With the more contagious Delta variant of Covid-19 sweeping across the country this summer, health care workers and officials are finding themselves returning to a crisis experienced last year when hospitals struggled to handle an influx of patients.

In the Southeast, Georgia is now seeing its highest number of hospitalizations since the start of the pandemic, matching peaks experienced in January, according to US Health and Human Services Department (HHS) data.

Dr. James Black, director of emergency services at Phoebe Putney Memorial Hospital in Albany, Georgia, told CNN’s Amara Walker Saturday that his hospital nearly doubled its ICU capacity yet is still faced with an overflow of patients.

“The emergency department is full and the hospital is full,” Black said. “Anytime a patient is discharged, we have patients waiting on those beds.”

The city of Albany, located in the southwestern part of the state, had one of the worst outbreaks of Covid-19 in the country at the start of the pandemic. Now hospitalizations are eclipsing those earlier numbers, Black said, calling it “disheartening” to be faced with its return as health care workers once again are on the front lines facing daily risk of infection.

“We were frustrated, a little bit bewildered, especially given what we’ve been through at the onset of the pandemic,” Black said, also noting that Georgia trails the national average in vaccination rates.

Georgia has fully vaccinated 42.1% of its population, according to data from the US Centers for Disease Control and Prevention, while nationally, 53% of the population is fully vaccinated.

“We were a little bit kind of surprised and disappointed at the lack of turnout. So, you know, we’ve had to redouble our efforts and pick each other up and certainly, we had hoped to not be having the same discussion 18 months into it. But here we are, seemingly in worse shape overall than we were initially.”

Total hospitalizations in the US nearly tripled in July and doubled again in August, according to HHS data, but weekly national numbers only went up by 2% on Thursday, a potential sign of improvement on the horizon. But this comes as little relief to hospitals in hotspots seeing ICU beds fill up.

“We are perilously close…of having, in certain areas of the country getting so close to having full occupancy, that you’re going to be in a situation where you’re going to be in a situation where you’re going to have to make some very tough choice,” Dr. Anthony Fauci told CNN’s Jim Acosta on Sunday.

More than 102,000 people nationwide are hospitalized with Covid-19, according to HHS data Saturday, with more than 25,000 in ICUs.

“What we really should be doing, and I hope we are doing, is to do everything we can to mitigate the number of people who are getting infected and requiring hospitalization and ICU beds,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases.

In Hawaii, the state’s health department reported 13 new deaths from Covid-19 on Wednesday, its highest single-day death figure of the entire pandemic. A number of restrictions on public businesses were reinstated in August, and Gov. David Ige urged out-of-state visitors to not travel to the islands unless they had urgent business.

Kentucky Gov. Andy Beshear has called for a special session of the state general assembly to meet Tuesday regarding Covid-19, with the aim to extend the state’s declared state of emergency to January 15 and to review executive, agency and cabinet orders.

“The Commonwealth is in a state of emergency. The Delta variant is spreading at a rate never seen before — impacting businesses, shuttering schools and worse, causing severe illness and death,” Beshear said Saturday.

Officials concerned about Labor Day weekend

Given the recent surge, public health officials are also worried about Labor Day weekend and whether it could exacerbate an already dire situation.

On Tuesday, CDC Director Dr. Rochelle Walensky asked unvaccinated Americans to not travel for the holiday weekend. Those who are fully vaccinated can travel with precautions, but the current transmission rates mean they, too, should take the risk of traveling into consideration.

“I know we’re all looking forward to the long weekend,” Mayor Derek Kawakami of Kauai County, Hawaii, said in a news conference Friday. But health care workers will not be able to celebrate, he noted, “because they’re busy taking care of our sick people.”

“Now what we choose to do over the next 72 to 96 hours is going to determine a lot of within the next two to three months, on whether we start to continue to burn our hospital systems, burn out our health care workers, keep our kids in school, keep our businesses running, and moving on with moving forward and coexisting with Covid-19.”

“And while we want everybody to have a great time and I hope to see people surfing, enjoying time with their family … we want to remind people, the steps to take are simple,” he said. “Wear your mask indoors, avoid large gatherings, and if you do, do it outside.”

Less-vaccinated parts of California face ICU capacity issues

California’s San Joaquin Valley region has met the threshold to enter “surge protocols,” with less than 10% of staffed ICU beds remaining for three consecutive days, the state Department of Public Health (CDPH) announced Friday.

All general acute care hospitals in the San Joaquin Valley region with ICU bed capacity must accept transfer patients when “clinically appropriate” and directed by state health officials or the California Emergency Medical Services Authority, in an effort to find open beds for patients in the area where available.

This is the first region in the state to trigger the public health order, according to CDPH. The region, which includes 12 counties in the central part of the state, had only 9.4% of adult ICU beds available Saturday, far less than the 20% availability in Southern California and the San Francisco Bay Area.

The protocol is set to be reevaluated Thursday, according to the department.

The surge in patients hospitalized with Covid-19 in the region comes as the vaccination rate in the area lags behind the state’s more urban coastal regions.

Less than 50% of eligible residents have been fully vaccinated against Covid-19 across much of the agriculture-rich San Joaquin Valley, CDC data shows, with fewer than one-third of all residents fully inoculated in Kings County.

“While the state works to further increase the number of eligible Californians vaccinated, we must take steps to protect the unvaccinated who are more at risk of severe illness, hospitalization and death from Covid-19,” CDPH said in a statement. “This action will ensure the state’s health care delivery system is prepared and can respond appropriately.”

Vaccinations for those in schools are critical, some states say

More children have needed emergency room visits and hospitalizations in states with lower vaccination rates, according to a recent study from the CDC. And some states are working to get ahead of the latest surge by getting as many eligible people vaccinated as possible.

The state of Washington, which has an October vaccine mandate for teachers and staff going into effect, is seeing “great news” regarding youth vaccination efforts, according to state health secretary Umair Shah on Thursday. At least 41% of children between 12- and 15-years-old are vaccinated and just under half of the state’s 16- to 17-year-olds are fully vaccinated as well.

“Washington schools have the structure, protocol and people to have successful in-person education,” Shah said.

In Illinois, Gov. JB Pritzker is extending the deadline for teachers, college students and health care workers to receive a Covid-19 vaccination.

The state mandate for those individuals to have at least one vaccination dose, originally set to go into effect September 5, is being pushed back to September 19 at the request of representatives of the health care industry and education organizations.

“While hospitals and schools move forward in good faith, this extension ensures they are prepared to meet this requirement to better protect our most vulnerable residents and children who are not yet eligible to get vaccinated,” Pritzker said in a written statement Friday.

Employees will only be required to have one shot by September 19 — with a second shot within 30 days, if necessary — but those who are not fully vaccinated must be tested for Covid-19 at least once a week. Workers must provide proof of the vaccination to their employers.

Exemptions are allowed for people with a medical or religious objection to the vaccine, but those employees also must get a weekly Covid-19 test.

Northeast Georgia Medical Center critical care staff work with COVID-19 patients, Monday, Aug. 30, 2021, in Gainesville, Ga. Like most in Georgia, the hospital is experiencing a surge in COVID-19 patients as the state set a new mark for infections on Tuesday, Aug. 31. (Scott Rogers/The Times via AP)