COVID ripped through the South this summer, leaving tens of thousands of Americans dead despite the existence of an effective vaccine and so many other tools to fight the spread of the disease.

Now the surge is coming north — just as surely as it came last winter, except with the more virulent delta variant.

And just as sure, it will cause preventable deaths, unless Mainers who have yet to take COVID seriously change their minds. Otherwise, the virus will continue to work its way through the state, causing illness and death until it runs out of fuel.

That’s where we are 18 months into the pandemic, able to see exactly where this is going but unable to stop it, as part of the population refuses to do much of anything to help.

We can even say with certainty where the virus will hit hard. While in office, President Donald Trump refused to take the virus seriously, interfering from the beginning with the work of health professionals who wanted to sound the alarm on what they believed was a life-altering virus.

They were right, of course. But the idea that COVID was overblown or a hoax, or that it was a money-making scheme for hospitals, or a ploy to ruin Trump’s reelection effort, has stuck with Republicans.

Now it is nearly impossible to find a Republican elected official, in offices big and small, who will support COVID-related restrictions, such as vaccination or mask mandates. On an individual level, too, conservatives are much less likely to follow COVID protocols.

The result is as predictable as it is sad and frustrating. The most recent surges of the virus have hit areas of low vaccination the hardest, which are also the areas that voted for Trump. In fact, COVID deaths in October were three times higher in counties that Trump won than in counties won by President Joe Biden, and that gap is growing faster than at any other point in the pandemic, the New York Times reported earlier this month.

The same is happening in Maine, as the latest surge, which has hospitalized a record number of residents, is centered on the rural counties in western Maine where vaccination rates are low. Positivity rates — the number of tests coming back positive — are also soaring in those counties, indicating that the virus is spreading faster than it can be found.

Meanwhile, it places like Cumberland County, where the vaccination rate is over 80%, transmission of the virus is relatively low.

The gap will only grow here, too. Just a week after kids age 5-11 became eligible for vaccination, more than a fifth of the age group has gotten the shot in Cumberland County. In rural Franklin County, just 2.2% were vaccinated.

It’s not just the unvaccinated who will suffer the consequences. Low vaccination rates in these regions make them less safe for everyone, including the vaccinated. They allow the virus to build up steam and infect others, some of whom will get very sick and perhaps die.

The decision to get the COVID vaccine is as much about protecting the community as a whole as it is about protecting oneself. With any luck, the prospect of another winter surge will be enough to drive that point home.

There are reasons for optimism. Vaccination rates have been rising recently, in part in response to mandates for work and activities, which are proving to be enough to get people over their hesitancy. A treatment for COVID in pill form has shown promising results, and should be ready for wide distribution sometime next year.

But it could be a rough winter in Maine and the rest of the Northeast, particularly where vaccination rates remain low, just as expected in Europe, where surges often have been just ahead of ours.

We know it’s coming. But on its own, that’s just not enough.