By Dr. Pier Boutin, MD
The headlines about the Covid Delta variant may seem terrifying. Delta is causing spikes in new infections. Delta is infecting young people. Delta is making people who were already vaccinated sick. Delta is ripping through areas with low rates of vaccination. Delta causes a higher rate of serious cases, hospitalizations and death. Beware Delta!
The bold and scary headlines invite the reader to click, but mislead the facts. To protect ourselves, our families and loved ones, a better understanding of true risk based on FACTS is needed. Let’s review.
Delta was never a surprise
The news may make it sound like Covid was on its way out and then suddenly, like the end of a horror movie, it sprang back to life in the mutated form of the Delta variant.
The truth is, it’s in the nature of viruses to mutate. Most mutations offer an advantage to the virus, such as being more contagious. Eventually, successful mutations come to dominate, so the emergence of Delta was always to be expected. For example, all that time when scientists were first creating the vaccine? They knew the vaccines would eventually need to stand up to variants of Covid in addition to the original strain. This went into their decision-making process as they formulated the vaccines.
And so far, Covid vaccines are clearly doing their job. The evidence is still overwhelming that Delta is not threatening to healthy people who’ve been vaccinated or previously infected. What’s more, since about 60% of Americans age 12 and older have been vaccinated, and probably 25-30% have already had Covid, we are nearly at herd immunity.
This is all good news.
Rising infection numbers aren’t a shocker
Spikes in local infection rates are so bad in some places that mask mandates are being reintroduced. What’s driving these numbers are infections among a very specific group of people: those who’ve neither been vaccinated nor previously infected.
Let’s call this group the “naïve”. If the naïve are 15% of the population over the age of 12, that’s about 45 million people who have no antibody protection from Covid. Add to this about 20 million kids under the age of 12 who are unvaccinated and never had Covid. The spike we see in numbers reflects Delta’s more contagious nature. Some estimates say it could be twice as contagious as the original strains. So if we have approximately 65 million naïve, and a more contagious strain, guess what? Infections go up. That’s not shocking. It’s expected.
Over time we should anticipate that everyone will either be vaccinated or infected – it’s really their choice. (The vaccination is less dangerous, to be clear!) But for now, the number of the naïve will gradually decline as more people get vaccinated and more people get infected.
Delta is a problem for the vulnerable
We don’t yet know that Delta is more deadly. Yes, deaths may be increasing (though still down 90% from their peak), but that could be because the people contracting the virus now are more vulnerable. It may also be that what makes Delta more contagious is a factor like higher replication rates — so the infected may be shedding higher amounts of the virus — which is a formula for higher infection and more severe cases.
During the first waves of Covid, vulnerable people generally knew they were vulnerable and developed routines to protect themselves. Fortunately, many of the most vulnerable people — the elderly and those who are immunocompromised — have been vaccinated.
However, there is some indication that Delta is infecting more “non-naïve” people (meaning the already-vaccinated or those who had the virus). Is this a startling turn of events? Not at all. We’ve always known that immunity isn’t black or white – on or off. It’s a spectrum. The vaccine, promoted to be 95% effective, helps to build antibodies against the virus, thus significantly reducing symptoms if exposed to the virus. It does not mean that 95% of vaccinated people will not get the virus. For example, in immune-impaired people, it makes sense that the vaccines or prior infection offer immune protection that is less complete or of shorter duration. So Delta will “re-infect” them despite being non-naïve. Given this, it makes sense that vaccinated people with medical issues should take extra precautions to mask up and avoid crowds.
It’s also common sense that young people will be more vulnerable to Delta than earlier strains, especially since young people seem to be relaxing their social distancing behavior very quickly – even eagerly. Vaccine rates among the young (teens and young adults) are lower and infection rates have been low in this group on the whole. Children under 12 years old have not yet been recommended to receive the vaccine. That’s a lot of naïve who are now ripe for catching this more contagious virus. We’re not accustomed to thinking of the young as vulnerable. But in this case, it appears to be true.
Sensationalist headlines don’t change the facts
In the midst of an endless doom and gloom news cycle, it can feel like we’re never going to be on the right track with Covid. However, here’s what is vital to remember: the evidence is overwhelming that vaccination protects virtually everyone from severe cases of Covid, even Delta.
The fact that hospitals are seeing more severe cases of Covid Delta variant doesn’t contradict that. Those increases may be because of the higher rate of contagion reaching more vulnerable people.
The bottom line — none of the facts listed above are an argument for being afraid. But they are an argument for getting vaccinated. Not necessarily for yourself – but to protect the most vulnerable among us.
As more is known, we’ll update this piece.
Read more: Covid vaccines are good for our country. But are they good for you?
