THE DESANTIS FLU:

In a Kentucky hospital bed at the end of November, a Covid-19 patient from the state's latest wave of infections lay alone behind the glass isolation wall.

A high-flow oxygen mask pushed extra air into his damaged lungs. His heart beat fast, though he lay frail and still. His mouth opened and closed to take tiny gulps of air. It looked like he was suffocating.

Kentucky's Covid landscape is a lot like what's happening in the rest of the United States. In some places, like Lexington, more than 60% of the population is fully vaccinated. But in many others, like the Appalachian counties 100 miles east, the rates are well under 40%. Diabetes, heart disease, smoking and obesity are prevalent--risk-factors that can make a Covid case severe, or deadly.

That made the state a tinderbox when the latest surge of infections began this summer. Outbreaks in less vaccinated counties filled up small, local hospitals. Sicker patients, or those who couldn't find space, went on to regional facilities. The most severe cases fed into the biggest and most advanced hospital in the state, the University of Kentucky Albert B. Chandler Hospital, until it too overflowed. Like the man gasping for oxygen in one of the state's many Covid wards, the outbreak starved Kentucky's hospitals of air, consuming every resource: staff, beds, supplies and time.

Immunization is often framed as an individual choice--particularly in Kentucky's less-vaccinated regions. But a Bloomberg analysis of vaccine, infection and hospitalization data for the state, combined with interviews of more than 20 doctors, nurses and medical staff, show how low vaccination rates strain entire communities and health-care systems.

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