As the COVID-19 Delta variant surges across the United States, two factors are the best protection against it: vaccination and mask-wearing. In some states, there is absolutely no mandate to wear masks. In others, vaccination rates are extremely low. In one state, both factors have caused a sharp increase in COVID-19 cases. Recently, one in five new cases across the country has been in Florida.

It is easy to forget how badly COVID-19 has savaged the United States since January 2020. Officially, America has had 35,039,644 confirmed cases, which is about 18% of the world total, despite large surges in high population countries such as Brazil, India and Indonesia. The number of U.S. fatal cases is 618,197, or about 15% of the global figure. Most of the cases came in waves. The first was in April of last year. Another occurred in late summer, and the worst just after the December holidays. A fourth wave apparently has started, and it has been particularly brutal in states with low vaccination rates, several of which have rates of little more than 40%.

At the county level across the United States, the vaccination rates in some places are even lower than 40%. These tend to be in the South, particularly Louisiana and Florida. In Holmes County, Florida, the vaccination rate is 21%. Over the past 14 days, newly reported cases per day have risen 527%. Hospitalization rates are up 81% over the same period.

Holmes County has demographics similar to those in many counties where the disease is surging. It is relatively small, with a population of 19,617. That has fallen slightly since the 2010 census. Over 86% of the population is white, above the national average. The median value of owner-occupied homes is an extremely low $92,700. Only 10.3% of residents over 25 have a bachelor’s degree. The median household income is $39,102, almost $30,000 below the U.S. figure. The poverty rate is an extremely high 20.1%.

As long as there are counties like Holmes County, COVID-19 almost certainly will spread rapidly and put people in the hospital, because so many individuals have not been vaccinated in these places.

Click here to see which city in each state has the most COVID-19 cases.

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