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This week, Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention, said new data shows that the Delta variant of the coronavirus, in rare breakthrough infections, can be passed from vaccinated individuals to others. The CDC revised its guidelines and said everyone should wear a mask in areas with “substantial and high” levels of Delta transmission. With these revised guidelines, how can people stay safe in social settings, and should fully vaccinated people be concerned? Dr Leana Wen, emergency physician and author of the new book “Lifelines: A Doctor’s Journey in the Fight for Public Health” explains what Americans can do.
Video transcript
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ROCHELLE WALENSKI: We have a country full of Delta. Delta is a more transmissible virus. And the new data we have is that Delta is able, in these rare breakthrough infections, to be passed on to others. The most important thing we have to say right now is that we have a lot of this country that has a lot of viral load. It’s a lot due to people who, mostly unvaccinated people.
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LEANA WEN: It is true, of course, that the majority of infections are from unvaccinated to unvaccinated. And yes, it is very true that the unvaccinated are the reason we are in the position we are in right now with massive outbreaks across the country, with the Delta variant being the most contagious variant to date, now dominant here. If you are vaccinated then why should you care if others around you are also vaccinated?
But here’s the thing – spillover infection, these revolutionary infections are happening. I compared the vaccine to a very good raincoat. It protects you well in case of drizzle. It protects you well if you are several times in average rain. However, if you are in and out of daily thunderstorms at some point you are going to get wet.
And that’s because if you’re around all these unvaccinated potentially infected people, at some point there will be a breakthrough. You could be infected. And that, then, could also be passed on to other people, including unvaccinated and immunocompromised family members. So I think we really need to change our attitude in this country and be honest about the likelihood of major infections.
We also have to be honest that it is not just a matter of individual choice. A person, of course, you could say, well, he could decide for himself to get sick. But in this case we are talking about a highly contagious disease. I don’t think anyone should have the choice of infecting others with a potentially fatal virus.
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Now we don’t have the numbers for that. It’s hard for us to quantify and say, well, you’ve got a 1 in 10 or 1 in 2 or 1 in 100 chance of that happening. We really don’t know this information. What I take away from all of this is that if you are an immunocompromised person or if you live at home with an immunocompromised or unvaccinated person – for example, unvaccinated younger children – then you need to take extra precautions, which means that if you are in public areas where people around you are potentially unvaccinated and in confined spaces indoors you should wear a mask.
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I believe that in the fall almost all schools will be open for in-person instruction. We now have overwhelming evidence that schools may, in fact, be among the safest places for children from a COVID-19 transmission standpoint. Also, of course, schools are really essential for the emotional development of children, their cognitive development if mitigation, protective measures are put in place.
It is important to talk about this as layers of protection. And so, if you have an area of the country where the transmission of the coronavirus is very high, you need more diapers. On the other hand, if there is a very high level of vaccination in the community, therefore a very low level of transmission of the coronavirus, fewer diapers are needed. And that’s the reason why if you take away the level of physical distancing, you really need to have indoor mask warrants still in place and add testing on top of that – regular surveillance testing of unvaccinated people in more of that will be really helpful.
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We know that immunization mandates work. The vaccine requires work for other childhood vaccinations. We have laws in all 50 states that mandate vaccines. This is the reason why we don’t have polio, why we don’t have smallpox, why we have relegated to the history books many of these diseases that used to kill so many children.
We could do the same with COVID-19. Legally, the mechanisms for imposing vaccine mandates, there are certain levers. So, for example, employers, workplaces certainly should. Federal city, county, and state governments are also employers. They can also consider what could be done under their control.
Then, we must also look, once again, at the examples of other countries. France, for example, they say, you can choose not to be vaccinated, but if you want to go into restaurants, bars, concert halls, museums, you are not allowed to be infected. and potentially give other people life-threatening illness. . And so be unvaccinated if you want, but if you want to enter public spaces, there is a societal obligation.
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