By Ramsey Archibald, The Associated Press

COVID cases per 100,000 residents

The 7-day average for new COVID-19 cases per 100,000 residents as of Nov. 10, 2021.

The delta wave keeps rolling, but Alabama appears to be firmly in its wake.

The huge surge in COVID-19 cases, hospitalizations and deaths that hit Alabama and much of the southeastern United States in July, August and September has now moved north and west. States like North Dakota, Colorado and Minnesota are now getting hit hard, cases are picking up in New England and the Southwest, yet much of the Southeast has cooled off.

Alabama, which at one point had the worst COVID positivity rate in the nation, is now among the states with the lowest numbers. The state’s positivity rate – or the percentage of tests that come back positive – is below 5%. It’s only the second time since the pandemic began that the state has reached that key threshold. The other was in June, just before the onset of delta.

And as of Thursday, Alabama had the 7th lowest 7-day average for new cases per capita, according to data from Johns Hopkins University.The state was averag- ing just over 500 new cases per day on Thurs- day, the lowest 7-day average for cases since July 11. That equates to 10 new cases per 100,000 residents per day, based on the latest Census counts.

That was more than just six other states and the District of Columbia, and most of those other states are also in the Southeast. Georgia had the lowest per capita case rate in the nation as of Thursday, with just 6.8 new cases per 100,000 residents per day. Florida was second, followed by Louisiana. Mississippi also had a lower case rate than Alabama. Hawaii, at No. 4, was the only non-Southern state with a 7-day average per 100,000 less than 10.

While cases continue to head in the right direction, Alabama’s recovery from the delta wave can be seen in other metrics as well. The state fell below 300 COVID hospitalizations this week for the first time since July 12.

As of Friday, the number of COVID patients in state hospitals had fallen to 291.

State hospitals are also seeing a higher percentage of those patients who are fully vaccinated. Earlier this week the Alabama Hospital Association reported 20% of Alabama’s COVID inpatients were fully vaccinated. That’s not surprising, according to Dr. Donald Williamson, head of the AHA.

“The higher percentage of people who are vaccinated with a vaccine that is not perfect, the more breakthrough cases you’re going to see,” he said in an interview with AL.com early this week. “The extreme of that is, if 100% of people are vaccinated, then every case is going to be a breakthrough case.”

And there’s another reason why that percentage might be rising, Williamson said.

“The other thing is, people who got vaccinated with just two doses, and have now been vaccinated more than six months, we know that immunity does weaken over time,” he said. “I suspect some of that is because of waning immunity.”

Williamson said that should encourage those people who are eligible for a booster dose to get one, and many Alabamians have already done so.

The Alabama Department of Public Health reported a notable increase in vaccine administration in the weeks following approval of all three COVID vaccines. The 7-day average for doses administered per day here doubled between Oct. 20 and Oct 29.

ADPH reports about 263,600 additional doses – or booster doses – had been given in the state as of Thursday.

Despite the uptick, Alabama remains near the bottom in vaccination rate. According to the Centers for Disease Control and Prevention, just 45.2% of Alabama’s total population is fully vaccinated, ahead of only West Virginia, Idaho and Wyoming.