As the highly transmissible Delta variant sweeps across poorly vaccinated populations in the United States, a cluster of midwestern and southern states has emerged as a new center of Covid-19 outbreaks.

The news represents a potentially serious setback for the Biden administration’s efforts to contain and control the pandemic, as the Delta variant – which has wreaked havoc in the UK and elsewhere – is spreading more widely in America.

It also comes as life in much of the United States has begun to return to normalcy, with many Covid-19 restrictions lifted and the vaccination program slowing. Kansas, Oklahoma, Missouri, Arkansas, Louisiana, and Mississippi have the highest rates of Covid-19 cases in the country, but the lowest vaccination rates. Covid appears to be gaining traction in the American West as well.

Nonetheless, the overall number of new Covid-19 cases is low. Even though new infections have more than doubled in the last two weeks, they are less than one-tenth of the average daily rate at the height of the pandemic in January.

According to the Centers for Disease Control and Prevention, approximately 55% of all Americans have been fully immunized against Covid-19 (CDC). Vaccines approved by the Food and Drug Administration continue to be safe and effective against Covid-19 and its variants, including Delta. According to state officials, the vast majority of people currently hospitalized with Covid-19 are unvaccinated.

Localized outbreaks, on the other hand, highlight a growing divide in vaccine adoption among US states, as a complex set of circumstances has resulted in Republican-leaning and rural areas having lower overall vaccination rates than Democratic-leaning states.

We’ve seen how quickly those counts can rise, so we need to be cautious without panicking.

Daily vaccination rates in the United States have plummeted from an average peak of 3.4 million per day to around 432,000 per day today. Mississippi and Alabama have some of the lowest vaccination rates in the country, with only about one-third of their populations immunized. Vermont, on the other hand, has vaccinated 67 percent of its population.

According to the Kaiser Family Foundation, the difference in vaccination rates between counties that voted for Joe Biden and counties that voted for Donald Trump increased from 2.2 percent to 11.7 percent between April and July. Republicans continue to be the most anti-vaccine group in the country. States in the Midwest and South that are now experiencing a Covid-19 outbreak have long been ranked lower on a variety of health metrics.

More than 98 percent of people hospitalized with Covid-19 in Arkansas and Oklahoma in recent weeks have been unvaccinated. In Arkansas, officials are seeing an increase in the number of people in their twenties, thirties, and forties being hospitalized.

While vaccine hesitancy remains complicated, conservative lawmakers’ constant attacks on pandemic mitigation measures, whether intentional or unintentional, reinforce the false notion that Covid-19 is not as severe as public health officials warn.

Legislators in Oklahoma have introduced legislation to make school mask mandates far more difficult to implement, even though children under the age of 12 are still ineligible for the vaccine, and to prohibit vaccine mandates. As of now, most schools are on summer break, most have not eliminated mask mandates, and none require vaccines.

Tennessee lawmakers attacked the state’s top vaccine official, eventually leading to her dismissal. After politicians chastised health officials, all vaccine-related messaging was dropped, including for vaccine-preventable diseases like measles and human papillomavirus (HPV). During the pandemic, more than 30,000 families did not receive measles vaccines.

In Missouri, Republican Gov. Mike Parson slammed the Biden administration’s announcement that surge teams would assist states in vaccinating people door-to-door. The rapid spread of the Delta variant among unvaccinated populations was demonstrated in a recently released investigation into an outbreak in an Oklahoma gymnastics gym.

In an April outbreak investigated by the CDC, 47 people became ill with Covid-19. The Delta variant was found in all 21 people whose test samples could be sequenced.

85 percent of those infected did not have a Covid-19 vaccine, many of whom were adolescents who were not eligible for the vaccine at the time. The Centers for Disease Control and Prevention recommends that unvaccinated people wear masks, but the gym had poor mask adherence and ventilation. Indoor, high-intensity sports are among the most high-risk activities for unvaccinated people.