MILWAUKEE — Wisconsin hit a grim milestone Monday: More than 700,000 residents have tested positive for COVID-19 over the course of the pandemic.

The U.S. also crossed a symbolic threshold this week. Over 675,000 Americans have died from COVID-19, making the current pandemic deadlier than the Spanish influenza outbreaks of a century ago.

Those numbers are set to keep growing, as the delta variant is driving infections and severe cases up in the Badger State and beyond. With students testing positive, hospitals filling up and booster shots still under debate, Wisconsin remains in a tough spot heading into the fall.

Here, we break down some of the key questions about the state of the pandemic in Wisconsin right now.

Where are our COVID-19 numbers headed?

Still in the wrong direction, for now, according to DHS data.

Infections in Wisconsin have risen dramatically since earlier in the summer as the delta variant has taken over in the state. And while new cases dipped briefly as September kicked off, the rate of infections has climbed again in the past week.

“After a prolonged period of a plateau in cases, we’ve seen a fairly pronounced increase over the past week,” Ben Weston, the chief health policy advisor for Milwaukee County, said at a briefing Tuesday.

As of Tuesday, the DHS reported a seven-day confirmed case average of 2,967 — the highest number since January. That’s a 70% increase from the first day of September, and nearly a 4,000% rise since July 1, when the average sat at 73 cases per day.

Last week, two Wisconsin counties — Forest and Buffalo — reached the DHS’ “critically high” disease activity level, the first time any counties had crossed into that category since January. Most counties are in the “very high” case activity category, the DHS reports, with six still in the “high” category.

The CDC, which has its own tracker, currently places every Wisconsin county in its highest transmission level. That means per CDC guidance, everyone in the state should be wearing a mask in indoor settings, even if they’re vaccinated.

What’s the status for hospitals in the Badger State?

With delta surging in the state, “it’s really a perfect storm right now, and our volumes are at an all-time high,” Dr. Kyle Martin, an emergency department physician at SSM Health, told Spectrum News 1 last week.

As of Monday, hospitalizations were at an eight-month peak with 1,099 COVID-19 patients across the state, according to Wisconsin Hospital Association data. 

In the first two weeks of September, more than 90% of all hospital beds and 93% of ICU beds in the state were occupied, the DHS reports. Most hospital ICUs were at peak capacity.

Deaths from COVID-19 have also ticked up recently: The state was averaging 11 coronavirus deaths per day as of Monday. At the start of July, that average was just one death each day.

Unvaccinated people are at the highest risk of these severe outcomes. According to DHS data, Wisconsinites who were not fully vaccinated were almost nine times as likely to get sent to the hospital with COVID-19 in August, and almost 11 times as likely to die from COVID-19.

How is Wisconsin’s vaccination rate stacking up?

More than 3 million Wisconsinites — or 53% of everyone in the state — are fully vaccinated, the DHS reports. Over 56% have gotten at least their first dose.

Since COVID-19 shots first opened up to the general public, Wisconsin has seen some steep ups and downs in its vaccination pace.

The spring saw rates quickly climb as the most eager Wisconsinites rushed to get their doses. As summer arrived, the pace dropped off dramatically: Weekly totals in early July were just 10% of their highs in April, according to DHS data.

The vaccination pace ticked up a bit in the late summer as the delta surge arrived in Wisconsin, and has more or less leveled off since then. 

The week of Sept. 12 saw 59,424 shots in arms, the DHS reports — higher than the week before, but lower than the late-August totals.

All of these shifts are pretty much in line with national trends. But Wisconsin, which once was a leader in its vaccination pace, has fallen behind the national average: It ranks at No. 27 out of the U.S. states for its share of adults with at least one dose, according to a New York Times tracker.

The state’s $100 reward for getting a first dose expired over the weekend. More than 142,400 residents got a shot during the reward window, the DHS reported, and are eligible to claim their $100 online, or by calling 844-684-1064.

“Whether you got vaccinated in March or just this month, every shot in an arm is bringing us one step closer to putting this pandemic behind us and ensuring our state’s continued economic recovery,” Gov. Tony Evers said in a release.

Milwaukee announced its own incentive program this week: Starting Thursday, the health department is giving away $100 U.S. Bank gift cards to city residents who get their first doses at the Southside Health Center or the Northwest Health Center, while supplies last.

How are schools faring?

Across the state, schools are dealing with another tough start to the school year as positive cases and quarantines challenge in-person plans.

According to Milwaukee Public Schools data, last week 210 students and 38 staff tested positive across the district. All in all, MPS has reported 937 confirmed cases — with 694 of those among students — since July, according to a district dashboard.

But most MPS students aren’t getting really sick: Only 3.4% of all those student cases have had COVID-19 symptoms, according to the dashboard. In contrast, around 70% of the reported staff cases were symptomatic.

Vaccines for kids aged 5 to 11 got a promising sign this week, when Pfizer announced its shots were safe and effective for these younger age groups at a lower dose. 

That means younger kids could be getting vaccines in the coming months, Weston said — but in the meantime, he stressed the importance of other measures, like wearing masks, social distancing and ventilation for keeping schools safe.

Older students are dealing with another pandemic school year too, as colleges across the state get back to campus.

As of Sunday, UW-Madison was averaging around 37 student cases and 1.7 staff cases per day, according to the school’s data dashboard. Other schools are seeing infections show up, too: UW-Milwaukee reported 67 student cases last week, while UW-Oshkosh reported 36 positive tests on campus last week.

Lots of UW students received their shots before heading back in the fall — but vaccination rates vary widely between the campuses, according to UW system data. Madison is in the lead with 91% of students vaccinated, while UW-Parkside has the lowest rate with 38% of students vaccinated.

When can I get a booster shot?

If you have an eligible condition that weakens the immune system — including an organ transplant, cancer treatment, stem-cell transplant, or HIV — you can get a third dose of a Pfizer, or Moderna COVID-19 vaccine to boost the immune response, according to DHS guidance.

If you are not immunocompromised, the verdict is still out on how soon, if at all, you’ll be getting another dose. Federal health officials have been debating whether to recommend COVID-19 vaccine boosters for the general public.

Last week, an FDA advisory panel voted to recommend Pfizer boosters for a couple vulnerable groups: Those 65 and older, and those at risk of severe disease. But the committee voted against boosters for the general public.

An advisory committee for the CDC is also discussing the booster plan this week, and the full FDA is expected to review the decision from its advisory panel and decide whether to authorize some boosters. Finally, the full CDC will have to make its formal recommendation. 

It’s a complicated process, Weston said, but could mean that an extra dose for those high-risk groups — including the 65-and-older crowd — could be authorized by the end of the week.

“There are so many checks and balances in the process to make sure that the vaccines are safe and effective,” Weston said.

Even as boosters may be rolling out soon for some high-risk groups, scientists are still working to figure out whether they’re needed yet for the general public. 

Studies have found that protection from the vaccine wanes in the months after you get your shots. But some scientists — including some FDA experts — have argued that boosters aren’t necessary yet, since the vaccines still protect against severe outcomes for most people.

As the science keeps moving forward, the DHS urged patience on the booster discussion, and promised that “everyone who is recommended for a booster dose will receive one.”

“While there are still steps to come, Wisconsin is prepared and stands at the ready to begin booster-dose vaccination,” the DHS advised.