NEWS & ANALYSIS

07/28/2021
Coronavirus Response

The Delta Variant: An Overview

What appears below is our attempt to provide a baseline of information, and some predictions of what we’re looking at over the next few weeks.

 
The Delta Variant

Covid By the Numbers

Cases are still increasing in all 50 states, but a handful of states are primarily driving the national numbers–Florida, California, Texas, Louisiana, Missouri, and Georgia are all the main drivers, each with over 2,000 new diagnoses today. Ohio has just eclipsed 1,300 new cases a day; this is the highest one-day number since May.

Covid Deaths

Mercifully, we’re not seeing deaths increase commensurate with new diagnoses, even accounting for the lag time we know exists between diagnosis and death. This was expected and hoped for, given that a significant majority of our oldest and therefore most vulnerable to Covid are fully vaccinated. Let’s hope this continues.

Why is Delta More Infectious

When someone gets Covid, the “viral load” that someone carries is a key reason why a virus can be more or less infectious. The Delta variant creates 1,000-times more viral load than the original Covid. This means that it takes much less exposure to contract the disease.

This is why lots of scientists and medical professionals and public health officials are calling for N95 masks, rather than just cloth masks or even disposable masks, to be worn by those that are not yet vaccinated. You can request N95 masks for your agency here

Shorter Incubation Period

Original covid had an incubation period of about six days. The Delta variant has an incubation period of about four days. 

The Surge in Diagnoses

What the Public Health Experts Are Saying About This Surge

First, the projections for where this surge is going in the U.S. are all over the place, even by the CDC. So I’m going to focus on the optimistic assessment based upon the UK’s please-be-a-bellwether-situation. The numbers in the UK–which has a similar-though-superior percentage of vaccinations and natural immunity to the U.S.–have started to fall as dramatically as they had risen. 

This has led Scott Gottlieb, the FDA Commissioner under the prior White House, to suggest that cases in the U.S. could peak in the next 2-3 weeks. I haven’t been able to find another expert whose opinion I respect as much as his to share that optimistic of a projected timeline.

Could This Be the Last Surge in the US?

The Delta variant is so infectious, some public health experts have gone so far as to say that this variant will expedite our country’s path toward herd immunity–and that this might actually prevent a winter spike of Covid. This assumes, of course, a variant does not emerge that evades vaccines. That remains the nightmare scenario, though the development of vaccines responsive to such variants is much further along than when this all started in the winter of 2020. 

Vaccines

Uncertainties and Boosters

There are some indications that the antibodies from vaccines begin to wane, even though indications remain strong that the vaccines provide excellent protection against serious Covid illness. This is why there’s increasing chatter about boosters being necessary later this year for those that are immunocompromised, and those over age 65. 

When Will Full Authorization Come?

The FDA is under withering criticism that it has not yet granted full authorization for any of the vaccines. At this point, various media reports have the FDA granting full authorization to the Pfizer vaccine in September. This would unleash the floodgates of mandated vaccinations across the country, though some cracks in that dam began to leak today. (More on that later.) The Moderna application has not yet been formally accepted by the FDA, so that is clearly going to be behind. Johnson & Johnson is still yet to submit its application. 

When Will Younger Children Be Eligible?

On this front, too, Pfizer is well ahead of Moderna and Johnson & Johnson. Pfizer is expected to seek emergency authorization for vaccinating children ages 5 to 11 in September. This would likely mean an EUA would be granted in October or November. However, the FDA just asked Pfizer to expand the number of participants in their clinical trial, which may delay the timeline some.

Pfizer’s application for vaccinating children ages 2 to 5 would come shortly thereafter, again meaning vaccinations would start for that age group in October or November. Lastly, an application for vaccinating children ages 6 months to 2 years is expected in October or November, meaning vaccinations would start in December or January 2022. 
Breakthrough CasesLast week, I told you about one of our members that had two staff members with breakthrough cases of Covid, requiring hospitalization. Those two people are now home and recovering. 

Overall, breakthrough cases are absolutely happening across the country–but indications are still extremely strong that serious cases of Covid are rare in vaccinated persons. 

That said, there’s not yet clarity on how frequently breakthrough cases are occuring. But consider that amongst the most vaccinated demographic age group in the U.S. (people over 65), new diagnoses remain low: 


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It should also provide some encouragement to those of you, like me, who have little children at home that cases aren’t spiking. But notably, older children are seeing double-digit increases in diagnoses–though not severity of disease, mercifully. 

Vaccine/Mask Mandates

A broad coalition of 60 healthcare groups–including the AMA and the American Nurses Association–have called for healthcare providers to mandate vaccinations for their respective staffs. Further, the State of California and the City of New York are mandating vaccines for their employees, as is the Department of Veterans Affairs for its 115,000 frontline healthcare workers. 

In Ohio, the ODH announced this week that schools will not be required to incorporate mask-wearing, nor to be vaccinated–they are strongly recommending both.

Further, Governor DeWine said today that employers must take the lead on vaccinating our state. This is why HSC is apart of the Coalition to Stop the Spread, an entity founded by the Ohio Business Roundtable.