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July 30, 2021 – Internal CDC documents support the high transmission rate of the Delta variant and present the risk in easier-to-understand terms. The documents also show that major infections in the vaccinated make people almost as contagious as those who are not vaccinated.
In addition, the agency released a new epidemic study that shows that major infections in vaccines make people about as contagious as those who are not vaccinated.
The new report, published today in Weekly Morbidity and Mortality Report (MMWR), also reveals that the delta variant likely causes more severe COVID-19 illness.
In light of these recent findings, the CDC’s internal slideshow advises the agency to “recognize that the war has changed.”
A “pivotal discovery”
CDC Director Rochelle Walensky, MD, MPH, said in a statement today that the MMWR report demonstrated “that delta infection resulted in similarly high SARS-CoV-2 viral loads in those vaccinated. and not vaccinated “.
“High viral loads suggest an increased risk of transmission and have raised concerns that, unlike other variants, vaccinated people infected with delta could transmit the virus,” she added. “This finding is concerning and was a crucial finding leading to the CDC’s updated mask recommendation.”
Investigators in the report analyzed 469 reported cases of COVID-19 in Massachusetts residents from July 3 to 17, 2021. The infections were associated with an outbreak following several events and large gatherings in Provincetown, Barnstable County the easternmost point of this state, also known as Cape Cod.
Notably, 346 infections or 74% of cases occurred in fully vaccinated individuals. This group had a median age of 42 and 87% were men. In addition, 79% of breakthrough infections were symptomatic.
The researchers also identified the delta variant in 90% of the 133 specimens collected for analysis. In addition, viral loads were about the same between samples taken from people who were fully vaccinated and those who were not.
Four of the five people hospitalized were fully vaccinated. No deaths have been reported.
The publication of these results was eagerly awaited following updated recommendations from the CDC on Tuesday.
Outside the scope of the MMWR report is the total number of cases associated with the outbreak, including visitors from outside Massachusetts, who are now approaching 900 infections, NBC Boston reported.
“Very worrying” data
“The new information from the CDC around the delta variant is sobering,” said David Hirschwerk, MD, an infectious disease specialist at Northwell Health in New Hyde Park, New York. Medscape Medical News.
“The CDC is trying to convey and clearly present this uncertain situation to the public based on new data accumulated, “he said. For example, given the evidence of greater contagiousness of the delta variant, added Hirschwerk, “there will be situations where people are infected, because the amount of virus overwhelms the immune protection”,
“What is new and concerning is that people who are vaccinated still have the same potential to transmit the virus,” he said.
today MMWR The study “helps us better understand the question of whether or not a person who has completed a COVID-19 series can spread the infection,” agreed Michelle Barron, MD, professor in the division of infectious diseases at the faculty. of Medicine from the University of Colorado at Aurora.
“The message is that because the delta variant is much more contagious than the original strain, unvaccinated people should get vaccinated because it is almost impossible to avoid the virus indefinitely,” Michael Lin, MD, MPH, specialist infectious disease and epidemiologist at Rush University Medical Center in Chicago, said when asked to comment.
Further, Lin added, “This new data highlights that vaccinated people, if they do get sick, should always look for COVID-19 tests and should always self-isolate, as they are likely contagious. “
More contagious than other infections
The CDC’s internal presentation also presents the new risk of transmission in layman’s terms. To say that the Delta variant is about as contagious as chickenpox, for example, immediately brings back vivid memories for some of staying indoors and away from friends during childhood or teenage epidemics.
“A lot of people will remember getting chickenpox and their siblings getting it soon after,” Barron said.
“The only important thing to note is that this does not mean that the mechanism of spread of the delta variant of COVID-19 is the same as that of chickenpox and Ebola,” she added. “The main way COVID-19 is spread, even the Delta variant, is through droplets. “
It also means that each person infected with the Delta variant could infect an average of eight or nine others.
In contrast, the original strain of the coronavirus was about as infectious as the common cold. In other words, one person was likely to infect about two other people on average.
In addition to the cold, the CDC notes that the Delta variant is now more contagious than Ebola, seasonal flu, or smallpox.
These comparisons are a tangible way to explain why the CDC on Tuesday recommended a return to masking in schools and other indoor spaces for people – vaccinated and unvaccinated – in about 70% of counties in the United States.
Comparing the delta variant to other infections, “I think the CDC is trying to help people better understand the situation we are now facing because the information is so new. We are in a very different position now that ‘just a few weeks ago, and it’s hard for people to accept it,’ Hirschwerk said.
The Delta variant is so different that the CDC considers it to act almost like a new virus.
Internal CDC documents were first published by The Washington Post Thursday. The slides cite communication challenges for the agency – continuing to promote vaccination while recognizing that revolutionary cases are happening and that, as a result, people who are fully vaccinated, in some cases, are likely to infect others.
Trust but verify
Going back to the scientific discourse, the CDC used as an example a recent outbreak in Barnstable County, MA. The cycle threshold, or Ct values, which measure viral load, were about the same between 80 people linked to the July 4 outbreak in Provincetown, who had an average Ct value of 21.9, compared to 65 other unvaccinated people with a Ct of 21.5.
Many experts quickly note that vaccination remains essential – in part because a vaccinated person also walks around with a much lower risk of serious consequences, hospitalization, and death. In the internal slideshow, the CDC points out that vaccination reduces the risk of infection by 3 times.
“Even with this large amount of virus, [the delta variant] didn’t necessarily make vaccinated people sick, ”Barron said.
In his statement, Walensky credited the collaboration with the Commonwealth of Massachusetts Department of Public Health and CD for the new data. She also thanked the residents of Barnstable County for participating in the contact tracer interviews and their tip in getting tested and adhering to safety protocols after learning of their exposure.
Next movements of the CDC?
The agency notes next steps for the agency which include possible measures, including vaccination mandates for healthcare professionals to protect vulnerable populations and universal masking for source control and prevention.
When asked if this potential policy was appropriate and feasible, Lin replied, “Yes, I think every person working in health care should be vaccinated against COVID-19, and it is doable. “
Barron also agreed. “As healthcare providers, we choose to work in healthcare and we should do everything possible to make sure that we protect our patients and keep our colleagues safe. “
“Whether you are a healthcare professional or not, I urge everyone to get vaccinated against COVID-19, especially as cases across the country continue to rise,” Hirschwerk said. “Vaccines unequivocally protect you from the virus. “
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