When the waves of grief hit, Michele Preissler tries to steady herself in the moment by allowing herself to cry it out.
In the two months since her husband, Darryl, 63, died of COVID-19, the Pasadena, Md., woman says she's not slept properly, stopped cooking and lives with a constant nagging sense of anxiety and guilt.
"You ever have a bad dream, and you're trying to get somewhere, and you can't run?" she said. "It's like that. Every day is like, 'How do I even breathe? Where is he? When is he coming in the door?'"
Preissler says she thinks her husband's death was preventable and that if he'd gotten his coronavirus vaccine when shots became available to his age group in his home state of Maryland, he would still be alive today.
As a hospital employee in Annapolis, she was vaccinated fairly soon after the U.S. began rolling out vaccinations in December 2020.
WATCH | Michelle Preissler says vaccination is about saving lives:
She says she repeatedly asked her husband if he, too, would get his shots. While he didn't dismiss the idea, he kept putting it off, saying he was busy with work. He was a well-respected, self-employed carpenter, known for his craftsmanship and attention to detail.
His wife says he also had concerns about potential side-effects, because some medication he was taking at the time compromised his immune system.
"My husband didn't get the vaccine, and now I'm also regretting that I didn't make the appointment," she said.
Attended wedding in April
In April, the couple went to a family wedding with more than 100 people. Preissler suspects that's where her husband contracted the illness.
She believes it happened during the reception. Darryl had asked his elderly aunt to dance during a slow song. Neither of them wore a mask.
"We didn't find out until later she was positive," Preissler said. "I know in my heart that's where he got it. I mean that's close contact, you know? Cheek to cheek, hugging and talking in each other's face."
One week after the wedding, Darryl began showing symptoms of COVID-19. He was eventually hospitalized and placed on a ventilator and at one point had a stroke. On May 22, less than a month after he began showing symptoms, he died.
His aunt died from COVID-19, too.
"I do know that if my husband had gotten that vaccine, he would still be here," she said tearfully during an interview in her home in Pasadena.
"And he's not here, and he's not coming back. So if anybody can learn from this, what I'm going through, please learn."
After weeks of declining case numbers, hospitalizations and daily deaths, the trajectory of the pandemic in the U.S. is changing quickly.
"There is a clear message that is coming through: This is becoming a pandemic of the unvaccinated," said Dr. Rochelle Walensky, the director of the Centres for Disease Control and Prevention (CDC).
At the White House coronavirus task force briefing on Friday, she painted a bleak picture of the state of the pandemic.
While numbers are dramatically lower than the January peak, all COVID-19 metrics are headed in the wrong direction.
When it comes to new daily cases, the CDC says the seven-day average is up nearly 70 per cent.
Hospitalizations are up 36 per cent week over week, and daily average deaths have increased 26 per cent in that time to 211 per day.
"We are seeing outbreaks of cases in parts of the country that have low vaccination coverage because unvaccinated people are at risk," Walensky said. "And communities that are fully vaccinated are generally faring well."
Overall, nearly 56 per cent of the entire U.S. population has had at least one dose of a coronavirus vaccine, according to the CDC. More than 48 per cent are fully vaccinated.
But vaccination rates vary wildly by state.
Vermont leads the U.S. in vaccinations, and also has the lowest number of new COVID-19 cases per capita. Roughly 75 per cent of residents there have had at least one shot. And according to the CDC's website, it has the lowest cumulative cases per 100,000 residents. The seven-day case rate is 10 per 100,000 residents.
Delta variant threatens spike
The spread of the more transmissible delta variant will likely bring "an increase in COVID cases in the weeks ahead, with these cases concentrated in communities with lower vaccination rates," according to Jeff Zients, the White House COVID-19 task force co-ordinator.
"Just four states accounted for more than 40 per cent of all cases in the past week, with one in five of all cases occurring in Florida alone," he said.
"And within communities, these cases are occurring primarily among unvaccinated individuals."
According to the CDC website, the four states with the highest number of new cases per capita are Arkansas, Missouri, Florida and Louisiana.
The seven-day case rate is highest in Arkansas, with nearly 229 cases per 100,000 people. Vaccination rates in these states are on the lower end of the scale.
Roughly 40 per cent of residents in Louisiana have had a single shot. In Arkansas, it's 44 per cent while in Missouri it is 46 per cent. Florida's uptake is a bit higher, with 55 per cent of residents having at least one dose.
Some of these national trends are playing out in the ICU at Nashville's Vanderbilt University Hospital, where Dr. Wes Ely works.
"Every patient who wheels through our ICU door basically is an unvaccinated person who ends up regretting that decision," he said during an interview from his office.
Not only are many of his patients unvaccinated, he said, but a younger demographic is ending up needing urgent care.
"We've dropped two to three decades in terms of the average age of who has COVID in our hospitals," he said.
"Our ICU used to be filled up with 60-, 70- and 80-year-olds. And now, it's all teenagers, 20- and 30-year-olds."
Ely says he does not judge his patients who have not been vaccinated, but he wishes more people would follow the science and get their shots.
"It makes me sad to think that this could have so easily been prevented, because the vaccine is extremely effective at preventing moderate to severe disease," he said.
Isolation, loneliness adding to health risk
Ely is a leading American researcher on patient experiences in the ICU, with a focus on humanizing medical care.
His latest book, Every Deep Drawn Breath, due out in September, focuses on the benefit of having family members by a patient's side in the pandemic.
"I think many people end up dying because of loneliness, isolation and the combination of organ failure that the virus caused," he said.
WATCH | Preissler says in her experience, risks of COVID-19 outweigh those of the vaccine:
Preissler was able to be by her husband's side in his final days.
When she looks back on his life, in photos of family vacations and holidays, she begins to cry as she realizes her husband will not be by her side for more of those special events or their 30th wedding anniversary this year.
"There's not going to be any more pictures … this is it, it's done," she said, holding on to a photo collage.
"It's very painful … but that's grieving. Grieving is really hard, hard work."
WATCH | U.S. health officials warn of increasing COVD-19 cases among unvaccinated: