Missouri outbreak patients are 'younger and sicker'; California softens school rules, still requires masks. Today's COVID-19 updates

The COVID-19 crisis in and around Springfield, Missouri, where hospitals are now flooded with coronavirus cases, is likely a preview of what's in store for the rest of the state as the delta variant continues to spread.

That's the belief of Steve Edwards, CEO of CoxHealth, a key health care system in southwest Missouri. Cox is currently treating 127 patients, similar to the number it had during last winter's horrific surge, and nearly a tenfold increase from the 14 such patients seven weeks ago.

Edwards said he hopes people in other parts of Missouri, whose vaccination rate ranks in the bottom 20 among states, "begin to realize that we're kind of a harbinger for the rest of the state."

Not only has the number of patients grown significantly, but their ages are much lower, with the average dropping 12 years since the winter. More concerning, they often have severe disease despite a lack of underlying conditions.

"We are seeing younger and sicker patients coming," Edwards said. "The delta variant's almost got to be looked at as a different disease, affecting younger people."

– Gregory J. Holman, Springfield News-Leader

Also in the news:

►Two neighboring counties in rural Indiana are very similar except for one aspect: One has the state’s third-highest vaccination rate, the other one the fourth lowest. Read here what made the difference.

►A state board on Tuesday certified a petition drive to repeal a Michigan law that was used by Gov. Gretchen Whitmer to set major pandemic restrictions. The decision, ordered by a court, means the Republican-controlled Legislature can kill the law without Whitmer, a Democrat, intervening.

►The Mississippi State Department of Health is now blocking comments on its Facebook coronavirus posts, citing a “rise of misinformation” about the virus and vaccinations, department spokesperson Liz Sharlot said. Only about 31% of Mississippians have been fully vaccinated.

►The Tennessee state government has fired its top vaccination official. Dr. Michelle Fiscus angered some Republicans when she sent medical providers information explaining the state's legal mechanism for vaccinating minors above the age of 14 without parental consent.

►Malaysia shut down a mass vaccination center Tuesday after more than 200 medical staff and volunteers tested positive for the coronavirus.

📈 Today's numbers: The U.S. has had more than 33.9 million confirmed COVID-19 cases and more than 607,700 deaths, according to Johns Hopkins University data. The global totals: more than 187.7 million cases and more than 4 million deaths. Nearly 160 million Americans – 48% of the population – have been fully vaccinated, according to the CDC.

📘 What we're reading: As many adolescents and young adults prepare to return to the classroom in the fall term amid the spread of the delta variant, the lagging vaccination rates among Generation Z are raising concerns among experts.

Keep refreshing this page for the latest news. Want more? Sign up for USA TODAY's Coronavirus Watch newsletter to receive updates directly to your inbox and join our Facebook group.

Under pressure, Tennessee health department ends adolescent vaccine outreach

Just as coronavirus cases are more than doubling in Tennessee, the state's health department is stopping adolescent vaccine outreach not just for COVID but for all diseases. The Nashville Tennessean, part of the USA TODAY Network, obtained an internal report and e-mails indicating the decision comes on the heels of pressure from Republican state lawmakers.

The health department will also stop holding coronavirus vaccination events at schools and sending postcards with reminders to teenagers to get a second COVID shot.

Tennessee ranks among the bottom 10 states with only 38% of its population fully vaccinated. Current health department projections show the state won't reach the 50% mark until March 2022. The average number of new infections per day has more than doubled in the past two weeks – from 177 to 418 – while the positivity rate has climbed from 2.2% to 5.4%.

– Brett Kelman, The Tennessean

California softens school guidelines but still requires masks indoors

California officials seem to have made up their minds about the masking requirements for the upcoming school year – at least for now.

A day after posting rules that called for K-12 students who refuse to wear a mask to be banned from campus, the state softened that position and said schools need to offer “alternative educational opportunities for students who are excluded from campus because they will not wear a face covering.”

The mandate that all students wear a mask indoors regardless of vaccination status remains in place. State Supt. of Public Instruction Tony Thurmond told the Los Angeles Times part of the reason is children under 12 are still not eligible to be vaccinated against COVID, and masks are a helpful measure when physical distancing may be difficult with full attendance.

The revised guidelines grant local school officials leeway on how to handle instances of students who don't have an exemption and refuse to wear a mask. California's school-safety requirements go beyond the CDC’s recommendations that allow vaccinated students to attend classes without masks.

J&J, AstraZeneca may alter vaccines because of rare blood clots

Johnson & Johnson, AstraZeneca PLC and the University of Oxford are conducting early-stage research into whether potential modifications of their coronavirus vaccines could reduce or eliminate the risk of rare but serious blood clots, The Wall Street Journal reported.

The Journal, citing sources it described as close to the process, said outside scientists also are joining the effort and that emerging clues into how the clots form are boosting hopes of identifying the cause. AstraZeneca hopes to update its shot by next year, the Journal said.

It is too early to know whether the J&J shot or the AstraZeneca shot can be modified, or whether doing so would make commercial sense, the Journal wrote. AstraZeneca has said it is “actively working with the regulators and scientific community" to learn more about the rare blood-clotting events, including information on early diagnosis and treatment.

As delta variant surges, Chicago adds Missouri, Arkansas travel advisories

After several weeks with no states on its travel advisory list, Chicago is now advising any unvaccinated people traveling from Missouri or Arkansas to obtain a negative COVID-19 test result no more than 72 hours prior to arrival in the city or to quarantine for 10 days upon arrival.

Last month, for the first time since July 2020, there were no states on Chicago’s travel advisory list. But Chicago added Missouri and Arkansas to the list Tuesday as the two states are once again reporting more than 15 daily new cases per 100,000 residents. Illinois is reporting 2.6 daily new infections per 100,000 residents.

“We continue to stress the importance of getting vaccinated for COVID, and adherence to all masking guidelines for travel,'' the Chicago Department of Public Health tweeted Tuesday. "While Chicago's case rate remains low, areas with lower vaccination rates are seeing surges.”

– Grace Hauck

Boston College rejects exemption for Catholics who don't want vaccine

Some Boston College students and their parents are angered by the Catholic school’s refusal to grant religious exemptions to people who don’t want to get a required coronavirus vaccine because of a purported link to aborted fetal tissue. Pope Francis, however, said in January that Catholics have a moral obligation to take the vaccine.

“A religious exemption may be granted if vaccination goes against the fundamental tenets of a faith,” school spokesperson Ed Hayward said in a statement. “Given that Pope Francis, (Boston) Cardinal Sean (O’Malley), and millions of Catholics worldwide have been vaccinated, it is difficult for Catholics to make an argument against a COVID-19 vaccination.”

French set record for vaccine appointments as infections rise

Nearly 1 million people in France made vaccine appointments in a single day amid pressure to salvage summer vacations and rescue the French economy. An app that centralizes France’s vaccine appointments, Doctolib, announced Tuesday that 926,000 people had made appointments Monday, a daily record since the country rolled out coronavirus vaccines in December. People younger than 35 made up 65% of the new appointments. 

Infections are on the rise in France amid talk that President Emmanuel Macron might announce vaccination requirements, driving new demand for appointments. About 41 % of the French population has been fully vaccinated.

FDA warns of possible link between J&J vaccine, autoimmune disorder

The Food and Drug Administration is warning about a possible link between that Johnson & Johnson vaccine and the autoimmune disorder known as Guillain-Barré syndrome. In a statement, the agency said the data "suggests an association” between the vaccine and a higher risk of the condition, but not enough "to establish a causal relationship.” About 12.8 million doses of the J&J shot have been administered.

The Centers for Disease Control and Prevention says on its website that people who have had Guillain-Barré syndrome can be vaccinated against COVID-19 and that no cases of the disorder were reported in clinical trials for the Pfizer and Moderna vaccines. One case was reported in J&J trials, the CDC said.

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US cases increased by 97.4% over last week, but likely because of July 4th reporting

New COVID-19 cases in the U.S. increased by 97.4% from the previous week, with 47 states now reporting a rise in infections, according to Johns Hopkins University data. But the major increase is likely from states that didn't report over the July 4 holiday and were closed Monday, likely artificially inflating the number of new infections.

The U.S. is again reporting cases at a pace of nearly 1,000 per hour. That's more than double the pace the country saw just a couple of weeks ago, before case counts began rising again. More than 99% of COVID deaths are now among people who have not been vaccinated, the Center for Disease Control and Prevention said.

"If (patients) are sick enough to be admitted to the hospital, they are unvaccinated. That is the absolute common denominator amongst those patients," Dr. Howard Jarvis, an emergency medicine physician in Springfield, Missouri, told CNN. "I can see the regret on their face. You know, we ask them, because we want to know, are you vaccinated? And it's very clear that a lot of them regret (not being vaccinated)."

– Mike Stucka

Contributing: The Associated Press.