In many rural areas, delta variant COVID-19 surge infected double the number of people

As the delta variant took off last summer across the U.S., it was the rural areas with low vaccination rates that were hit the hardest, researchers at Augusta University said.

More than 82% of those counties were rural, which likely compounds the problem, said Dr. Neil J. MacKinnon, AU's provost.

"Vaccination rates are lower in rural America. And on top of that they also have reduced capacity to deal with it," he said, in terms of health care resources.

As Georgia and Augusta appear to be emerging from the omicron surge, recognizing the lack of resources in those areas that contributed to worse outcomes is important the researchers said.

Vaccination rates were as low as 26% in Screven County and 34% in Richmond County during that delta surge and Fulton County was one of the few areas to reach 50%, according to an analysis by the Augusta Chronicle. Screven has since increased to 49%, Richmond to 42% and Georgia overall has achieved 55% fully vaccinated, the analysis found.

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The improved vaccination may be one reason Augusta hospitals are finally starting to see their cases dwindle this week as community transmission of COVID-19 declines in most area counties for a fourth straight week. University Hospital saw its COVID-19 patients dip to 99 after beginning the week at 126 and hit 144 two weeks before, according to spokeswoman Rebecca Sylvester. AU Medical Center had 108 after starting the week at 129, spokeswoman Lisa Kaylor reported. Doctors Hospital of Augusta went from 45 to 39, spokesman Kaden Jacobs said.

It was the previous surge involving the delta strain that the AU researchers focused on, looking at county-level data across the United States from July 1 through the height of the surge on Aug. 31, according to the study in JAMA Open Network.

Those counties where the fully vaccinated rates were below 30% saw their cases jump from 190 per 100,000 people to 1,272. That's almost double the case rate compared to those counties where vaccination rates were greater than 50%, which went from 71 per 100,000 to 531 per 100,000, the researchers found.

Screven County, which had a 37% vaccination rate during that surge, went from 6,065 per 100,000 in July to 8,069 in late August while Taliaferro County, with a 36% vaccination rate, jumped from 6,250 per 100,000 to 7,292, according to the Chronicle analysis. 

"The data and facts are, as demonstrated in this study, that vaccination has an impact on outcomes from COVID-19 and more importantly the spread in this case," said Dr. Phillip Coule, chief medical officer for AU Health System.

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The study demonstrates the need to recognize that not all areas felt the same burden from the pandemic, Coule said.

"It doesn’t affect all of those areas equally and that’s why it is very important to look at this on such a granular level," he said.

And that means having a strategy that recognizes those variables, whether it is a new strain, or other diseases or the opioid crisis, which MacKinnon has also studied on a county-level basis.

"It really means you have to have community-based approaches to deal with it. Yes, you need a national strategy and a state strategy but you also have to tailor that to the needs of the community. I don’t know that we have always seen that in the pandemic."