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Alabama has no available ICU beds while thousands of students quarantine in New Orleans and Florida

CNN logo CNN 8/18/2021 By Holly Yan and Madeline Holcombe, CNN
a car parked on the side of a building © WSFA

Those unvaccinated against Covid-19 aren't just risking their own health -- they're also jeopardizing medical care for others and fueling a surge that's forcing more students to quarantine, doctors say.

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

No ICU beds are left in the entire state of Alabama, the Alabama Hospital Association told CNN on Tuesday.

"We in fact are in a negative 11," Dr. Don Williamson, president of the association, told CNN affiliate WSFA. "In the Montgomery area we have eight more patients who are getting ICU care than we have designated ICU beds here. In other parts of the state, we have over 30 patients in hospitals, needing ICU care, who are not in a designated ICU bed."

Alabama has 1,557 staffed intensive care unit beds and on Tuesday, there were 1,568 patients in need of ICU care, Williamson said. 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 Hillsborough County Public Schools, which includes Tampa, were in isolation or quarantine as of Monday morning because of Covid-19 cases, according to the school district.

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 August 13 to 16 and made up of a nationally representative sample of 1,041 US adults, also found that 64% of Americans support state and local governments requiring masks in all public places.

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 US 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," CNN medical analyst Dr. Leana 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.


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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.

White House expected to share first US data on waning immunity

President Joe Biden plans to speak Wednesday about Covid-19 vaccine booster shots, according to White House press secretary Jen Psaki.

Top health officials in the Biden administration are coalescing around an agreement that most Americans should get Covid-19 booster shots eight months after becoming fully vaccinated, two sources familiar with the discussions told CNN's Kaitlan Collins.

Wednesday's planned announcement of a Covid-19 booster shot plan for the general population will include details on the first data on waning immunity among the vaccinated inside the United States, a senior federal health official tells CNN's Dr. Sanjay Gupta.

Officials have previously said they were closely monitoring such data from Israel and Europe, but had not yet seen evidence from the US supporting the need for a booster. That is expected to change in Wednesday's briefing.

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 available only for Americans 12 and older, face masks play a key role in helping children avoid the Delta variant -- and keeping students in school instead of quarantine, 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 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."

Hospitals feeling the weight of the increase

Thirty-seven 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. Florida had 170 children hospitalized with Covid-19.

Correction: A previous version of this story incorrectly listed which state had 170 pediatric Covid-19 hospitalizations. As of Monday, Florida had 170 children hospitalized with Covid-19.

a man drinking from a cup: A health care worker prepares a dose of the Pfizer/BioNTech vaccine in Lake Worth, Florida. © Saul Martinez/Bloomberg/Getty Images A health care worker prepares a dose of the Pfizer/BioNTech vaccine in Lake Worth, Florida.
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