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Because of the delta variant of COVID-19, a premature relaxation of mitigation measures and people who refuse to be vaccinated, alarm bells are ringing once again regarding the virus. West Virginia is seeing a dramatic jump in active cases, as well as in the number of deaths, underscoring the surge in COVID-19 hospitalizations across the United States.

On Sept. 6, the Risk Level Map of the Harvard Global Health Institute showed all counties in West Virginia with a COVID-19 risk level of red, which denotes 25+ cases per 100,000 people. The health institute calls this scenario a tipping point, and advises stay-at-home orders and/or rigorous test-and-trace programs.

It strains credulity to believe that all of the people one sees in the supermarket and elsewhere in the community in indoor situations who are not wearing masks have been fully vaccinated. Their behavior puts all of us at risk.

Masking, social distancing and hand washing are still relevant measures to take to help ward off this killer, which does not discriminate in its relentless path to sicken and cause death.

If you have not been vaccinated, it is not too late. For unvaccinated patients who have been hospitalized and request the vaccine, it usually is too late.

The most recent update of the U.S. Centers for Disease Control and Prevention’s COVID Data Tracker displayed a high level of community transmission in West Virginia and the entire country.

“If you are fully vaccinated, to maximize protection from the delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission,” reads a statement from the CDC.

We have no control over whether citizens of the Mountain State — or anywhere else, for that matter — get vaccinated. However, we can control the ways in which we protect ourselves.

And we are not in a bubble. What we do here in West Virginia affects the rest of the nation and the rest of the world.

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It is unlikely that herd immunity will save us from the novel coronavirus. Instead, we appear to be looking at a dichotomy of the vaccinated versus the unvaccinated.

Charles Darwin, author of “On the Origin of Species,” is known for his theory of natural selection and survival of the fittest.

“One general law, leading to the advancement of all organic beings, namely, multiply, vary, let the strongest live and the weakest die,” he said.

In that regard, COVID-19 has been described as a Darwinian predator, predominantly striking those who are older. People 65 years of age and older make up 20.5% of the population in West Virginia, according to the most recent figures from the U.S. Census Bureau.

Nearly 100,000 more people are projected to die nationwide from COVID-19 by Dec. 1, if current behavior does not change, according to a model from the Institute for Health Metrics and Evaluation at the University of Washington.

“We can save 50,000 lives simply by wearing masks. That’s how important behaviors are,” said Ali Mokdad, Ph.D., a professor of Health Metrics Sciences at the Institute for Health Metrics.

The West Virginia Osteopathic Medical Association joined others in calling on Gov. Jim Justice to reinstate the indoor mask mandate and, in doing so, to demonstrate “clear leadership” concerning the pandemic.

While the arguments continue and the virus rages on, you are urged to be responsible for your own fate. The lives of West Virginians hang in the balance.

“The only person you are destined to become is the person you decide to be,” Ralph Waldo Emerson said.

Robert Grossman is retired from practice in health care. He lives in Morgantown.

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