A guide to assessing personal risk

As the Delta variant spreads rapidly across the United States, fueling hospitalizations linked to Covid-19 in areas with low vaccination rates, Americans remain uncertain of the effect this highly infectious mutant will have on their lives. While vaccines would prevent serious illness and death in those who received them, stories of fatal infections in individuals of all ages are causing a stir, leading some to speculate that vaccine-mediated immune protection may not be possible. as strong or last as long as before. hoped for.

To be clear, any protection is better than no protection, so mass vaccinations should and must continue. But the growing dominance of Delta, which is significantly more contagious than previous strains of SARS-CoV-2, demands that we reconsider our current approach to situational awareness and security. These required adjustments do not need to be undertaken in panic or confusion. It is the responsibility of government and health officials to restore basic safety measures, but individuals can take action on their own to determine their level of personal risk and act accordingly.

The question many ask is simple: if I am vaccinated, am I still protected? But the answer is much more complicated. Even the best of the current generation of Covid-19 vaccines, the mRNA vaccines created by Pfizer and Moderna, do not erect an impenetrable barrier between the body and the virus. Instead, they trigger an immune response that teaches the body to recognize and neutralize the virus on sight. If the virus mutates beyond immune recognition, the vaccine loses all or most of its effectiveness, hence the recently popularized term “anti-vaccine variant”.

Here are some practical considerations we can do while we wait for more clarity and advice on upcoming variations. First of all, as long as new variations keep appearing, be comfortable with maintaining a certain level of situational awareness. What are the infection rates like in your neighborhood? What about the communities of people you interact with on a daily basis? The higher the prevalence, likely, the higher your personal risk.

Second, remember that “Covid-21” is not the same as Covid-19. The Delta variant appears to be up to ten times more infectious than the parent strain of SARS-CoV-2 from Wuhan. It also appears to effectively infect people of all ages, including adolescents and young children, in some cases causing serious illness and even death. This means that the basic safety measures we have relied on for most of 2020 to protect ourselves – mask wearing, hand washing, social distancing – don’t go far. Even people who have religiously followed these CDC guidelines over the past 18 months can become infected. Until our public health checks are as aggressive as the virus itself, it will be up to individuals to exercise caution than before.

Third, re-evaluate and improve your mask-wearing and social distancing habits. Until we know how effective non-clinical grade masks are in protecting against newer variants, I recommend wearing an N95 mask when meeting someone outside of your immediate bubble, whether it’s at inside or outside. I also recommend avoiding large groups of people even outdoors and limiting indoor exposure to as few people as possible. Keep in mind that the Delta variant is so contagious that Australian health authorities have documented transmission through “fleeting” non-physical contact in coffee shops and malls.

But what about vaccine status? This brings me to my fourth and final point: If you are vaccinated, do what you can to monitor your personal level of immune protection. This involves two main variables. First, your level of anti-SARS-CoV-2 antibodies. Two types of antibodies, similar but not identical, have been established as adequate correlates of immune protection against Covid-19: those that bind to the spike protein and those that inhibit it. The latter, also known as neutralizing antibodies, have the closest correlation, but advanced protein antibodies are a reasonable substitute.

A combination of clinical safety and efficacy data and computer modeling studies show that the higher your antibody titer, the higher your likely level of protection. Different vaccines cause different titers of antibodies, with mRNA vaccines generating the highest. My recommendation is, starting two weeks after vaccination, to get tested for antibody counts and have the same test – no standardized test available yet – repeated every four months. Your antibody titer will give you a rough approximation of your protection against infection.

The second variable is time. In addition to your antibody count, which is largely determined by the type of vaccine you’ve received, tracking the time since your last injection can also help you estimate your level of protection. According to one study, antibodies generated by vaccines can decrease by up to 50 percent in as little as 10 weeks. All anti-SARS-CoV-2 antibodies go away, but how quickly they go away depends on your age and medical history. This is why some countries are in the process of making booster shots available to older people, whose immune responses tend not to be as vigorous or long-lasting.

No magic number of antibodies or anything else can guarantee immunity against existing and future variants of SARS-CoV-2. But it’s time we came to terms with the fact that with a highly contagious variant on the loose, the chances of a vaccinated person getting sick and dying are inevitably higher. At least 100 people have been lost in such circumstances in Massachusetts, according to a new report. Studies also show that the Delta variant generates higher viral loads in our nasal passages, regardless of vaccination status, increasing the opportunities for transmission.

Going back to where we started, if protection is likely to weaken or wear off, is it worth getting the vaccine in the first place? Absolutely yes, on this question I have no doubts. But it is only by being vigilant about situational awareness, the threat presented by the new SARS-CoV-2 variants, and the strength and length of our antibody titers that we can ensure that we protect each other and each other to the best of our ability.

Overall, we need to improve our game when it comes to countering and defending ourselves against more infectious and dangerous forms of the Covid-19 virus. If our governments and local health officials do not step in, we must take responsibility for our individual actions and behaviors to minimize the risks to ourselves and those around us. Over time, we can end this pandemic with more broadly protective vaccines, prophylactic drugs and strong public health measures. But until those reinforcements materialize, we must keep our collective guard in place, or risk letting whatever we have built to ensure our recovery collapse.