How a Cape Cod Covid outbreak turned what we know about vaccines upside down and could put us all back in masks



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When Joe Biden gave his first-ever prime-time speech to the nation as president, he expressed his high hopes that July 4 of this year would “mark independence” from Covid-19 – as long as the people would be vaccinated.

Perhaps beach goers in Provincetown, many of whom are comfortable knowing they had done just that, remembered his words as they celebrated Independence Day during a Relaxed weekend of barbecues, parties, crowded bars and restaurants in Cape Point Massachusetts. Cod.

In fact, this weekend led to a Covid-19 outbreak that shocked health officials and upset medical hypotheses, demonstrating as it did, that the Delta variant can be as transmissible by vaccinees as by unvaccinated people.

As the Centers for Disease Control and Prevention (CDC) noted in a leaked data report revealed by the Washington post: “The war has changed.”

Before Provincetown, it was considered extremely rare for a vaccinated person to be infected with Covid-19, let alone pass it on to others. But among the nearly 900 confirmed cases of Covid-19 linked to the cluster, 74% involved people who had been vaccinated.

The outbreak was “a crucial discovery” about the Delta variant, CDC chief Dr Rochelle Walensky said in a statement on the new information, and it quickly led to the agency’s release of new guidelines. on wearing masks earlier in the week.

The new guidelines announced by the CDC urged people vaccinated in Covid-19 hotspots to resume wearing masks in indoor public places, regardless of their vaccination status. He also recommended indoor masks for all teachers, staff, students and visitors to schools across the country.

This was in part a withdrawal from earlier CDC guidelines from May, which said those vaccinated no longer needed to wear masks in most settings, with the understanding that vaccines would largely prevent the disease. virus transmission.

But the CDC’s latest report, released Friday, said 127 vaccinated people infected with the Delta variant during the outbreak appeared to carry as much of the virus as 84 unvaccinated or partially vaccinated people who are infected.

Explaining the link between the Delta variant and the so-called “breakthrough cases” where a person is infected despite being fully vaccinated, Dr. Walensky’s statement said: “High viral loads suggest an increased risk of transmission and raised concerns that, unlike other variants, vaccinated people infected with Delta may transmit the virus, “adding,” This finding is concerning. “

Highlighting how worrisome the contagiousness of the Delta variant might be, a leaked CDC slide presentation described the Delta variant as being as infectious “as chickenpox,” the CDC reported. Washington post. Chickenpox affected up to four million Americans a year before a vaccine was available in the mid-1990s.

The Delta variant is more transmissible than colds, seasonal flu and smallpox according to the document, and each infected person can, on average, end up transmitting the virus to eight or nine others.

“It is not good news that masking is going to be a part of the lives of people who have already been vaccinated,” Dr Walensky told reporters when she initially announced the CDC’s update. “This new direction weighs heavily on me.

But while the CDC’s new mask guidelines have been interpreted by many as a step backwards in the United States’ fight against the virus, not everyone has interpreted the Provincetown outbreak the same.

Alex Morse, the city manager, said what he was seeing: “The vaccines are working. “

“Day by day things are improving,” Mr. Morse told Yahoo News, adding that while unwelcome, the city’s rapid re-imposition of a mask warrant had been crucial to improving infection rates.

Mr Morse also made a key point about the positive cases from Provincetown: while 70% of the cases were symptomatic, the symptoms were generally mild, there had been no increase in hospitalizations – and most importantly, none of the seven. patients hospitalized with Covid-19 have died.

While any outbreak is “of course tragic,” said Dr. Lucy McBride, internist in Washington, DC, it “demonstrates the potency of Covid vaccines,” which have resulted in the overwhelming majority of Provincetown cases were mild or asymptomatic.

Unlike commentators who have used the revolutionary new case data to question the effectiveness of vaccinations, the Provincetown cluster is in fact, she said, “a stark reminder of the critical importance of being vaccinate “.

The leaked CDC document, despite its alarming comparisons to other infectious diseases, echoes his analysis. He said those vaccinated are safer, with the risk of serious illness or death decreasing by 10 times and the risk of getting an infection being reduced by up to three times.

Vaccines may be less effective at preventing infection or transmission, but “prevent more than 90% of serious illness,” he said.

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