The rise in COVID-19-related cases among unvaccinated Americans continues, causing massive disruptions to states and health systems across the country. Florida and Louisiana are the most affected.Nearly one fifth of all new cases in the US are reported daily in Florida, the third-most populous and lowest-vaccination state. The Centers for Disease Control and Prevention reported 21,683 cases from Florida on Friday. This is the highest daily number of cases reported by the Sunshine State in the pandemic. The state is close to breaking its all-time record in current hospitalizations. At least 10,682 Florida residents were hospitalized by COVID-19 as of Monday. Baker county, which has only 21 percent of its residents fully vaccinated, is one of the counties with the highest infection rates.Louisiana is currently the nation's state with the highest infection rates. Pelican State is just over 25% larger than Florida and has a rate of 89 daily new cases per 100,000 residents. This is higher than Florida's current average of 74 new cases per 100,000. Louisiana currently reports an average of 4,000 cases per days. According to the CDC, every county in Louisiana is considered to have a high level of transmission. Louisiana has the lowest overall vaccination rate in the country, with only 37% of the state being fully vaccinated. The vaccination rates in some counties with high case rates are as low as 26 %.Louisiana's Democratic Governor. John Bel Edwards reinstated the statewide mask mandate that requires everyone aged five years and over to wear a mask inside. Governor Edwards stated, "It is clear that the current recommendations have not worked." Edwards spoke at a press conference today.Florida's Republican Governor. Ron DeSantis, however, took the opposite approach. He signed Friday's executive order prohibiting school districts from requiring students to wear masks.AdvertisementAt a Monday press conference, US health officials reiterated that masks and vaccines can be effective against the current surge in cases, which is largely among those who are not vaccinated.Make sure you get vaccinated.CDC Director Rochelle Walensky stated that "This is still a pandemic among the unvaccinated." Even with the hypertransmissible Delta variant, vaccines can be highly effective against severe illness, hospitalization, death, and even disability. Although mild infections are possible, the risk of contracting a breakthrough infection is extremely low, Dr. Walensky stressed.The CDC updated its masking guidelines last week in response to new data regarding breakthrough infections among fully vaccinated persons. Walensky Monday said that the central data came from a large outbreak in Provincetown (Massachusetts) which saw 934 cases COVID-19 in July. 73 percent of those were people who had been fully vaccinated.Many cases were due to indoor, maskless spreading. The outbreak also showed that the delta variant spread from vaccinated individuals to others, something not seen in previous versions. The data combined convinced the CDC that it should reverse its mask guidance. The agency recommends indoor masking in all settings, including schools and areas that have high or substantial transmission. This is the majority of the country.Anthony Fauci, a top infectious disease expert, and Walensky stressed that although breakthrough infections are alarming, they only affect a small percentage of fully vaccinated people. Fauci and Walensky stress that these infections are almost always mild or asymptomatic. Only seven of the 934 cases were hospitalized in Provincetown. None of the cases ended in death.Dr. Fauci stated that as of July 26, 2016, the CDC had reported 6,587 cases of breakthrough infections that led to hospitalizations or deaths among 163 million people who were fully vaccinated. This means that only 0.004 percent of people who are fully vaccinated get a severe breakthrough illness.Rare and rareFauci stated that data from Virginia, the District of Columbia and other places showed that the rate of breakthrough infections among fully vaccinated persons ranged between 0.26 percent and 0.03 percent. Fauci stated that breakthrough infections are uncommon and rarely occur, although they can lead to hospitalizations or even death.Fauci and Walensky noted in the past that COVID-19 hospitalizations accounted for 97 percent and over 99 percent respectively of COVID-19 deaths.Vaccinations are on the rise nationwide due to new fears about delta and its wildfire spreading. This includes many of the hardest-hit states. The current surge of cases is unlikely to be stopped by the vaccine surge, as it can take up to six weeks to get fully vaccinated.