(CNN)The US is battling rising death tolls and strained hospital resources under the Covid-19 pandemic, and all that could be made more difficult by the upcoming flu season, health experts said.

“We are bracing ourselves for an awfully busy winter ahead,” Associate Dean of Public Health at Brown University Dr. Megan Ranney told CNN Tuesday.The United States is once again at a point where an average of more than 2,000 people are dying of Covid-19 every day, according to data from Johns Hopkins University.And hospitals are straining to keep up with the number of patients coming in. Staff shortages and employee fatigue in Pennsylvania hospitals have reached a point where some health systems are offering signing bonuses, loan forgiveness and other incentives to staff. And in Wyoming, nearly 100 members of the state’s national guard were activated Tuesday to assist hospitals dealing with the surge.Covid-19 cases forcing hospitals to ration care is unfair and unacceptable, expert saysCovid-19 cases forcing hospitals to ration care is unfair and unacceptable, expert saysCovid-19 cases forcing hospitals to ration care is unfair and unacceptable, expert saysAnd though it isn’t clear yet what this year’s flu season has in store, it could add additional stress to an already pressed health care system.Read More”Flu is still a killer, not as much as Covid-19, but between 12,000 and 50,000 Americans lose their lives every year from flu,” vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine Dr. Peter Hotez said.Flu numbers were actually relatively low last year, but experts said that doesn’t necessarily foreshadow how this year will turn out. “Let’s be clear on why flu cases were so low last year, it’s because we were all masked and we were all distancing,” Ranney said. “Those things are not being done anymore in the vast majority of the country.”Vaccines are the surest way to get the pandemic under control, experts have said, but rates are still lower than they need to be. About 54.8% of the US population is fully vaccinated, and over the past month, the rate of vaccination has fallen by 30%, according to data published Tuesday by the US Centers for Disease Control and Prevention (CDC).Now, health officials are asking the public to get both their Covid vaccine and their flu shot.Pediatricians recommend that both adults and children 6 months and older receive their flu vaccinations by Halloween, Dr. Flor Munoz, a pediatric infectious disease specialist at Texas Children’s Hospital, told CNN. Some vaccine clinics around the country are offering both shots — and encouraging people who come in for one to make sure they have the other.”If somebody comes in wanting the flu vaccine and they haven’t had a Covid vaccine then we can encourage them to get both, or vice-versa,” said Dr. Robert Hopkins, chief of general internal medicine at the University of Arkansas for Medical Sciences and chair of the National Vaccine Advisory Committee. If health care providers can encourage people to do both, “We potentially are going to have a greater impact on both disease prevention efforts,” Hopkins said.Doctor Delkhah Shahin checks on a 34 year old, unvaccinated Covid-19 patient at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California.Doctor Delkhah Shahin checks on a 34 year old, unvaccinated Covid-19 patient at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California.Doctor Delkhah Shahin checks on a 34 year old, unvaccinated Covid-19 patient at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California. Two-dose Johnson and Johnson vaccine 94% effective, company saysPfizer has suggested a third dose of its vaccine will boost protection for those already vaccinated, and now Johnson & Johnson has announced an extra dose of its vaccine is helpful as well.A two-dose version of the vaccine provides 94% protection against symptomatic infection, the company said Tuesday — making a two-dose regimen of J&J’s Janssen vaccine comparable to a two-dose regimen of Moderna’s or Pfizer’s.Johnson & Johnson’s single-dose vaccine was given emergency use authorization by the US Food and Drug Administration on February 27. It has been given to about 14.8 million Americans, according to the CDC.Vaccine boosters for more people are on the horizon. But the unvaccinated remain the biggest obstacle to curbing the pandemicVaccine boosters for more people are on the horizon. But the unvaccinated remain the biggest obstacle to curbing the pandemicVaccine boosters for more people are on the horizon. But the unvaccinated remain the biggest obstacle to curbing the pandemicThe company released some details of three studies looking at various aspects of its Janssen vaccine, and said that, taken together, they showed the vaccine provided long-lasting protection that could be boosted with an extra shot. “Our single-shot vaccine generates strong immune responses and long-lasting immune memory. And, when a booster of the Johnson & Johnson COVID-19 vaccine is given, the strength of protection against COVID-19 further increases,” Dr. Mathai Mammen, global head of Janssen Research & Development, said in a statement.The company’s ongoing Phase 2 trial of a two-dose regimen showed giving two doses 56 days apart provided 100% protection against severe Covid-19 and 94% protection against moderate to severe Covid-19 in the US. A second study showed people given a booster shot six months or longer after their first dose had a 12-fold increase in antibodies — compared to a four-fold increase for people who got a second dose at two months. So, protection should be stronger if people get boosters later, Dr. Dan Barouch, head of Beth Israel Deaconess’ Center for Virology and Vaccine Research, told CNN.Death rate four times higher in least vaccinated statesThe average rate of Covid-19 deaths in the 10 least vaccinated states was more than four times higher over the past week than the rate in the 10 most vaccinated states, according to a CNN analysis.In the least vaccinated states, roughly eight people out of every 100,000 residents died of Covid-19 over the past week, compared with only about two out of every 100,000 people in the 10 most vaccinated states.Covid-19 death rate more than 4 times higher in least vaccinated states than in most vaccinatedCovid-19 death rate more than 4 times higher in least vaccinated states than in most vaccinatedCovid-19 death rate more than 4 times higher in least vaccinated states than in most vaccinatedCNN used data from Johns Hopkins University and the CDC for the analysis.Less vaccinated states tend to have higher hospitalization rates, too.The latest data from the US Department of Health and Human Services shows an average of 39 Covid-19 hospitalizations per 100,000 people in the 10 least vaccinated states, nearly three times higher than the average rate of 14 per 100,000 people in the 10 most vaccinated states.The states with the lowest vaccination rates have fully vaccinated less than 45% of their residents. They are Alabama, Arkansas, Georgia, Idaho, Louisiana, Mississippi, North Dakota, Tennessee, West Virginia and Wyoming.The 10 states with the highest vaccination rates have fully vaccinated more than 62% of their residents. They are Connecticut, Maine, Maryland, Massachusetts, New Jersey, New Mexico, New York, Rhode Island, Vermont and Washington.

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https://www.cnn.com/2021/09/22/health/us-coronavirus-wednesday/index.html

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