversed course in late July, recommending masks for both vaccinated and unvaccinated people in areas of higher transmission.

The shifting guidance has caused confusion over which rules to enforce and how. Walmart and Target, for instance, recently began requiring masks for employees __ but not customers __ in areas where virus transmission rates are high. McDonald’s is requiring masks for both employees and customers. Home Depot’s mask mandate is nationwide.

A handful of places, like Louisiana, the San Francisco Bay area and Las Vegas, are mandating masks indoors.

Many business owners didn’t wait for the CDC or their local governments before acting. In mid-July, Tamra Patterson reinstituted a mask mandate and reduced seating capacity from 200 to 65 at Chef Tam’s Underground Cafe, the restaurant she owns in Memphis, Tennessee.

“I need every dollar and dime and penny I can get, but if I don’t have employees healthy, I don’t have a business. If customers are sick, I have nothing,” Patterson said.

Customers are generally receptive to the mask mandate, Patterson said. Only one has walked out.

PanTerra Gallery, a women’s clothing store in Bisbee, Arizona, reinstated a mask mandate for customers a few weeks ago after watching cases climb nationwide.

“We’re a tourist town, so it was just a matter of time before it reached us again,” said Lisa Wines, a PanTerra employee. Most people are fine with the new mandate, she said, but some turn around and stomp out of the store.

Not every business supports the mandates. Basilico's Pasta e Vino, a restaurant in Huntington Beach, California, has railed against masks on social media. A sign on its door requires patrons to prove that they're unvaccinated.

Some workers also don't want to see masks return.

Dru W., a grocery employee in Houston who asked not to use his full name for fear of reprisals at work, said he was fully vaccinated months ago and enjoys the freedom it gives him to go without a mask. Few stores around him are enforcing the new CDC guidelines, he said, and he won’t either.

“I didn’t get both my doses and deal with the rather gnarly side effects only to be told to go back to the way things were during the pandemic,” he said.

But other retail workers see masks as an important way to end the pandemic. Austin Ray Shanks, who works at a Walmart in Monroe, Washington, said he finds masks uncomfortable but necessary. He's disappointed that many customers at his store refuse to wear them.

Marshall Crawley said his gym in Morrisville, North Carolina, recently announced that it would require masks for both vaccinated and unvaccinated patrons. But the rule isn’t being enforced, he said.

“It doesn’t really feel like it is doing much good wearing a mask when everyone around me is not,” said Crawley, a client manager for J&J Editorial, a managed services company for scholarly publishing.

Crawley thinks the CDC went too far when it told vaccinated people they could remove their masks this spring. Now, he said, it will be too hard to convince people to put them back on.

Jose Backer, who works in customer service at a food packaging manufacturer in Los Angeles County, said his company began letting vaccinated workers remove their masks earlier this year. But soon everyone stopped wearing them. That angered Backer, who doesn’t want a repeat of a COVID-19 outbreak that sickened him and others at his workplace last year. He's relieved that his county is requiring masks for everyone again.

The new wave of mandates give some comfort to companies that never gave up on masks, even when U.S. cases ebbed earlier this summer.

Liz Manasek, the co-owner of Warner Bodies, a custom truck manufacturer in Elwood, Indiana, kept a mask policy in place after watching other companies struggle with different rules for vaccinated and unvaccinated workers.

About 60% of the company’s 105 employees are now vaccinated, she said. She has told employees she won’t consider removing the mandate until that level reaches 80%.

Manasek has gotten some pushback from workers, but she reminds them that the policy has been effective. Only one or two employees have tested positive for COVID-19 since the pandemic began, she said.

“We’ve just got to hold out and keep on the basics,” she said.

Related video: U.S. hits Biden's 70% vaccination goal one month after target date

Can I get ‘long COVID’ if I’m infected after vaccination?

It's unclear, but researchers are studying the chances of long-term symptoms developing in anyone who might get infected after vaccination.

The COVID-19 vaccines in use around the world are effective at preventing severe illness and death from the coronavirus, but some people do get infected after the shots. With such “breakthrough” cases, health experts say the vaccines should help lessen the severity of any illness people experience.

But researchers are also looking at whether those breakthrough cases could lead to long COVID-19, which is when people experience persistent, returning or new symptoms a month or more after an infection. The condition can develop after severe initial infections or even in those who initially had mild or no symptoms.

Some estimates indicate about 30% of unvaccinated COVID-19 patients develop long-term symptoms, including shortness of breath, fatigue, difficulty concentrating, insomnia and brain fog. Similar symptoms can develop after other viral infections, too.

A small study from Israel published recently found apparent long COVID-19 in several health workers with breakthrough infections. They developed mild symptoms including cough, fatigue and weakness that persisted for at least six weeks.

Larger studies are ongoing.

Researchers don’t know why symptoms linger, but believe some symptoms reflect lung scarring or damage to other organs from severe initial infections. Another theory suggests that the virus may linger in the body and trigger an immune response that leads to the symptoms.

As the delta variant continues to spread, experts say vaccine rates are not keeping up.

It has taken a month for the number of fully vaccinated Americans to get from 47% to almost 49.8% after vaccination rates rose dramatically in the first few months of its availability, and experts think much of that can be attributed to misinformation about the vaccine that has spread online.

The nonprofit called the Center for Countering Digital Hate did a recent study that found 65% of vaccine misinformation on social media sites came from 12 influencers they dubbed as the “disinformation dozen.”

After analyzing more than 815,000 Facebook posts, the group found that on Facebook alone the “disinformation dozen” was responsible for 73% of posts purporting conspiracy theories about the vaccine.

Together, the 12 people have a group following of more than 59 million people.

“They’ve got a lot of sway and a lot of pull because that is how those kinds of ecosystems are set up,” said Dr. Sam Jay, a communications studies professor at Metro State University in Denver. “Convenience is such a good word. It’s easier for us to find those shortcuts [to information]. It’s easier to find someone who does the thinking for us, and so, that’s why we’ve glommed onto these 12 folks because, again, they have credibility. Those are names that we recognize.”

Among the 12 people are a physician that embraces pseudoscience, a chiropractor, a wellness blogger, and a religious speaker, among others.

The CDC, and nearly every other scientific institution, has championed the vaccine as safe and effective. Even some governors of conservative states where vaccination rates are lower have changed their tune and started supporting it as well. But there is a stickiness to negative information that Jay says makes it more popular and viral than true information.

“We kind of need to rethink how we’re doing this because at that 30,000-foot level, the vaccine messaging just doesn’t work,” said Jay. “Evolutionarily, and as animals, that negative [information] sticks, it lasts. Those messages, they circulate faster, and I think it’s very hard for us to kind of break that cycle.”

Jay says there needs to be a change in dialogue, with more face-to-face conversation where emotion can be felt and a change in thinking that maybe the science is not lying.

The Center for Countering Digital Hate has a more hands-on approach, suggesting in its study that Facebook, Instagram, Twitter, and YouTube completely remove these 12 people from their platforms, saying they are influencing people with misinformation at a pivotal point in the pandemic.

New York City Mayor Bill de Blasio strongly encouraged vaccinated people to wear masks indoors but stopped short of reissuing a mask mandate on Monday, spurning guidance from the U.S. Centers for Disease Control and Prevention."We want to strongly recommend that people wear masks in indoor settings even if you're vaccinated," de Blasio said. "If you don't know the people around, if you're not sure if they're vaccinated or not, or if you know some are unvaccinated, it's absolutely crucial to wear a mask even if you are vaccinated."Still, he did not require masks in all indoor settings, a step that Washington D.C., Los Angeles County and some other large metro areas have taken. Already, New York City requires vaccinated people to wear masks on public transit, in hospitals and in schools.Last week, the CDC issued new guidance that fully vaccinated people should wear masks indoors when in areas of "substantial" or "high" COVID-19 transmission, a metric based on case rates and positivity rates in a county. All five boroughs in NYC are in areas of "substantial" or "high" transmission.De Blasio's decision not to reissue a mask mandate reflects the waning influence of the CDC at this point in the pandemic, when protective vaccines are widely available for everyone 12 and older.The CDC's new mask guidance was based on an outbreak of the delta variant among mostly vaccinated people in Provincetown, Massachusetts, in which five people were hospitalized and no one died. The vaccines, though not 100% effective, provide substantial protection against severe illness and death.In recent weeks, the mayor has emphasized the importance of vaccinating as many people as possible and downplayed the use of masks, saying vaccines are "the whole ball game.""Masks can be helpful, we are going to delineate to New Yorkers the best way to use masks, but they don't change the basic reality. Vaccination does," he told CNN on Friday.About 55% of all NYC residents are fully vaccinated, according to city data, a number higher than the total U.S. rate of about 50%. The rate differs by borough, however: about two-thirds of Manhattan residents are fully vaccinated, while only 46% of Bronx residents can say the same.Mayor de Blasio said Monday the city still plans to focus its efforts on raising vaccination rates. "Everything we do is vaccine-centric," de Blasio said.The city has offered both carrots and sticks to encourage vaccinations. Any resident who gets a first dose of the vaccine at a city-run vaccination site will get $100. At the same time, all unvaccinated city employees will be required to start weekly testing on Sept. 13.The mayor also announced Monday that every new employee for the city of New York will be required to prove they are vaccinated before they can begin work.

CINCINNATI — Tuesday, the Centers for Disease Control and Prevention recommended wearing masks indoors in areas experiencing a surge in COVID-19 cases -- including for those who are fully vaccinated.

In Hamilton County, COVID-19 cases are rising. As of Tuesday, the Hamilton County Public Health Department said nearly 120 people were hospitalized due to the virus. Two weeks ago that number was closer to 40 on any given day.

Hamilton County Health Commissioner Greg Kesterman said to follow guidance from the Ohio Department of Health instead of federal leaders.

Mercy Health’s chief clinical officer, Dr Stephen Feagins, said the more contagious delta variant was able to become stronger as it spread among the unvaccinated.

“It is the dominant circulating strain. That was predicted,” Dr. Feagins said.

The CDC said studies show even vaccinated people may be able to spread it. That is why the team recommended Tuesday that people begin masking indoors even though they are fully vaccinated.

“While a break-though case of COVID on a vaccinated individual is still a reportable event, it's rare,” Dr. Feagins said.

Hamilton County Public Health is working to get more people vaccinated.

“We're seeing, in our hospital systems, a lot more 40- and 50-year-olds ending up in the hospital,” Health Commissioner Greg Kesterman said. “So, we want to make sure that we're getting the right messaging and the right information to those folks so they can make an informed decision.”

Local health departments had not changed mask recommendations as of Tuesday evening.

The number of people with coronavirus is surging again across the country. Just three states - Missouri, Texas, and Florida - account for 40% of new COVID-19 cases in this country right now.

"The delta virus is much more infectious. Its viral load is thousands of times higher than our previous variants. It's going to make even the average healthy person sick now," said Dr. Catherine O'Neal of Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana. 

The delta variant of the coronavirus is now more than 83% of all COVID-19 infections in this country. The three vaccines with emergency use authorization protect people at a high rate against serious illness or death from the delta variant.

"We do know that in our ICUs, we are seeing younger people intubated who are very sick or who are on the floors and are very sick. That should be a gigantic wake-up call," said Jeanne Marrazzo, director of the Division of Infectious Diseases, at the University of Alabama at Birmingham  

However, the vaccines are not 100% effective and as community spread increases, so do the number of vaccinated Americans who test positive and transmit the virus to others.

Even the White House has seen new breakthrough cases.

Now the Biden administration is talking with the CDC about whether masking guidelines should be updated.  

"We've never said that battle is over, it's still ongoing. It would more concerning -- or should be more concerning -- to you and the American people if we were not having those conversations," White House Press Secretary Jen Psaki said Thursday. 

CDC guidance currently says vaccinated Americans can resume normal activities without wearing a mask or social distancing.  

The problem though is, without mask mandates, unvaccinated Americans are also dropping their masks. Health officials fear the honor system is failing in many places.  

"We are always looking at the data as the data come in. Our guidance has been clear since, since we put it out several months ago," CDC Director Dr. Rochelle Walensky said Thursday. 

The CDC says its guidance remains unchanged, but some vaccinated health experts say they are keeping their masks on.

"I have not really taken my mask off. I go outside and walk — I still have my mask. I certainly, when I go into the post office or the grocery store or the pharmacy, or any other place, I keep my mask on. It's added protection," Dr. Zeke Emanuel told CNN.

Jerome Adams, who was the U.S. Surgeon General under former President Donald Trump, wrote an opinion piece in the Washington Post this week that called for the CDC to change their guidance.

"The agency urgently needs to revise its guidance on masking to combat the rapid growth in COVID-19 infections driven by the delta variant," he wrote.

"Without a mechanism to determine who is vaccinated and who is not, businesses and others have been helpless to determine which people were following the guidance — that is, vaccinated and safely unmasked — and which people were simply taking the opportunity to eschew a highly politicized (and widely loathed) public health intervention," Adams continued.

Kellan Howell contributed to this report.

CINCINNATI — President Joe Biden visited the Tri-State Wednesday to talk about infrastructure and the economy among other things, but a few of the president's statements were outright wrong or factually false.

One of the things the president discussed was gun violence in the Tri-State.

Biden said, "You've had a lot of gun violence here in Cincinnati. I think it's up to what, how many dead? Five hundred over a period? Don't hold me to the number whatever it was."

However, according to Cincy Insights, there haven't been 500 shootings in Cincinnati so far in 2021. There have been 191 reported shootings in the city, and 39 of them were deadly. Even if the time frame is extended to the last five years, the data shows there have been 278 deadly shootings.

While one deadly shooting is too many, the president saying there have been 500 deadly shootings is wrong.

The president also said, "We're not in a position where we think that any virus, including the delta virus, which is much more transmissible and more deadly in terms of non- unvaccinated people... the various shots that people are getting now cover that. They're, you're okay. You're not going to, you're not going to get COVID if you have these vaccinations."

That's false. Vaccinated people can still get COVID-19. A couple from the Tri-State were both vaccinated, but they both contracted the delta variant.

"A lot of folks I know got the vaccine, and they're like, 'OK. It's all over,' but, clearly it's not," Rachelle Caplan said. "We still should be being cautious for ourselves and other people."

The Centers for Disease Control and Prevention reported in July that 5,492 people who died or were hospitalized with COVID-19 were vaccinated. However, the CDC also said more than a quarter of hospitalizations were asymptomatic or not related to COVID-19, and about a quarter of those who died were found to be the same.

Finally, Biden commented on bridges and infrastructure.

"Take a look at Ohio and Kentucky," Biden said. "Combined, there's well over, there are thousands of bridges that need repair."

According to the Federal Highway Administration, there are about 42,000 bridges in Ohio and Kentucky and 2,400 of them are in "poor condition." The maligned Brent Spence Bridge actually falls into the "fair" category per the administration.

SPRINGFIELD, Mo. —

A COVID-19 surge in Missouri that is being fueled by the delta variant has taken its toll on hospital staff there.

Registered nurse Brittany Dillard has been working at Mercy Hospital in Springfield, Missouri, since January.

She told sister station 40/29 News that she’s seen more patients die in the last two weeks from COVID-19 than in the last 6 months.

"There’s not a time I help a family member call their family and I don’t cry, I sit in the corner and just sob," Dillard said.

For the past 16 months, Dillard has been travel nursing across the country in hot spots areas. Last year, she was working on the frontlines in New York City.

"Sometimes, I wish I could wear a GoPro and bring people to work with me," Dillard said.

She said one of the hardest parts of her job is putting someone on a ventilator and intubating them.

"I wish people could see the genuine fear right before I sedate them and put them on the ventilator, because they have no idea if this is the last time they are going to be conscious," Dillard said.

She said throughout the pandemic, about half of her patients have come off of the ventilator and recovered, but that's not true with the delta variant.

"I have not had one patient where I get to take the ventilator off and they get to succeed and move out of our unit," Dillard said.

She said on top of that, she’s been seeing much younger patients in the hospital.

“We have mothers and fathers with kids, on their deathbed, losing their battle to this horrible, horrible virus,” Dillard said.

She said all but one of her patients recently admitted in the COVID-19 ICU have been unvaccinated.

"We hear all kinds of reasons, and they are not factually based on at all, it's all something they saw on a not credible site, and it's literally killing people," Dillard said.

Dillard said for the past few weeks, the ICU has been at full capacity at her hospital. She says at any one time, there may be over 100 people waiting in the emergency room for a bed.

Watch the video above to learn more about this story.

New York held a ticker-tape parade Wednesday for the health care workers and others who helped the city pull through the darkest days of COVID-19, while authorities in Missouri struggled to beat back a surge blamed on the fast-spreading delta variant and deep resistance to getting vaccinated.

The split-screen images could be a glimpse of what public health experts say may lie ahead for the U.S. even as life gets back to something close to normal: outbreaks in corners of the country with low vaccination rates.

"We've got a lot to appreciate, because we're well underway in our recovery," declared New York Mayor Bill de Blasio, who rode on a parade float with hospital employees down the Canyon of Heroes, the skyscraper-lined stretch of Broadway where astronauts, returning soldiers and championship teams are feted.

In Missouri, meanwhile, the Springfield area has been hit so hard that one hospital had to borrow ventilators over the Fourth of July weekend and begged on social media for help from respiratory therapists, several of whom volunteered from other states. Members of a new federal "surge response team" also began arriving to help suppress the outbreak.

Missouri not only leads the nation in new cases relative to the population, it is also averaging 1,000 cases per day — about the same number as the entire Northeast, including the big cities in New York, New Jersey, Pennsylvania and Massachusetts.

California, with 40 million people, is posting only slightly higher case numbers than Missouri, which has a population of 6 million.

Northeastern states have seen cases, deaths and hospitalizations plummet to almost nothing amid widespread acceptance of the COVID-19 vaccine.

Vermont has gone 26 days with new case numbers in single digits. In Maryland, the governor's office said every death recorded in June was in an unvaccinated person. New York City, which was the lethal epicenter of the U.S. outbreak in the spring of 2020, when the number of dead peaked at over 800 a day, regularly goes entire days with no reported deaths.

The problem in Missouri, as health experts see it: Just 45% of the state's residents have received at least one dose of the vaccine, compared with 55% of the U.S. population. Some rural counties near Springfield have vaccination rates in the teens and 20s.

At the same time, the delta variant is fast becoming the predominant version of the virus in Missouri.

Epidemiologists say the country should expect more COVID-19 outbreaks in areas with low vaccination rates over the next several months.

"I'm afraid that that is very predictable," said Dr. Chris Beyrer, an infectious disease epidemiologist at the Johns Hopkins University. "If politician seize on this and say, 'Who could have predicted this?' The answer is every licensed epidemiologist in the country."

Republican Gov. Mike Parson said Wednesday that his administration has done "everything possible" to fend off outbreaks.

"Right now, the vaccine's out there," he said. "I mean, people walk past it every day, whether they're in a pharmacy, whether they're in a Walmart, whether they're in a health center."

Mercy Hospital Springfield reported Tuesday that it had more than 120 patients hospitalized with COVID-19 — the highest total since the pandemic began. Seventeen people died in the latest two-week reporting period in the county that surrounds Springfield, the most since January. None were vaccinated, authorities said.

Erik Frederick, Mercy's chief administrative officer, said staff members are frustrated knowing that "this is preventable this time" because of the vaccine.

"We try to convince people, but it is almost like you are talking a different language," he lamented. "There is no way they are going to get a vaccine. Their personal freedom is more important."

The Mercy system announced Wednesday it is requiring vaccinations among staff at the hospital in Springfield, as well as at its hundreds of other hospitals and clinics in Missouri and neighboring states. It said about 75% of its more than 40,000 employees are vaccinated.

Missouri also never had a statewide mask mandate. The sentiment against government intervention is so strong that Brian Steele, mayor of the Springfield suburb of Nixa, is facing a recall vote after imposing a mask rule, even though it has long since expired.

At Springfield's other hospital, Cox South, several patients are in their 20s and 30s, said Ashley Kimberling Casad, vice president of clinical services. She said she had been hopeful when she eyed the COVID-19 numbers in May as she prepared to return from maternity leave.

"I really thought when I came back from maternity leave that, not that COVID would be gone, but that it would just be so manageable. Then all of a sudden it started spiking," she said, adding that nearly all the virus samples that the hospital is sending for testing are proving to be the delta variant.

Citing the rise in cases, the Springfield school district reinstated its mask requirement for its summer program starting Wednesday.

The contrasting scenes in the U.S. came as the worldwide death toll from COVID-19 closed in on 4 million, by Johns Hopkins University's count. COVID-19 deaths nationwide are down to around 200 per day from a peak of over 3,400 per day in January.

In New York, those honored at the parade included nurses and doctors, emergency crews, bus drivers and train operators, teachers and utility workers. The crowds along the route were thin, in part because many businesses are still operating remotely.

"What a difference a year makes," said parade grand marshal Sandra Lindsay, a nurse who was the first person in the country to get a COVID-19 vaccine shot.

"Fifteen months ago, we were in a much different place, but thanks to the heroic efforts of so many — health care workers, first responders, front-line workers, the people who fed us, the people who put their lives on the line, we can't thank them enough."

——

Tom Murphy contributed to this report from Indianapolis.

West Virginia Gov. Jim Justice didn't mince words Tuesday in urging his constituents to get vaccinated against COVID-19.

During a televised press conference, Justice, a Republican, told West Virginians who are choosing not to get vaccinated that they "part of the problem," adding that their actions could cause more people in the state to die of the virus.

"If you're not vaccinated, you're part of the problem rather than part of the solution. You know, that's all there is to it," Justice said. "If we had you vaccinated, less people would die. That's all there is to it."

West Virginia is among a handful of states that are lagging behind the national average when it comes to vaccine distribution. Just 47% of West Virginians are fully vaccinated, compared with 55% of the entire country.

According to Bloomberg, West Virginia ranks 45th out of 51 U.S. states (plus D.C.) for the number of vaccines distributed per capita.

Young people are among the groups holding the state back from reaching herd immunity. Just 54% of West Virginians above 12 have been vaccinated, compared with 77% of people older than 65.

Justice has tried to incentivize young people to get vaccinated with $100 saving bonds and cash lotteries. However, West Virginia continues to lag behind other states when it comes to vaccine distribution.

"When it really boils right down to it, they're in a lottery to themselves," Justice told ABC News in an interview that aired Sunday. "We have a lottery, you know, that basically says, 'if you're vaccinated, we're going to give you stuff.' Well, you've got another lottery going on, and it's the death lottery."

Across the country, vaccine distribution has slowed in recent months. According to Bloomberg, the U.S. has distributed an average of 800,000 vaccine doses a day in the past week, down from a peak of 3.3 million a day in April.

Officials fear that places like West Virginia — where large swaths of people remain unvaccinated — could soon be the site of new COVID-19 outbreaks as the dangerous delta variant quickly spreads around the world.