As we enjoy this summer's reprieve from an ever-present COVID menace, new information about how easily the Delta variant spreads should shift our gaze to how we get ready for the fall. In the U.S., which seems to have been caught off guard by Delta, despite obvious warnings from Canada and the U.K. where it showed up earlier, COVID has increased dramatically in recent weeks. Predictably, this has mostly happened in areas with combined factors that allow the virus to thrive: large pockets of unvaccinated residents (even in states with fairly high average vaccination rates) and an absence of protective restrictions. But within the predictable outcomes, something troubling and unexpected has emerged: "breakthrough" infections among the fully vaccinated, together with news that even those with two doses can carry enough of the virus to pass it to others. In studying outbreaks, including one associated with a large indoor gathering in Massachusetts that turned into a super spreader infecting more than 1000 people, many of whom had been vaccinated, here's what health officials have concluded:
The Delta variant is as contagious as chicken pox and far more contagious than either the seasonal flu or the common cold.
Those infected with the Delta variant appear to have a "viral load" (the amount of virus in their nose and throats) 1000 times greater than with the original form of the virus.
If infected, the fully-vaccinated can carry the same viral load, thereby transmitting the virus as readily as an infected unvaccinated person.
Though still somewhat rare – perhaps less than one percent of all cases – breakthrough infections happen more frequently than initially expected.
Early thinking was that immunization would prevent the creation of enough virus for the vaccinated to spread it to others, and that may have been true with the first strain. But because Delta is thought to produce too much virus in the nose and throat for the vaccine to effectively contain, it can still be spread through particles emitted when an infected person coughs, speaks or breathes. All of these worrying revelations need to be understood in context and placed alongside the continued overwhelmingly good news about vaccination:
Fully-vaccinated people are unlikely to get COVID in the first place – even with the Delta variant circulating widely – and are therefore much less likely to pass it on.
The small percentage of fully-vaccinated people who do get infected are extremely unlikely to get seriously ill or die.
In other words, the new revelations do not undermine the importance of vaccines. They do, however, underline just how dangerous this virus is and the amount of public co-operation it will take to effectively contain it.
What's happening in the U.S. is mostly a warning about how rapidly the virus can cause serious illness among the unvaccinated in states like Florida, now hitting new records for hospitalization. All evidence points to a very high rate of vaccination - perhaps 90% - as being the only realistic way of containing the spread of COVID to the point that we can resume most aspects of daily life.
Although we now know that the vaccinated can spread the virus, it is overwhelmingly the unvaccinated who will do so, thereby keeping the cycle of infection going.
Some countries and cities such as New York have already introduced rules designed to protect the vaccinated from the unvaccinated by limiting the latter's ability to travel, dine indoors or attend public events. In the United States, many companies are requiring employees to be vaccinated. Canada has been slow off the mark in developing policy on both these fronts (more on that in the next newsletter).
Here at home, COVID case counts are slowly rising again, indicating that we are likely heading towards a fourth wave as restrictions ease, classrooms re-open, residents becomes complacent, and cooler weather pushes gatherings indoors.
Vaccination, including the possibility of a third booster shot to increase immunity or to specifically target Delta or other variants, provides the only real path to limiting the next wave so that we can stay safe without business shutdowns, school closings or extreme limitations on our social lives. Nobody wants to see any of that again.
Continued masking and social distancing indoors – especially around anyone who is unvaccinated - will also become increasingly important.
Today, I'm thinking how the coronavirus feels like a hotel where "you can check out any time you like, but you can never leave". This week's music video is a note-for-note recreation of Hotel California using only one instrument – the human voice.