The pandemic is ‘spiraling out of control’ due to unvaccinated people, Trump’s surgeon general says

By Travis Caldwell, Holly Yan and Dakin Andone, CNN

For anyone who loves freedom and hates mask mandates or remote learning, Dr. Jerome Adams has a blunt message: Get vaccinated.

“More mitigation is coming. Whether it’s masking, or whether it’s closures or whether it’s your kids having to return to virtual learning, that is coming,” the Trump administration official and WISH/TV Indianapolis Medical Expert told CBS’ “Face the Nation” on Sunday.

“And it’s coming because this pandemic is spiraling out of control yet again. And it’s spiraling out of control because we don’t have enough people vaccinated.”

As of Sunday, only 49.1% of Americans have been fully vaccinated, according to the US Centers for Disease Control and Prevention.

That’s nowhere near enough vaccinations to stop the spread of the Delta variant, the most contagious strain of novel coronavirus ever identified.

In 48 states, the rate of new Covid-19 cases this past week jumped by at least 10% compared to the previous week, according to data from Johns Hopkins University.

In 34 of those states, the rate of new cases increased by more than 50%.

Hospitals are filling up again with Covid-19 patients except now, patients are younger than before, said doctors in Alabama, Mississippi, Florida and Missouri.

“The thing that’s making this possible is the fact that we are dealing with the most transmissible version of Covid-19 that we’ve seen to date,” current US Surgeon General Dr. Vivek Murthy said.

So eligible Americans who want to prevent more mask mandates, business closures and a return to remote learning need to do their part and get vaccinated, said Adams, the Trump administration official.

“It’s going to help every single American enjoy the freedoms that we want to return to,” he said.

Vaccine mandates easier with FDA approval, official says

Vaccine mandates would be the quickest way to raise vaccination rates, Adams told CBS Sunday. But that won’t happen without full approval by the US Food and Drug Administration.

“If you want to get a bunch of people vaccinated really quickly, get these vaccines licensed,” Adams said. “And then you’ll see the military make it mandatory, you’ll see businesses make it mandatory.”

Each vaccine available in the United States has been authorized by the FDA for emergency use, but they have yet to be fully approved.

And the lack of full-fledged approval is contributing to vaccine hesitancy, he said.

Asked Sunday if vaccine mandates should be on the table, White House coronavirus coordinator Jeffrey Zients told CNN municipal governments and businesses should consider any strategy that would make it safe to enter their location, whether that’s requiring vaccines or negative Covid-19 tests.

But he wants the FDA to take its time to thoroughly review the applications for approval, so the public knows the agency wasn’t “bowing to political pressure.”

Dr. Doran Fink of the FDA’s Center for Biologics Evaluation and Research said last week the agency was “working as rapidly as possible” to review submissions for approval.

Zients is hopeful some approval will come sometime in August or September. President Biden last week said full approval could come before the end of August.

Pfizer/BioNTech and Moderna have started their applications for full FDA approval, while Johnson & Johnson has said it intends to file for licensure.

Immunocompromised people might be the first to get an extra dose

The Covid-19 vaccines used in the US don’t have any coronavirus in them, but they do require an immune system response to work.

So millions of Americans who are immunocompromised or take drugs that suppress the immune system might not get as much help from a vaccine as others do.

While there’s been much speculation as to whether (or when) booster shots might be needed, the CDC and the US Food and Drug Administration said this month that “Americans who have been fully vaccinated do not need a booster shot at this time.”

But that could change as the data evolves, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

If a booster dose of vaccine is needed, people with suppressed immune systems might be the first to get one, Fauci told CNN on Sunday.

Those with suppressed immune systems can include transplant patients, those undergoing cancer chemotherapy, people with autoimmune diseases and those who are taking immune-suppressing drugs, Fauci said.

Like with many other vaccines, a small fraction of vaccinated people have gotten breakthrough infections.

But more than 97% of those hospitalized with Covid-19 are unvaccinated, CDC Director Dr. Rochelle Walensky said last week.

Within the tiny percentage of US hospitalized Covid-19 patients who were fully vaccinated, a study found 44% of them were immunocompromised people.

The CDC and the FDA are “exploring multiple options” for how to make a third dose of Covid-19 vaccine possible for immunocompromised people if needed, according to a statement Friday.

“Emerging data show there is an enhanced antibody response after an additional dose of mRNA COVID-19 vaccine in some immunocompromised people,” the CDC said in a statement to CNN on Friday.

“While early data show some potential benefit to administering an additional dose, more evidence is needed to determine safety and effectiveness in immunocompromised people.”

Those who are immunocompromised and vaccinated against Covid-19 might still want to keep wearing masks, Murthy said.

Surging Covid-19 numbers

In California, San Diego County and Los Angeles County both reported their highest number of cases since February, and hospitalizations in LA County have more than doubled in two weeks. On Sunday, Los Angeles County officials said hospitalizations surpassed 700 for the first time since March.

In Florida, state health data shows that new case positivity nearly doubled in two weeks, from 7.8% the week of July 2 to 15.1%.

A total of 870 hospitalized patients were reported Sunday in Alabama, according to the state’s public health Covid-19 dashboard. Hospitalizations there have been steadily rising since early July: On July 4 there were just 213 hospitalized patients reported.

And Louisiana now has the highest increase in cases per capita in the US, state officials said Friday.

“We know that more than 80% of these are the Delta variant — that is what’s causing this surge,” Gov. John Bel Edwards said.

“And what’s enabling the surge is a very low percentage of people who have been vaccinated.”

In the rare case that a fully vaccinated person later gets infected, that infection will likely result in mild or no symptoms at all, Murthy said.

“If you do get a breakthrough infection — which itself will be unusual — it will be more likely to be mild or asymptomatic,” the surgeon general said.

The bottom line? “If you get the vaccine and still get a breakthrough infection, you are protected close to 100% from being hospitalized, getting severely sick and dying,” said Dr. Saju Mathew, a primary care physician and public health specialist.

“What more do you really want from a vaccine?”

This story has been updated with additional information about Dr. Adams

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CNN’s Melissa Alonso, John Bonifield, Elizabeth Cohen, Deanna Hackney, Chuck Johnston, Lauren Mascarenhas and Alexandra Meeks contributed to this report.