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Sunday 11 July 2021
PHOTO: file
Latest information from the Centers for Disease Control shows the Delta variant of SARS-CoV-2 is now responsible for 52% of all COVID infections in the United States, with some states like Missouri reporting it now causes more than 70 % of infections.
This was both predicted and predictable, based on the Delta’s rapid rise in other regions where it emerged such as England, Japan and India, where it is now the origin of 95% of COVID infections. The wave of Delta infections in Japan prevented spectators from attending the Olympics. It can be expected to continue to increase in the United States
News and information continues to come out quickly about the Delta variant. Much is still unknown, but this is what is known at this time.
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1. The Delta variant is much worse than the previous strains
There have been a number of studies over the past few months analyzing the impacts of Delta and other variants. The World Health Organization has described Delta as the “fastest and fittest” variant to date. It is 40 to 60% more contagious and spreads easily than the Alpha variant (B.1.1.7), which itself is more transmissible than the original strain.
It also causes more serious illness, in part because it multiplies faster in the body. A recent study suggests that Delta can create a 1,000 times higher viral load in the body than previous strains. This makes the infection more serious and also makes those infected more contagious earlier. The risk of being hospitalized is double with Delta compared to other strains.
Delta also has some level of resistance to vaccines and antibody treatments, although vaccines continue to be generally very effective against it.
It is also clear that this phase of the pandemic primarily affects young people. This has been seen around the world, and here in Rhode Island, about 70% of COVID cases in the past two months have been in people under the age of 39.
2. The Delta variant hurts those who are not vaccinated
Half of all states in the United States are reporting an increase in COVID cases over the past week. This follows what happened in the world where Delta has become predominant, such as England. In the United States, COVID cases have increased 16% over the past week, along with a 9% increase in hospitalizations.
The curves look like the start of another push, because that is what it is.
There is a correlation between lower vaccination rates and higher infections and hospitalizations – the more people vaccinated, the less infected they are https://coronavirus.jhu.edu. States with low vaccination rates have an average of three times as many infections as those with higher vaccination rates.
According to Dr Rochelle Walensky, director of the Centers for Disease Control, about 93% of COVID-19 cases in recent days have occurred in counties with vaccination rates below 40%, and 99.5% of COVID deaths. -19 occurred in unvaccinated people.
Even more striking is a comparison of the most vaccinated states with the lowest – those with low vaccination rates experience about 10 times higher rates of new infections.
Status% 1+ vaccine dose Daily New cases / 100,000
Vermont 74% 0.6
Massachusetts 71% 0.7
Connecticut 68% 1.4
Maine 67% 1.0
Louisiana 39% 11.4
Arkansas 43% 16.1
Missouri 45% 16.1
Nevada 50% 13.7
Source: covidactnow.org
The evidence continues to be overwhelming: vaccinations reduce infections. People and places that avoid vaccines pay a painful price.
3. We don’t have a good idea of what’s going on in Rhode Island
The good news in Rhode Island is that infections have been dropping steadily since early May. Since early June, the risk in Rhode Island has dropped from “high” to “medium” according to covidactnow.org, although the CDC still classifies RI as “moderate” risk for infection https://covid.cdc.gov/ covid- data-tracker / # county-view.
However, testing has declined significantly, from more than 130,000 weekly tests performed at the end of January to just 32,609 last week, a drop of 75%. Tests have been steadily declining since early April. The state has closed a number of testing centers in recent weeks, making testing more difficult.
Unless enough testing is done, we can’t find out what’s really going on with Delta or other variants. Given the worrying developments in other states and the surges happening around the world, now is not the time to downgrade our early warning system. Without enough testing, we are preparing to be blinded by Delta and we won’t know what hit us until hospitalizations increase – which will be too late to do anything about it.
Last week, new hospitalizations for COVID dropped from 11 to 16 in the previous week (and 14 in the last 5 days), reaching 82% of intensive care capacity – Critical according to covidactnow.org. We don’t know if this is just variability in the numbers, or the start of a bigger problem caused by the July 4th application events.
So far, only a small number of Delta cases have been confirmed in Rhode Island, albeit on a low level of testing. Over the past week, only 50 genomic sequences for COVID variants have been taken in Rhode Island, making it difficult to know how widespread Delta is or where the hot spots are. Without this knowledge, it is impossible to react to flare-ups or prevent problems proactively.
It is crucial to do enough testing and genomic sequencing to identify variants and contain outbreaks before they can spread. In total, Rhode Island has performed only 4,093 genomic sequences – out of 4.5 million COVID tests in total and 152,738 positive cases. With Delta and other variants circulating and causing major problems elsewhere, now is the time to dramatically speed up testing and genomic sequencing, not cut back. By reducing testing and sequencing, we are leaving ourselves wide open to the risk of being caught off guard.
Just a few months ago, Rhode Island was literally the most infected place on Earth https://www.golocalprov.com/news/ri-is-the-most-infected-place-in-the-world – according to new data. We have learned a lot since then and we have stepped back from that precipice. Let us not forget those painful experiences and risk a new portrayal of one of the darkest and deadliest periods in Rhode Island public health history.
4. The vaccines work against Delta
Over the past two weeks, several studies have reported varying efficacy rates of Delta variant mRNA vaccines, with reported efficacy in preventing symptomatic disease ranging from 64% to 88%.
Importantly, all of these studies show that mRNA vaccines are very effective in preventing symptomatic illness, and almost completely (but not perfectly) effective in preventing serious illness, hospitalization, or death. If you are vaccinated and have Delta, you are much less likely to get sick and have very little chance of being hospitalized or dying. Each of these studies was performed somewhat differently and in its own particular populations. We are fortunate to have vaccines that work so well and have shown excellent safety profiles.
You are much more likely to have health problems from COVID than a side effect from a vaccine.
5. It is high time to get vaccinated – or risk becoming a factory of mutations
All viruses mutate. It is the fundamental evolutionary process of nature. Life evolves in a way that promotes its own survival. In the case of the coronavirus, that means evolving in a way that becomes more contagious, causes more serious disease (and thus creates more virions), or becomes resistant to vaccines.
The more people who are infected, the more variants will be created and the greater the risk that the virus will continue to evolve so as to become increasingly resistant to vaccines.
Each person who chooses not to be vaccinated not only puts their own health and life at risk and poses a risk to others, but is also essentially a factory of mutations. An infected person will have between 1 and 100 billion virions in their body. Based on how quickly the coronavirus mutates, this means that each infected person could potentially generate thousands to hundreds of thousands of new mutations. How many of these could result in a new variant with increased transmissibility, disease severity, or vaccine resistance?
Without restrictions, masks or social distancing, an infected person could cause 1,000 infections in one month and a million infections in two months.
“My Body, My Choice” does not apply when one person’s actions may cause harm or death to many other people.
Unless more people are vaccinated enough to break the cycle of transmission (“herd immunity”), new and more dangerous variants are likely to continue to appear every few weeks. There are already others circulating beyond Delta.
Another recently described new variant is called Lamba (C.37) first identified in Peru https://www.livescience.com/lambda-coronavirus-variant.html. It contains 7 mutations in the “peak” region of the virus, including one called F490S, which a recent study found could be a “vaccine escape mutation”.
Peru has the highest COVID per capita death rate in the world and is a vivid example of what a deadly variant can do. Lamba has already been found in the United States
Here in Rhode Island, we might already be seeing an increase in the Gamma variant, also known as P.1 or “Brazil”. 236 cases of Gamma have been confirmed to date in Rhode Island, including a 20% increase and accounting for almost 80% of all COVID cases sequenced over the past week. Gamma is also both more transmissible than previous strains and shows some resistance to vaccines. Gamma and Delta are quickly becoming predominant in the United States.
Each infected person can become the source of another variant. You wouldn’t like (and might not survive) the experience of a new variant coming from your body, and our state doesn’t want to be known to produce the “Rhode Island variant.”
The only way to break this cycle is to dramatically increase the number of vaccinations. The IR is doing well, but needs to do a lot better if we are to avoid another surge.
Even Donald Trump and his family were vaccinated and received it at the start of the pandemic in January. If even he chose to get it, right?
Nick Landekic is a retired scientist and biotechnology executive with over 35 years of experience in the pharmaceutical industry.
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