Gov. John Bel Edwards on Tuesday extended his Phase 2 coronavirus restrictions for another 28 days, while urging businesses to have employees work remotely where possible as COVID-19 cases and hospitalizations remain high.

The governor has made dire warnings about the trajectory of the state’s coronavirus metrics in recent weeks, but has remained hesitant to implement new restrictions, saying it is clear many residents aren’t following the current rules. Those restrictions require most businesses to operate at 50% capacity, while disallowing indoor service at bars.

"The state remains in a precarious place," Edwards said. "Cases and hospitalizations are increasing in every region.”

Dr. Joe Kanter, the head of the coronavirus response at the Louisiana Department of Health, said the number of COVID deaths are “simply unacceptable,” and asked residents to follow the state’s rules on masks, social distancing and limits to gatherings.

“To be very blunt and very clear it has never been as bad as it is right now,” Kanter said. “There has never been as much COVID in Louisiana as there is right now.”

At the same time, state officials are grappling with changing guidance from the federal government on the mass vaccination effort, as well as Biden administration that will soon take over and may not keep the changes in place.

Federal health officials in the Trump administration Tuesday announced the government would no longer hold back half the doses to account for the second shot needed for both Pfizer and Moderna vaccines. They also said the CDC is recommending states start offering vaccines to people aged 65 and up immediately, an effort to juice the vaccination effort after a slow start. And allocations for future vaccines would be based on how well states do in administering the vaccines they have, though it is not clear whether that policy will come to pass when President-elect Joe Biden takes office later this month.

Louisiana’s top leaders said they were considering the new federal guidance, but Edwards said he would probably not make any changes to the state’s priority groups soon. He already strayed from federal recommendations by lowering the age of people eligible for the vaccine after nursing homes and health workers to 70, from 75. Since the state began offering vaccines to the elderly, demand has soared, and a wide swath of elderly people are waiting for their shots.

“It’s going to be some time before we announce any changes, if at all, on our priority groups,” Edwards said.

After a slow start, in which Louisiana ranked near the bottom of U.S. states in administering the vaccines it had received, data released this week show the state has improved. According to the CDC, Louisiana ranks 23rd in states and the District of Columbia in how many doses of vaccine it has used per 100,000 residents. So far, doses have been allocated strictly on a per-capita basis to each state.

Louisiana and the federal government have administered about 44% of doses allocated so far, up from under 30% last week, state and federal data show. The feds handle the state’s share of doses heading to nursing homes and other long-term care facilities, which totals more than 93,000 doses.

A list of 210 pharmacies and other providers received 35,785 doses of vaccines this week, Kanter said, up from 10,500 doses to those providers last week. These doses are primarily vaccinating people 70 and older. But the state took about 13,500 doses of Moderna’s vaccine as well as 4,000 doses of Pfizer’s vaccine that were sitting on shelves and used them to boost this week’s allotment, Kanter said, meaning next week the state likely won’t have enough to resupply all 210 providers. Those providers will be given the second dose needed for each patient they vaccinate, however.

Replay: What's next for Louisiana's coronavirus rules? John Bel Edwards addresses plan

The state also saw its first patient experience a severe adverse reaction to the vaccine, Kanter said. An individual who received the vaccine experienced gastrointestinal issues and dizziness later in the evening and spent “one or two nights” in the hospital before recovering and being released. State and federal officials and hospital leaders around the U.S. have stressed the vaccine is safe and effective.

All jury trials paused until March 1 due to coronavirus, Louisiana Supreme Court orders

While the state works to reach herd immunity by sometime later this year, the governor’s administration is also trying to get through to residents who have relaxed their precautions as the pandemic dragged on, pleading with them to get food from restaurants to go, work remotely and socialize via Zoom or Facetime.

Still, the governor didn’t increase restrictions on indoor dining or any other businesses Tuesday. His restrictions allow parishes to open indoor service at bars if they see under 5% of coronavirus tests coming back positive over two weeks; Ernest Legier, commissioner of the Louisiana Office of Alcohol and Tobacco Control, said only East Feliciana Parish has met the requirement but hasn’t “opted in” to allow bar service. Bars are allowed to operate outdoor patios.

Edwards ratcheted up restrictions in late November as the state entered a deadly third wave of the pandemic. In late December, he extended those rules again. They are set to expire on Wednesday, which is why Edwards announced the extension at a press conference Tuesday.

Louisiana’s average daily COVID-19 case increase over seven days was 2,822 as of Tuesday, up from 1,573 when Edwards first put the state in the modified version of Phase 2.

Hospitalizations remain high, at 1,982 patients, well above the 1,600-patient peak from the summer surge in cases.

Warner Thomas, the CEO of Ochsner Health System, said Tuesday the metrics have been a cause for concern among hospital and state leaders in recent weeks.

Dr. Katherine Baumgarten, an infectious disease official at Ochsner, said the system is seeing patients arriving at hospitals after catching the disease at holiday gatherings.

“Hopefully we won’t have to have more restrictions and people will adhere to the guidance,” Thomas said. “If not I will not be surprised if we have to (add restrictions).”

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