The Delta variant is changing the rules

Never put it past Mother Nature to take the upper hand. Dismiss the value and importance of Nature and the tightly interwoven relationship of human survival with the health of our natural world and our fellow citizens long enough, and Nature will take steps to remind us who is in control. We are seeing this with climate change and we are seeing this with the development of more transmissible and potentially deadly SARS-CoV-2 viral variants. It’s time to pay respect, to drop our hubris, and to remember our place in this world. And when Mother Nature adapts, we must adapt with her. The Delta variant is changing the rules of the game. If we don’t change in response, the virus will win.

Growing frustrations over necessary change

Every day I hear people express anger and frustration that we are talking about going back to universal masking and distancing requirements in schools and workplaces; that businesses are now imposing vaccination mandates for employment or patronage.

Image of teacher back to school wearing a mask. Photo from Pixabay.

I am also frustrated. But my frustration is directed towards those people out there refusing to protect self and community through vaccination. I’m frustrated that all the work that we have done to educate and protect hasn’t been enough (though, never fear, I am not deterred and my work will go on). I am frustrated FOR our leaders who are being forced to make difficult decisions to protect the masses, even those who won’t protect themselves.

Is change hard? Absolutely! But, we must recognize how much we still don’t know about this virus. Humility is vital right now. Humility, and recognition that we are learning as we go, will help us not be so surprised when we have to change course in the Pandemic. It will help us remain nimble. And I’m quite certain that this will not be the last pivot in our Pandemic response that we will have to make.

Not yet vaccinated? Read on…

I fully recognize that there are people out there that are not vaccinated because of a legitimate medical concern. I also acknowledge that a portion of our population is not vaccinated because of lack of access (and we must do better to make preventative medical care, not just reactive medical care, available to ALL individuals). If you fall into one of those categories, my next comments are not directed towards you. What I am about to say is meant more for those people out there who have yet to be vaccinated… by choice.

Some believe they have a superior immune system and that they, personally, wouldn’t see harm from the virus (that’s a nice middle finger to those out there who could become deathly ill if they contract the virus from that person). Did I mention humility? I hope they’re knocking on wood somewhere because that line of thinking is bound to come back and bite them in the keester.

Others are giving in to fears and seeds of doubt – buying into theories that have no basis in science or fact – that, by causing them to choose against vaccination, actually increases their risk of harm. This is a group I have greater empathy for, by the way, as emotions and health anxieties are easily preyed upon.

And some are completely blinded by conspiracy theories, believing in Jewish lasers from space causing wildfires, 5G cell towers spreading disease, and microchips for mind control placed in the vaccines. I cannot help these people.

But here is what we all need to recognize about our new common enemy – the Delta variant…

Easier, younger, sicker, quicker

• The Delta variant is more contagious than prior COVID virus strains.
  • If you’ve been following my blogposts through the Pandemic, you will recall a discussion of R0. This is the reproduction number of a virus – the ability of one infected person to transmit the virus to others. The R0 of the original virus was ultimately felt to be about 2-3 (meaning one person could transmit the virus to 2-3 others). The R0 of the Delta variant is felt to be between 5-9!
  • Through mutation, it is theorized that the Delta variant has gained the ability to bind more tightly to our cells and to more easily and rapidly replicate (make copies of itself) in our respiratory passages.
    • More virus in your respiratory passages means it is easier to transmit, even sometimes by people who have been previously vaccinated.

Infographic from the CDC showing increased contagiousness of the Delta variant vs the original COVID strain.  

• The Delta variant is suspected to be more virulent – more dangerous.
  • Widespread anecdotal evidence from those working in ICUs suggests that people are coming in sicker than before and deteriorating (ending up on ventilators, etc.) more quickly than with earlier viral variants (NYTimes: Is the Delta variant making younger adults ‘sicker, quicker’?).
• The Delta variant is causing more serious illness in younger people.
  • Those under age 50 now make up close to 40% of hospitalizations and ICU admissions.
  • Now, maybe that’s because younger people are not immunized at the percentage that older Americans are. But, all the more reason for younger adults to get out there and get vaccinated with haste!

So, what we knew about the earlier viral variants doesn’t always apply in the case of the Delta variant. As we said before, the Delta variant is changing the rules of the game.

Vaccines are THE BEST way to protect yourself and others

Here’s what we know about our COVID vaccines…

• Those who are fully vaccinated are significantly more protected from severe illness and death from COVID than those who are unvaccinated or under-vaccinated.
  • Hospitals around the country are reporting that the unvaccinated, by far and away, make up the greatest percentage (around 97%) of their patients who are severely ill and dying with COVID. Here is what we are seeing in Washington state.

Washington State Dept. of Health data on % of persons hospitalized and dying from COVID between February and June 2021 who were not fully vaccinated.

• Our COVID vaccines are giving us at least 6 months of protection from COVID. We will know more as we follow the immune response of study participants out over time.
• Mutations happen because we have, through lack of adequate numbers in the population being vaccinated, allowed this virus to continue to infect us, its human host.
  • Without a host, the virus can’t learn to evade our defenses. If we can limit the number of people getting infected (THROUGH VACCINATION), we can limit the chance of even deadlier variants developing in the future.

“But what about breakthrough infections?”

1. Breakthrough infections are expected! The vaccines are not 100% effective – no one ever claimed they were. Some people will not mount a full or adequate immune response to vaccination. The Pfizer and Moderna vaccines are nearly 95% effective, at least against the original strains of the virus. That means that we would expect up to 5% of vaccinated individuals to still develop illness despite vaccination. The breakthrough numbers we are seeing now are closer to 0.01%! Not too shabby!
2. Also, as a greater percentage of the population is vaccinated, if infections occur, we would expect that a growing number of those positive cases would come from vaccinated people. That’s just math, people.
   • Just remember, people that get infected despite full vaccination are more likely to be asymptomatic or minimally symptomatic. They also clear the virus more rapidly and will be less contagious for shorter periods than those who are unvaccinated.
     • This is the point of vaccination, right? To keep you from being seriously ill and make you less likely to spread the virus?
   • Unvaccinated persons, on the other hand, are at high risk for serious disease and are the greatest contributors to viral spread.

“When will we need booster shots?”

1. As stated above, our current vaccine protection is still going strong for the large majority of people.
2. BUT, there are select groups in our population for whom we have growing concern. Those who are immune compromised and the elderly often don’t mount as robust of an immune response to vaccinations. We may see recommendations about boosters for certain groups coming out in the next 1-2 months. Keep your ears open.
3. For the rest of the population, it all really depends on what happens with the viral variants and whether they develop the ability to evade our immune response.
4. You’ll hear about some countries starting to offer booster shots to their citizens. However, the World Health Organization just put out a statement recommending against boosters for the general population. Instead, they recommend focusing on immunization for those around the world that have not yet been vaccinated.
   • Decreasing COVID throughout our global community will decrease the chance that further deadly mutations will develop. Remember, our human lives are intricately intertwined. Disease elsewhere eventually will mean disease in our own back yard.

Take home points:

• We must expect change and be able to adapt to it – both at an individual and a societal level.
• The Delta variant is dangerous. Anyone who has yet to get vaccinated, or hasn’t completed their vaccine series, needs to march themselves right out and get immunized.
• Young people are not immune to the devastating effects of this virus.
• Our vaccines are HIGHLY effective at preventing serious and deadly disease.
• Estimates now project that we will need more than 80% immunization to achieve herd immunity. Until we have a significant percentage of the population vaccinated, our safest bet is to go back to our highly effective public health mitigation measures (masking, sanitizing, and social distancing).

If the rules of the game change, we’ve got to play by new rules.

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