La Dallas Mitchell is working overtime to care for her daughter.

"It's just been nonstop," Mitchell said. "She's probably been sick like five times."

At the same time, parenting means working around that sickness.

The U.S. is the only developed country that does not guarantee any paid sick leave, according to the Center for Economic Policy and Research, though some states like New York, New Jersey and California have laws with requirements.

Medical experts say the surge of viruses right now highlights the need for paid sick time off.

"With RSV, COVID and the flu, this is very taxing to the health care system but also taxing to our families," said Dr. Willie Underwood, with the American Medical Association. "People get sick and ill; they can't work. They have increased health care costs. It's detrimental to us."

In October, a record high 104,000 Americans missed work due to "childcare problems," according to the Bureau of Labor Statistics.

A recent Robert Wood Johnson Foundation report found workers lost $28 billion in wages during 2020 to 2022. Women, Latino, and Black workers felt the brunt of it. It also found people making less than $25,000 a year were about 2.5 times more likely to not have paid sick leave compared to someone making $100,000.

Epidemiologist and research director Mona Shah worked on the foundation report.

"For a family member who had to take off a week of work to take care of themselves or their child, that meant they lost an average of $815 in wages," Shah said. "That would have huge implications for paying for food, housing, health care, gas and other essentials."

SEE MORE: Doctors: Get Your Flu, COVID Vaccines Now To Be Safe During Holidays

Shah says when someone works while they or a loved one is sick, it impacts more than that single household.

"They're working when they're sick, and they're potentially impacting the people that they come across, whether at work or at school, and so it's really a compounding effect," Shah said.

She said that's why paid time off is important for a community to stay healthy, especially during busy holiday seasons.

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Data from the Centers for Disease Control shows, as of Jan. 1, only about 40% of pregnant women have been vaccinated against COVID-19.

A new study out of Scotland is shining a much larger light on the benefits and safety of getting vaccinated while pregnant.  

More pregnant mothers are weighing whether to get the vaccine, especially with the surging omicron variant.

"I didn't want to get it and potentially harm my baby but looking back, that doesn't really make any sense because I obviously wouldn't have wanted to get COVID with the baby," Heaven Taylor-Wynn said. 

Doctors are trying to convince their pregnant patients to get the vaccine because they are seeing rough outcomes in some unvaccinated pregnant women and their babies. 

"I felt like there was a herd of elephants on my chest, and I couldn't breathe," Ashley Duque said.

"I've seen women they got really bad preeclampsia and a funny variant of preeclampsia called help syndrome that makes them very, very, very sick and requires urgent delivery," said Dr. Brad Holbrook, maternal fetal medicine specialist at Community Medical Center.

"I've seen women with stillbirths. I've seen babies die after they were born," she added.

The study out of Scotland confirms everything doctors like Holbrook have been saying,

The Scotland team studied all women who were pregnant or became pregnant from December 2020 through October 2021. 

"They looked at the entire population of the whole country and because they have a whole, you know, an integrated system," Dr. Holbrook said. "They have 130,000 women in this study that essentially showed the same things, which is that, that women who get COVID are potentially in for some problems. So women who get COVID are more likely to have a pre-term delivery, a stillbirth complication with baby or with their pregnancy, and that women who are vaccinated and then get sick with COVID are very likely to have a much more mild course, so it really just confirmed everything that we've seen."

Among unvaccinated women, the study found they made up 77.4% of COVID infections. They accounted for 90.9% of cases that required hospitalization or critical care, and all 450 fetal and newborn deaths associated with the virus. The rate of deaths in babies after 28 weeks was much higher in women who got COVID-19 within a month of giving birth.  

"The risk of getting infected is pretty high, and the risks involved in being vaccinated are almost nonexistent," said Dr. Alisa Kachikis, assistant professor of maternal fetal medicine at University of Washington.

"I do feel like when I can sit down and talk with them face-to-face about it, look, you know, I'm not representing a drug company," Dr. Holbook said. "I'm not representing the government. I'm just representing the science and what I've read and understand about this and my own experience and based on that and what I've seen, I've seen a lot of complications from COVID."

The highly-transmissible omicron variant brings new concerns, especially in places just starting to experience the surge, like Montana.

"We're gonna have this big bunch of pregnant women come in really sick with COVID and not just pregnant women, unpregnant people as well coming into the hospital, and the hospital is gonna be totally full and understaffed," Dr. Holbrook said. "It's gonna be a very difficult couple of weeks, I think."

This story was originally reported on Newsy.com.

The omicron surge is pushing hospitals to capacity as they struggle to keep up with the highest number of COVID-19 patients on record.

“We’re certainly at our highest water mark to date,” St. Elizabeth Dr. Jim Horn said.

St. Elizabeth surpassed their highest number of COVID-19 patients set last year at 219. The new number set this week is 232.

“It just means that everyone is extremely busy, and everyone is stretched to the max,” Horn said.

Every facet of hospital operations is affected from pharmacy to supply chain to the thin ranks of the staff.

“They’re tired, they’re demoralized, they’re emotionally stretched,” Horn said.

There are so many health care workers out sick, even those who are not normally on the front lines are called into action to help.

“Every, every hospital from our rural hospitals to our urban core hospitals are hit by this,” the Health Collaborative’s Tiffany Mattingly said.

Mattingly said almost every hospital in the region is hitting historic high number of COVID-19 patients.

“Definitely as bad as we’ve seen since the start of the pandemic. They’re operating at a whole new level of surge right now,” Mattingly said.

WASHINGTON, D.C. – President Donald Trump's re-election campaign has scrapped plans to hold a rally in Alabama next weekend, CNN and The New York Post have confirmed.

The cancellation of the event comes amid concerns about the rising number of coronavirus cases in parts of the United States, including the South.

The campaign never formally announced the plans for the Alabama rally, but Trump was slated to travel to the state ahead of the GOP’s Senate primary race between his former attorney general, Jeff Sessions, and former Auburn University football coach, Tommy Tuberville.

Campaign officials ultimately decided against it as state officials voiced concerns about a mass gathering during the COVID-19 pandemic, CNN reports.

A person close the Trump campaign told CNN there are currently no rallies on the horizon, but aides are scoping out possible venues for future events.

The canceled plans come as Trump continues to complain about the low turnout during his first return to the campaign trail in Tulsa, Oklahoma.

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.

Paramount Pictures on Wednesday postponed the release of “Top Gun: Maverick," sending another of the fall's top movies out of 2021 due to the rise in coronavirus cases and the delta variant.

Instead of opening Nov. 19, the “Top Gun” sequel, starring Tom Cruise, will instead debut Memorial Day weekend next year, on May 27. Additionally, “Mission: Impossible 7” will be delayed from May 27 to Sept. 30 next year.

The postponement is the latest setback for Hollywood's once-hopeful fall movie season. The delta-driven surge has upended the industry's plans for some return to normality at multiplexes. The flight of “Top Gun: Maverick" follows a similar delay for Paramount's “Clifford the Big Red Dog." Paramount also on Wednesday pushed “Jackass Forever” from Oct. 22 to Feb. 4.

While some studios have hedged their bets with big releases by simultaneously streaming them on release, Paramount Pictures and Sony Pictures have tried to stay the course of a more traditional theatrical release. Sony earlier delayed “Venom: Let There Be Carnage” from September to Oct. 15 due to the rise in cases. Following Paramount's announcement, Sony on Wednesday moved “Ghostbusters: Afterlife” from Nov. 11 to Nov. 19.

But several prominent big-budget releases haven't vacated the fall. Most notably, MGM and United Artists' James Bond movie “No Time to Die” remains slated for release in North America on Oct. 8.

Until recently, Paramount was gearing up to release “Maverick.” The studio last month teased the film's first 13 minutes at CinemaCon, the annual exhibitor convention.

Paramount hasn't kept all of its films. It has sold off some release, like “The Tomorrow War," with Chris Pratt, to streamers. “Infinite,” a poorly reviewed sci-fi thriller with Mark Wahlberg, debuted directly on Paramount+. But films like “Top Gun: Maverick” would in normal times hope to approach as much as $1 billion in worldwide box office.

Universal's “F9" has grossed more than any other movie during the pandemic, with more than $700 million in ticket sales. But most of its receipts came before the delta variant surge. Paramount's “A Quiet Place Part II," one of the first tentpoles to wade into theaters earlier this year, took in close to $300 million worldwide.

Hospitals being pushed to the brink of capacity are looking for ways to decompress as the delta-driven COVID-19 surge shows no signs of backing down.

“It's taking a toll, it is causing a lot of strain on the caregivers and the ability to give that care,” said Ohio Hospital Association spokesman John Palmer.

Palmer said physical hospital beds are not the most pressing issue to reducing capacity.

“We have facilities and equipment to help accomplish that, but at the end of the day, the health care is delivered by the caregivers,” Palmer said.

Hospitals are looking for any way to decompress.

“Elective procedures, those surgeries that can be safely moved or rescheduled, whether that’s a couple of days, a couple of weeks, hospitals are starting to look into those opportunities,” Palmer said.

TriHealth is using the method saying it’s “proactively scheduling fewer elective surgeries each day that require inpatient stays.”

St. Elizabeth is among the hospitals now treating some COVID-19 outpatients with monoclonals.

“Because of our ability to treat outpatients with monoclonal antibodies I think we are seeing a decline in terms of our total inpatient escalation,” said St. Elizabeth Dr. John Horn.

Video above: Oregon to require school employee vaccinations

With an alarming rise in COVID-19 cases and hospitalizations, more Americans have recently made the decision to get vaccinated than in the last six weeks.

More than 1 million doses of the vaccine were reported administered Thursday, new U.S. Centers for Disease Control and Prevention data showed, marking the first time since early July for the single-day change in reported doses. The average pace of those initiating vaccination is more than 70% higher than one month ago.

Oklahoma and Louisiana — two states that have lagged the rest of the nation in vaccinations — are now outpacing the national average, White House COVID-19 Response Team Chief of Staff Asma Mirza said in calls with local faith leaders Thursday.

"We're seeing a new willingness, a new openness to getting vaccinated," she said in a discussion with Louisiana faith leaders.

The boost in vaccinations, however, comes as more health care systems are reporting an increasingly dire situation, with an influx of patients flooding waiting rooms due largely to the spread of the more infectious delta variant.

And because it takes weeks to gain immunity following full vaccination, even those beginning their inoculations need to remain cautious against infection.

Dr. Robert Jansen, chief medical officer at one of Atlanta's largest trauma centers, Grady Health System, said it was seeing a "tsunami of patients coming into the emergency department."

The situation is also critical in Texas, where Gov. Greg Abbott announced the state will deploy additional medical personnel to hospitals across the state.

Lauren Meyers, director of the University of Texas COVID-19 Modeling Consortium, warned that hospitals are at a "breaking point."

"We are sort of in a very dire situation in Austin," Meyers said.

The rate of hospitalizations is still below pandemic highs seen in January, CDC data shows. But at the current pace — an average of more than 11,000 new hospital admissions for COVID-19 over the past week — the U.S. might reach a record high within a month, the CDC said.

Preventative vaccinations are the most effective means to combat COVID-19 infections, and the Food and Drug Administration will likely approve the Pfizer/BioNTech vaccine around the end of August, former FDA Commissioner Dr. Mark McClellan said Thursday. Current vaccines have been granted emergency use authorization.

"I think that approval, at least for the Pfizer vaccine, is going to come very soon -- probably by the end of the month or right around there," McClellan told CNN.

Booster shots for those inoculated are expected to be made widely available by Sept. 20, and about 75% of the eligible population will have received at least one dose of COVID-19 vaccine at current vaccination rates, according to a CNN analysis of CDC data.

Around 51.1% of the total U.S. population is fully vaccinated, according to the CDC.

Vaccine requirements beginning to take shape

With the efficacy of vaccines continuously proven in keeping recipients out of hospitals, more jurisdictions nationwide are taking steps requiring employees to be inoculated, barring medical or religious exemptions.

Massachusetts Gov. Charlie Baker issued an executive order Thursday that will require approximately 42,000 executive department employees to provide proof of vaccination by mid-October or face possible termination, according to a spokesperson.

In New Orleans, all city employees and public-facing personnel will need to submit proof of vaccination or receive routine Covid-19 testing starting Aug. 30, according to Mayor LaToya Cantrell.

The mayor's office said the additional step was taken "to protect residents, City employees and public-facing contracted personnel from the COVID-19 outbreak, and more recently the Delta variant outbreak in Orleans Parish."

In Oregon, all K-12 teachers, educators, staff and volunteers at schools — both public and private — will need to be fully vaccinated for COVID-19 by Oct. 18 or six weeks after full FDA approval, Gov. Kate Brown announced at a press conference Thursday.

Brown's announcement came as the chief physician executive at St. Charles Hospital, in Bend, Oregon, said hospitals are in crisis.

"Our frontline health care workers that have been caring for patients every day are exhausted," Dr. Jeff Absalon said. "They're burned out. And we're in a pandemic that many of us regard as largely preventable."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN Thursday that vaccine requirements at schools is a sound strategy to create a safe environment.

"One of the most important ways is to surround the children with people who are vaccinated, if they're eligible to be vaccinated — and that means teachers and personnel in the school," Fauci said.

'This is not an adult disease anymore'

With schools back in session, local officials are faced with deciding whether to mandate masks in classrooms, plus the day-to-day challenges of quarantining students exposed to COVID-19.

Legal battles over mask mandates continued Thursday in Texas, as the state Supreme Court refused Gov. Abbott's request to quickly intervene over some local jurisdictions' decision to require masks in schools.

Dr. Sara Cross, a member of the COVID-19 task force for Tennessee's governor and an infectious disease specialist at the University of Tennessee, said bans on mask mandates would have "catastrophic consequences" for those in classrooms.

"When one child doesn't wear a mask, it doesn't only affect that child. It affects the entire classroom. It affects teachers. We just had a teacher in the Memphis area, a 31-year-old woman, die of Covid in the past few days from acquiring it in the classroom," Cross told CNN on Thursday.

"We can't handle what we're seeing. We are estimating that the number of cases in Tennessee will increase six-fold by the end of September if we don't take measures to mitigate the spread," Cross said.

"This is not an adult disease anymore," Cross said, saying the pediatric hospital in downtown Memphis "currently has at least 9 children in the ICU from COVID-19."

At least 15 states have temporarily or indefinitely required K-12 students to wear masks in schools, according to a CNN analysis, with some provided exceptions: California, Connecticut, Delaware, Hawaii, Illinois, Kentucky, Louisiana, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Virginia and Washington.

Related video above: Louisiana doctors train with nurses to help with staff shortages

With the spread of the more dangerous and transmissible delta variant as well as lagging vaccination rates, states such as Texas are in the midst of a surge in COVID-19 cases that quickly halted a summer of reopenings.

And as Texas faces another rise in hospitalizations approaching a peak witnessed during the 2020 holiday season, officials are concerned over health care worker shortages.

Texas Gov. Greg Abbott announced that more than 2,500 medical personnel will be deployed to hospitals around the state to care for an increasing number of COVID-19 patients.

"The State of Texas is taking action to ensure that our hospitals are properly staffed and supported in the fight against COVID-19," Abbott said in a news release Wednesday. Details on where the additional medical staff were coming from, or where they would be deployed, have yet to be revealed.

There are only 368 ICU beds currently available throughout the state and 10,463 lab-confirmed COVID-19 patients in hospitals across the state, according to state health data Wednesday. Finding people to administer these beds is becoming increasingly difficult.

Dr. Esmaeil Porsa, president and CEO of Harris Health System in Houston, told the Texas Senate Committee on Health & Human Services on Tuesday that health care employees are "tired, overworked and constantly under siege."

Citing long work hours, constant exposure to COVID-19 infection, and yet another surge of patients who are generally sicker and require more attention, Porsa said staffs are reaching critical shortages that are difficult to fill.

"I have lost staff to fatigue and retirement," Porsa said, adding that one area hospital had 25% of its ICU beds unavailable because of staffing issues.

"I always see the silver lining, but I am frightened by what is coming," Porsa said.

It's not just that the hospitals are full, Porsa said Thursday morning.

"What is concerning is the rate by which our COVID-positive patients are increasing," Porsa told CNN's Brianna Keilar. It took only five weeks for the hospital system to go from a baseline of 11 patients to its peak recently, compared to the three months it took during the winter surge, he said.

"If this continues to go at the rate that it is right now — and again, I emphasize that I don't see any intervention, any mitigating interventions being put in place to try to slow this down — this would be a disaster."

Health care systems strained

Because hospitals are filling up and there is less staff available to intake patients, a bottleneck effect is compounding ambulance availability, creating "risks for delays in emergency response to the next call in our community," Houston Fire Chief Samuel Peña said.

"In an EMS system as busy as Houston's, detention of EMS crews at the hospitals will result in increased response times for the entire system," Peña told CNN on Wednesday, noting that ambulance crews are waiting more than an hour at hospitals in some instances.

The fire chief said strategies such as utilizing COVID-19 tents would be beneficial in relieving the bottleneck at hospital emergency departments.

The Lyndon B. Johnson Hospital that set up tents to handle the overflow of patients recently had 130 patients in its waiting room, which is designed to hold at most 70, Porsa said.

"The idea of the tent is that as people screen positive for COVID-19, we can send them to the tent for them to continue their diagnostics and treatments until they figure out what to do with them," he said.

When asked about comments he made to CNN affiliate KTRK regarding a patient left on a stretcher inside an ambulance for five and a half hours waiting for a hospital bed, Peña said the patient was a man in his 60s who was in stable condition.

"He was evaluated at the hospital by medical staff, including blood lab tests and X-rays, all while on our ambulance stretcher because there was no room available for the patient to be transferred to. The patient's symptoms/chief complaint resolved sometime after the physical assessment at the hospital. So for many hours he was stable and symptom-free, but still on an emergency ambulance stretcher," he said.

"Keeping a patient on an ambulance stretcher and an ambulance unit out of service for this long is not acceptable. This is not good for the patient, it is not good for our ambulance crews and it is not good for our community," he said.

Peña says his message to the community is that anyone who can get the COVID-19 vaccine should do so immediately.

"The vaccine will help protect the recipient and help reduce the stress on local hospitals. People who are hesitant to get the vaccine due to any comorbidities should consult their primary care physicians for advice," the fire chief said.

But because it takes weeks after inoculations to gain full immunity, Porsa said in his Senate testimony that even in the rosiest of scenarios, the surge is likely to continue in the near future and immediate measures must be taken.

"Even if the entire population of Texas got vaccinated today, we do not really, logically expect any impact on the numbers a month from now," Porsa said. "There is no way my hospital is going to be able to handle this. There is no way the region is going to be able to handle this."

State vs. local control over masks intensifies

While experts say that vaccinations are the key to controlling the pandemic and lessening hospitalizations over time, other mitigating actions such as widespread mask-wearing can help stop the spread of COVID-19. Yet mandates have been fiercely rejected by Texas state leaders opposing local control and decision-making.

Gov. Abbott and state Attorney General Ken Paxton filed a petition on Wednesday attempting to block a Dallas County mask mandate issued for schools and businesses.

Judge Clay Jenkins' emergency order, Abbott and Paxton say, violates the governor's latest executive order on COVID-19 which says that no governmental entity, including school districts, could require mask-wearing.

"Attention-grabbing judges and mayors have defied executive orders before when the pandemic first started, and the courts ruled on our side — the law. I'm confident the outcomes to any suits will side with liberty and individual choice, not mandates and government overreach," Paxton said.

Abbott and Paxton's statement doesn't mention San Antonio and Bexar County, who have been granted a temporary restraining order against the governor's mask order and announced their own mask mandate, or Houston's Fort Bend County, which announced Wednesday a temporary restraining order of their own.

"The virus is not a political issue, and it's not an issue that we can resolve by way of ignoring it, and following GA 38 (Abbott's mask order) would have had the local officials here in Fort Bend County ignoring the virus," Fort Bend County Attorney Bridgette Smith-Lawson said after a judge granted their emergency health directive request.

With COVID-19 cases and hospitalizations increasing in communities with low vaccination rates, an expert says Americans face a choice: get vaccinated or continue dealing with the impacts of the pandemic.

"We can't have it both ways; we can't be both unmasked and non-socially distant and unvaccinated. That won't work," Dr. Jonathan Reiner, a CNN medical analyst and professor of medicine and surgery at George Washington University, said Monday.

COVID-19 cases rose a sharp 47% over the past week as the more transmissible delta variant spread, but not all communities were impacted equally.

About a third of the nation's cases came out of five states, Florida, Louisiana, Arkansas, Missouri and Nevada, Reiner said. And impacts were felt most among the unvaccinated. Of all the deaths from the virus in June, more 99% were among unvaccinated people, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said.

"We have to pick sides and the side is we need to be vaccinated," Reiner said. "We have the tools to put this down — we can put it down this summer — but the way to do that is vaccination."

To get more Americans vaccinated, officials will need to address the reasons behind some of the population's hesitancy.

For some, it is that the vaccines have not been fully approved, which Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN is only a matter of time. And for some, political divide has inhibited vaccinations, but Reiner emphasized that with more than 600,000 Americans dead, it is the virus that should be seen as the enemy, not vaccines.

In Arkansas, which has one of the lowest vaccination rates in the U.S. at 35% according to CDC data, Little Rock Mayor Frank Scott Jr. said he, as a Black man, was skeptical of getting a vaccine, but now wants to lead the way to ensure all residents get the shot.

"It's serious and we should not have to allow someone to die for us to really believe the research and science. What we continue to do is go by data-driven policies and research and all that we do in our administration, and this is just another way to continue to do that because, again, this saves lives," said Scott.

'Nothing changed' after Pfizer booster meeting

Federal health officials met with vaccine maker Pfizer/BioNTech Monday to discuss if and when a booster shot for its COVID-19 vaccine might be needed.

Pfizer presented data to federal health officials for about an hour, suggesting boosters may soon be needed to sustain COVID-19 protection, but Fauci told CNN after the meeting, "Nothing has really changed."

He said based on the present data, federal health agencies, like the CDC and U.S. Food and Drug Administration, are not ready to recommend a booster.

"We made it very clear that their data is part of a much larger puzzle," Fauci told CNN.

The meeting came after Pfizer said last week it is seeing waning immunity from its coronavirus vaccine and is picking up its efforts to develop a booster shot to protect people from variants.

Pfizer emphasized in a statement Monday that it will be publishing "more definitive data in a peer-reviewed journal and continuing to work with regulatory authorities to ensure that our vaccine continues to offer the highest degree of protection possible."

The message Fauci hopes the public will take away from the meeting, he said, is that discussion of boosters does not mean current vaccines are not offering sufficient protection against the virus.

"What we are talking about is not necessarily how good they are, because they are unquestionably terrific," he said. "It's the durability of the response that's in question, which is a perfectly reasonable thing when you are dealing with a vaccine.

"We don't know how long that extraordinarily high degree of protection is going to last and that's what we're talking about."

Boosters aren't recommended now, but that doesn't mean they will not at some point be advised for the entire population or for specific, vulnerable groups, he said.

For example, Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said Monday it was surprising that there was no discussion during the briefing about boosters for immunocompromised people.

A 'tidal wave' coming toward unvaccinated Americans

The rate of infection among unvaccinated Americans is so much higher, CNN Medical Analyst Sanjay Gupta said Monday, that America will soon more from a divide between vaccinated and unvaccinated populations to vaccinated and infected.

Dr. Howard Jarvis, an emergency medicine physician in Springfield, Missouri, told CNN on Monday that his sick patients are all unvaccinated.

"If they're sick enough to be admitted to the hospital, they are unvaccinated. That is the absolute common denominator amongst those patients," he said. "I can see the regret on their face. You know, we ask them, because we want to know, are you vaccinated? And it's very clear that a lot of them regret (not being vaccinated)."

In St. Louis County, Missouri, officials said new cases have increased by 63% over the past two weeks, and County Executive Sam Page said, "a tidal wave is coming towards our unvaccinated populations."

COVID-19 related hospital admissions rates increased by 36% over the past two weeks in the St. Louis metro area, according to a report from the St. Louis County Public Health Department.

"This variant is spreading quickly, and this variant has the ability to devastate those in its wake, and that is why it is so critical to get vaccinated now," Page said.

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."

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Tom Murphy contributed to this report from Indianapolis.

WASHINGTON, D.C. — Massive spring break crowds, states ending mask mandates, and the loosening of other COVID-19-related restrictions: all are playing a part in the country’s latest climb in COVID-19 cases.

“In fact, we have settled at a very high level of daily deaths, nearly 1,000, and now, we're starting to see cases go up again and starting to see hospital admissions go up again,” said Dr. Vivek Murthy. “This is deeply concerning because every time we've seen it in the past, it's led to another surge."

More than 30 million people in the U.S. have been diagnosed with COVID-19 since the pandemic began last year. After cases declined in February, just in the past two weeks, there was a 20 percent jump in the daily number of COVID-19 cases, an average of 66,000 new cases every day.

“A fourth wave may be imminent,” said George Washington University’s Dr. Amanda Castel, who is an infectious disease epidemiologist.

Dr. Castel said spring break revelers, as well as gatherings and travel from the Easter and Passover holidays, could be tough on the nation’s COVID-19 response in the next few weeks, potentially spreading more mutations of the virus, known as variants.

“It's really important to note that we also do very limited surveillance for the variants in the United States. So, what we're seeing is really just the tip of the iceberg,” Dr. Castel said. “And we know that certain variants, like the U.K. variant, are more easily spread from person to person and may potentially lead to more severe infections.”

Beyond April looms another holiday, Memorial Day, that Dr. Castel says could lead to a potential uptick in COVID-19 cases and a possible fifth wave. She said what happens will depend on how many people get vaccinated by then.

“That's why it's so critical that we need to encourage people to get vaccinated as soon as possible, because we really are in a race, essentially, between the variants and vaccination," Dr. Castel explained.

It’s a race where the finish line hasn’t been crossed yet.

At least 21 states have recorded at least a 10% rise in daily average positive cases of COVID-19, according to Johns Hopkins University data Thursday, demonstrating that the fight against the pandemic is far from over.

In Michigan, hospitals are increasingly overwhelmed and reaching full capacities in part due to the influx of new coronavirus cases. State and local officials across the country are attempting to avoid a similar situation and are pushing to increase vaccination levels among adults, which shows continuing signs of improvement.

More than 30% of U.S. adults have been fully vaccinated, according to the most recent data from the Centers for Disease Control and Prevention and a CNN analysis has some states being able to vaccinate all willing adults by June.

However, between varying rates of vaccine hesitancy and the pace of vaccinations, the timeline for vaccinating all willing adults varies greatly among states — a growing concern because, for some locations, a new surge may have arrived.

"We have knocked down this virus already three times, but we have to knock it down a fourth time," Washington Gov. Jay Inslee said Thursday, as the state's infection numbers have increased again.

In order to prevent a new surge as well as the spread of COVID-19 variants that may be more infectious, health experts continue to recommend mask-wearing, social distancing, and above all else, vaccination.

"The vaccines have saved thousands of lives already," Emory University executive associate dean of medicine Dr. Carlos del Rio told CNN. "We've seen mortality in the U.S. decline despite cases going up, and that's because we're vaccinating people."

Dr. Kawsar Talaat, an infectious disease physician and assistant professor at Johns Hopkins Bloomberg School of Public Health, told CNN on Thursday that while the Centers for Disease Control and Prevention data has shown that vaccines cannot fully prevent all COVID-19 infections, such "breakout" cases are rare. Widespread vaccination means that less virus is circulating and there is less opportunity for exposure.

"That's the whole point of getting to herd immunity," Talaat said. "Because once we get to a point where enough people in the community are vaccinated, then if somebody develops COVID in that community, the people around them are protected and it's much harder for that person to spread the virus to somebody else, and therefore the transmission stops."

While more than 78% of those ages 75 and up have received at least one dose of vaccine, the percentage of those vaccinated ages 18-29 is at roughly 25%, CDC data shows. And young and relatively healthy people who have had COVID-19 before should still get a vaccine to prevent reinfection, according to research published Thursday in the journal Lancet Respiratory Medicine.

The effect of rising infection rates is being felt on a local level. Ohio Gov. Mike DeWine said Thursday that although more than 36% of residents have received at least one dose of vaccine, hospitalizations are increasing.

"It's a lagging indicator, so not a direction that we want to be going," DeWine said.

"We just have to keep going," DeWine said. "We know how to get out of this. You know, this is not five months ago, four months ago, we know how to get out of this, and we have the tool to get out of it. We just have to use the tool and we've got to use it every day. And that is vaccinate."

States push to get ahead of rising infections

Nationwide, states are racing to inoculate as many residents as possible.

"We know that these vaccines are really responsible primarily for the 90% reduction in deaths we've seen over the first 13 weeks of 2021," Dr. Clay Marsh, West Virginia's COVID-19 czar, said Thursday.

Aware that transportation can be a barrier for some, Rhode Island announced that free public transit trips to and from vaccination appointments will be available starting Monday.

"This is a big win for Rhode Island's vaccination efforts," Gov. Dan McKee said. "I hope that no-cost trips will enable everyone who wants to get to a vaccine clinic to get there easily."

News coming out of several states was cautiously optimistic, as Pennsylvania, Kentucky, Connecticut and Georgia all highlighted increases in vaccination numbers.

New York reported its lowest number of hospitalizations since Dec. 1 and that more than half of New York adults had received at least one dose of a vaccine, according to Gov. Andrew Cuomo's office.

Citing a 95% drop in the daily average of deaths in the state, New Hampshire Gov. Chris Sununu announced that a mask mandate set to expire Friday will not be renewed.

"The lifting of the mandate does not diminish the importance of wearing a face mask," Sununu said, noting that numbers remain high across the state. "We ask that people continue to take steps to protect their own health, the health of their family and friends, and the health of their community."

Johnson & Johnson vaccine side effects are investigated

As vaccine distribution continues, the Johnson & Johnson vaccine remains paused.

A severe form of blood clot in the brain known as cerebral venous sinus thrombosis may be linked to the vaccine, yet the occurrence rate is rare. So far, only six cases have been reported in the U.S. out of the approximately 7 million doses administered to date. One person died and another is in critical condition, an FDA official said Tuesday.

One of the six cases involved a 26-year-old Pennsylvania woman, according to the state's department of health, which recovered after receiving treatment at a hospital. The state, which is pausing J&J distribution until April 24, said that federal oversight of vaccine safety is functioning as intended.

"The safety procedures built into the vaccination process are working and should instill confidence in the safety and effectiveness of the available COVID-19 vaccines," Pennsylvania Acting Secretary of Health Alison Beam said. "I urge individuals who have appointments scheduled to receive a Pfizer or Moderna vaccination to keep those appointments."

After the CDC and the Food and Drug Administration recommended a pause on Tuesday, the CDC's Advisory Committee on Immunization Practices met Wednesday without voting on taking any further action, stating that more information is needed, and vaccine advisers to the CDC have scheduled a meeting for April 23 to determine whether additional intervention is required.

"Hopefully, we'll get a decision quite soon as to whether or not we can get back on track with this very effective vaccine," Dr. Anthony Fauci told a Congressional hearing Thursday.

In response, Johnson & Johnson decided to pause vaccinations in all of its clinical trials while the company updates "guidance for investigators and participants," according to a news release posted Tuesday afternoon.

Recipients of the vaccine who develop a severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination should contact their health care provider, the CDC and FDA said.

For those that received the J&J vaccine more than a month ago, the risk is "very low," said CDC principal deputy director Dr. Anne Schuchat during a virtual briefing on Tuesday.

Dr. Raul Magadia and his team all gathered in the basement of their Anniston, Alabama, hospital last month for a big announcement he was preparing to make through the intercom system.

That system is usually reserved for emergency codes.

But Magadia, an infectious disease specialist at the Northeast Alabama Regional Medical Center, had other plans on May 25.

He was about to share that in a few minutes the hospital would discharge the last Covid-19 patient from their COVID-19 unit. It was a surreal milestone, he later told CNN, for staff who have been on the front lines of the battle against the virus for more than a year.

"We were really aiming for some good news after 13, 14 months of horrible news," Magadia said. "That moment ... that we had zero (patients), it's an unbelievable feeling."

On the other side of the country, inside the Zuckerberg San Francisco General Hospital, similar celebrations took place in late May after hospital staff announced they had no COVID-19 patients — for the first time since March 2020.

"It's incredibly hopeful for us," said Dr. Susan Ehrlich, the hospital's CEO. "It was a very fatiguing year and a half, very stressful."

Both facilities say they have since seen several COVID-19 patients — but numbers remain so low they don't compare to the harsh peaks they experienced over the winter.

Across the United States, other hospitals have welcomed similar milestones in recent weeks, which health experts largely credit to COVID-19 vaccinations.

A Utah hospital said in mid-May they had no COVID-19 patients for the first time in more than 430 days, calling the news a "welcomed light." Shortly after, a Minnesota hospital said it was shutting down its COVID-19 unit following a gradual decrease of patients. In Connecticut, one hospital recently saw its COVID-19 patients drop to one.

More than 22,400 Americans are hospitalized with COVID-19 nationwide, according to data from the Department of Health & Human Services. That's more than an 83% decrease from the country's peak in early January, when more than 136,000 Americans were hospitalized with the virus.

But with uneven vaccination rates across the U.S., some hospitals are still struggling amid recent upticks in COVID-19 patients — almost all of whom are unvaccinated — and worry about another surge fueled by summer gatherings.

It's what concerns Magadia as well.

"It's really looking good. We're seeing the light at the end of this long, long tunnel, but we're not quite out of the woods yet," he said.

Some hospitals still see surge of patients

Late last month, the University of Kansas Health System recorded several days with only one or two COVID-19 patients. That's a far cry from early December, when staff were treating more than 200 COVID-19 patients, according to Dr. Steven Stites, the chief medical officer.

"We had COVID-19 patients everywhere," he said. "That was clearly the worst, darkest days of the pandemic for us."

Now, those who are getting hospitalized because of the virus have not been vaccinated, Stites says.

"If you're here sick with Covid, you've not been vaccinated," he said. "We've had one person who had been vaccinated that I can think of off the top of my head."

It's a pattern other hospitals have noted, too. In Alabama, Magadia said close to 95% of patients hospitalized because of COVID-19 since vaccinations began have been unvaccinated.

"It's really a compelling point that vaccines work," Magadia said.

In central Oregon, Dr. Jeff Absalon, the chief physician executive for the St. Charles Health System, said they are still "in the middle of a surge of Covid patients." Roughly 98% of hospitalized COCID-19 patients since March have been unvaccinated.

"We have spent a few weeks near our highest point recently," he said. "We're still in the thick of the pandemic."

Absalon is not sure why the numbers remain high.

Local leaders have continued to push vaccination efforts, but Absalon suspects the recent uptick may be due to increased community transmission among unvaccinated crowds as the weather warms up as well as due to the frequent tourists traveling to the area.

He says they are also testing current COVID-19 patients for variants of the virus.

"Our vaccination rates in our county are quite good but, with all that being said, we're clearly not at a herd immunity level," he said.

Younger Americans hospitalized

Wyoming, which has one of the lowest COVID-19 vaccination rates in the U.S., recently saw hospitalization numbers climb again, state data shows.

Dr. Jeffrey Chapman, chief medical officer at the Cheyenne Regional Medical Center in the southeastern part of the state, says he and staff members are worried over a recent rise in COVID-19 patients.

"When we see literally numbers doubling and tripling in a week, we get scared," he said.

With lower age groups lagging in vaccination numbers, the hospital's COVID-19 patient demographics have shifted younger.

"Two-thirds of the people we have in the intensive care unit ... are 50-60, whereas in the past, it was almost all 70s and 80s," Chapman said. "And we've actually seen a small number of pediatric patients, which we haven't seen for quite some time."

"So I think one can postulate that, because younger age groups are vaccinated at a lower frequency ... we're seeing more people at a younger age that are requiring hospitalization," Chapman said. "Can I say association? Yes. Can I say causation? I don't have absolute data to back that up, but I don't think it's unreasonable to say that."

Older Americans, who were prioritized for shots, have some of the highest COVID-19 vaccination coverage numbers. As a result, parts of the country have reported their COVID-19 patients have skewed younger, to crowds that aren't vaccinated.

But now that vaccines are widely available, U.S. officials have stressed the importance of younger groups getting their shots, too — both for their own safety and to help their communities suppress the spread of the virus.

And a recent increase in COVID-19 hospitalizations among people 12 to 17 reinforced the importance of vaccinations as well as prevention measures against the virus, according to a study released Friday by the Centers for Disease Control and Prevention.

"In the month leading up to the recommendations of the Pfizer COCID-19 vaccine for teens and adolescents 12 and older, CDC observed troubling data regarding the hospitalizations of adolescents with Covid-19," CDC Director Dr. Rochelle Walensky said during a White House COVID-19 briefing.

"More concerning were the number of adolescents admitted to the hospital who required treatment in the intensive care unit with mechanical ventilation," Walensky said, adding the data "force us to redouble our motivation to get our adolescents and young adults vaccinated."

'Post-Covid stress disorder'

As hospitals continue to treat COVID-19 patients, one of the biggest challenges they're facing is exhausted, emotionally overwhelmed staff.

In Kansas, Stites said there is underlying fatigue and mental and physical exhaustion.

"There's just been a lot of pain and suffering amongst healthcare personnel" who often were the last ones to see a COVID-19 patient alive and had to communicate the bad news to families, he said. "I think that there is a scar, there is a wound that is deep in your mental psyche about what this disease really means."

It's somewhat of a "post-Covid stress disorder," he said.

"This is having a personal toll on the people that are committed to helping others," Absalon, in Oregon, said. "One of the things that's particularly difficult right now is that they're taking care of people that have chosen not to be vaccinated. And it's very heartbreaking to see that at this point in the pandemic a lot of what we're seeing in the hospital is preventable."

In Wyoming, Chapman looks at the hospital's COVID-19 patients every morning and every night to ensure they're prepared for another surge.

"I don't want to see people get sick, and I don't want to see people die, so that's part of my anxiety. What can I do to stop this?" he said. "I personally believe the vaccine is the answer to that."

Video above: FDA says Johnson & Johnson COVID-19 vaccine risk is low

After several weeks of reporting concerning COVID-19 case increases, a leading health official says the U.S. could be starting to see a hopeful trend.

The country's seven-day average of new reported infections is going down, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said during a White House COVID-19 briefing on Friday.

But what's concerning officials now, Walensky said, are the "unsettling gaps" in COVID-19 vaccine coverage in different parts of the country.

"Some areas are doing very well with greater than 65% coverage for those over the age of 65... but many areas have far less coverage, less than 47%," she said. "Because this virus is an opportunist, we anticipate that the areas of lightest vaccine coverage now might be where the virus strikes next."

Experts have stressed for months that the best way Americans can protect themselves -- and their communities -- is through COVID-19 vaccinations which can, when enough people are vaccinated, suppress the spread of the virus.

"I think it's really important to understand that vaccines work best at a population level, not at the individual level," infectious diseases specialist and epidemiologist Dr. Celine Gounder told CNN on Saturday. "If you're in a community that is swimming with virus, 95% reduction is good, but you're still at risk."

"Really the best way to reduce the risk for all of us is for as many people to get vaccinated as possible," Gounder added.

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Reports warn of vaccine 'tipping point'

In parts of the country, some local officials are reporting drops in demand for COVIID-19 shots.

And in just a few weeks' time, the U.S. could hit a "tipping point" on vaccine enthusiasm and supply will likely outstrip demand, a Kaiser Family Foundation report said.

"Once this happens, efforts to encourage vaccination will become much harder, presenting a challenge to reaching the levels of herd immunity that are expected to be needed," the report said.

So far, roughly 41.8% of the U.S. population has received at least one dose of a COVID-19 vaccine, CDC data shows, and about 28% of the population is fully vaccinated.

Some experts, including Dr. Anthony Fauci, have estimated somewhere between 70% to 85% of Americans need to have immunity to the virus -- either through vaccination or previous infection -- to control its spread.

Behind the slowing vaccine demand are several factors, experts say, including vaccine hesitancy.

In their latest COVID-19 briefing, the University of Washington's Institute for Health Metrics and Evaluation wrote that the "slow erosion of vaccine confidence unfolding over the last two or more months is cause for concern."

"Facebook runs a survey every day, and we look at that data on a daily basis and that's shown that vaccine confidence in the U.S. has been slowly but steadily going down since February," IHME Director Dr. Chris Murray told CNN on Friday.

"There's a lot of people out there, and it's a growing fraction of people, who are not sure they want to get the vaccine, and that's really important that we overcome that," he added.

COVID-19 vaccinations declined last week

Some officials worry the recent recommended pause on the Johnson & Johnson COVID-19 vaccine could have also further fueled hesitancy.

The CDC and the Food and Drug Administration lifted that pause recommendation on Friday, saying the vaccine label will be updated to warn of blood clot risks.

"We have concluded that the known and potential benefits of the Janssen COVID-19 vaccine outweigh its known and potential risks in individuals 18 years of age and older," acting FDA Commissioner Dr. Janet Woodcock said in a statement.

The administration of the J&J vaccine can resume "immediately," Walensky said Friday.

The pause contributed to a decline in the total number of Americans who got vaccinated last week, the CDC's Dr. Amanda Cohn said Saturday.

"Last week was the first week that we saw a decline in vaccination, in terms of the total number of people who got vaccinated over the course of the week, and there is clearly the contributory factor of the pause in the J&J vaccine," Cohn said.

In a statement on Saturday, New York Gov. Andrew Cuomo announced the state would immediately resume administering the J&J vaccine at all state-run sites.

"The vaccine is the weapon that will win the war against COVID and allow everyone to resume normalcy, and we have three proven vaccines at our disposal," the governor said in a statement. "The sooner we all get vaccinated, the sooner we can put the long COVID nightmare behind us once and for all."

New Jersey's top health official also recommended that the state resumes administering the single-shot vaccine.

The United States is ranked number one in the world for pandemic preparedness, according to the Global Health Security Index. Still, hospitals and medical professionals are in dire need of personal protective gear, ventilators and beds as a looming surge in patients draws near.

Some hospitals are as ready as possible, but it’s unclear if even the best can handle what’s to come.

In the nation’s third largest city, Rush University Medical Center is one hospital tower built to handle disaster.

“That includes infectious disease pandemics, like we're experiencing now. So, not just did we build the tower, but we also routinely drill on these different scenarios,” says Paul Casey, Rush’s chief medical officer.

Constructed after 9/11, Rush’s CEO, Dr. Omar Lateef, says the facility was designed to handle mass casualty incidents, and now, it could be a model for epidemic response.

“Many of the same features of the building make it a building structured to treat highly contagious infections,” says Lateef.

The hospital has the ability to quickly ramp up to 130 percent capacity. Intake and extra beds can be added within minutes and are already on deck.

“We are essentially extending our emergency department into our ground floor pavilion area,” says capital projects construction manager Angela Tosic.

The ambulance bay area has been transformed into a triage area. They are converting spaces into what are known as “negative pressure” units that help to prevent cross-contamination.

“We can take entire quadrants of the building flip switches and make them negative pressure,” explains Lateef. “We can take massive areas of the building that when we built them are nice hallways but secretly inside the columns are oxygen dispensers.”

The incident command center is at the heart of the operation.

“We closely monitor both the activity of coronavirus locally, as well as our testing of coronavirus,” says Casey. “And then, we look at what's the next step that we need to be prepared to take.”

Keeping staff safe and preventing the spread of the virus is a top priority. Employees are being asked to self-monitor and check their temperature at home twice a day.

Once at work, facial recognition scanners not only confirm their identities but also take real-time temperature readings to ensure they do not have fevers.

Should staffer’s exhibit symptoms, a drive through COVID-19 testing area is already up and running.

Patients exhibiting COVID-19-like symptoms enter and are housed in a completely separate unit.

Rush says it will max out its bed capacity as much as possible but has to balance that with not running out of available staff.

“The number we have is when patients stop coming in we'll figure out a way to not turn people away,” says Lateef.