CDC director: Delta variant is growing threat to unvaccinated people

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POLITICO 01 July, 2021 - 12:53pm 51 views

Nearly 25 percent of recent infections have been linked to Delta, up from 6 percent in early June.

By ERIN BANCO, ADAM CANCRYN and DAN GOLDBERG

Nearly 25 percent of new infections have been linked to Delta, she said, up from 6 percent in early June.

"Looking across the country we have made incredible progress," Walensky said during a press briefing Thursday. "However, looking state by state and county by country it is clear communities where people remain unvaccinated are communities that are vulnerable. I expect that in the coming weeks the [Delta] variant will eclipse the Alpha variant."

Walensky’s remarks come just days before the July 4 holiday, which President Joe Biden has targeted as the date by which the country would return to normal life. Biden also set a goal in May of having 70 percent of U.S. adults vaccinated with at least one Covid-19 shot by the holiday — a goal that the White House will narrowly miss amid dwindling demand for vaccines. About 57 percent of American adults are fully vaccinated, according to CDC data.

The Biden administration is in the midst of an aggressive campaign to reduce vaccine hesitancy. Top officials including Anthony Fauci, the president’s chief medical adviser, and First Lady Jill Biden have traveled to communities in Washington, D.C. and Florida in an effort to address Americans’ concerns about Covid-19 shots. But the rate of vaccination has not improved in recent weeks, prompting Biden health officials to warn that undervaccinated communities are vulnerable to new outbreaks.

Despite the rise of the Delta variant, the CDC does not have plans to reinstate masking recommendations for those who are vaccinated, according to people familiar with the discussions. That represents a break from the World Health Organization, which last week reiterated its belief that everyone should continue wearing masks, regardless of vaccination status.

"If you look at the share of the population that is fully vaccinated in U.S. and worldwide it is dramatically different. So is the dynamics of the infection," Fauci said. "People at the local level will make recommendations or not according to the situation."

Biden officials have stressed in recent days that masks are necessary to protect the unvaccinated population increasingly at risk of infection. Those who get the shot, by contrast, are overwhelmingly shielded from the disease. The CDC is working to model the risk posed by Delta variant and is studying how well the vaccines available in the U.S. protect against it.

Walensky said the Delta variant poses the greatest risk in parts of the country where the vaccination rate is still lagging. Approximately 1,000 counties in the U.S. have vaccination coverage of less than 30 percent, Walensky said. That includes counties in states such as Missouri, Oklahoma and Texas.

The administration is set to send response teams composed of officials from the CDC, the Federal Emergency Management Agency and the Department of Health and Human Services to areas struggling to increase their vaccination rates. The officials plan on helping deliver vaccine supplies and providing staff for vaccination sites. It is unclear what exactly the new teams will do differently to tackle the Delta variant from what the federal government has already been doing to contain the spread of Covid-19.

The federal government has for nearly a year relied on CDC, HHS and FEMA staff to help states to respond to the Covid-19 pandemic. FEMA has spent the past six months sending significant resources, including military personnel, to states to set up vaccination sites. CDC staff have worked with state public health departments to track Covid-19 cases and isolate people who test positive for the virus.

Two Biden officials working on the administration’s vaccine campaign said the federal government is currently discussing ways to more efficiently target communities that are hesitant about receiving the shot or simply do not want to get the jab. In some instances, those officials said, the federal government may not be the best messenger. The push to get people vaccinated may fall largely on local public health officials and community members.

State officials in Nevada are redoubling efforts to push the vaccine amid one of the worst outbreaks in the country. The daily case count has more than doubled over the last two weeks and hospitalizations are up 40 percent. Vaccination efforts are focusing on Clark County, home to Las Vegas, where the governor this week announced he would be deploying additional mobile vaccine units and offering grants to community organizations doing direct outreach to vaccine hesitant residents.

Arkansas Gov. Asa Hutchinson urged unvaccinated people celebrating the holiday weekend to remain masked or socially distant as the state is experiencing a surge in cases. Arkansas has 300 people hospitalized with Covid-19 for the first time since March.

Hospitalizations in Missouri have nearly quadrupled in six weeks as the Delta variant has swept through the northern and southwestern parts of the state. Gov. Mike Parson on Wednesday told local media that the state is focused on a marketing campaign to boost vaccination rates.

Some local and state officials have ramped up their messaging about the importance of wearing masks amid the spread of the Delta variant.

In Los Angeles, public health officials have urged residents to begin wearing masks again in public places, including restaurants and stores. The city dropped its public mask mandate June 15. Illinois Gov. J.B. Pritzker said Wednesday that residents of the state, even the fully vaccinated, should begin to wear masks again in high-risk situations, including crowded indoor gatherings.

In the unfolding pandemic, economic crisis and reckoning on race, governors and mayors are shaping our shared future. Who are the power players, and how are they driving politics and influencing Washington?

Read full article at POLITICO

What parents need to know about children and the Delta variant

CNN 01 July, 2021 - 04:32pm

Updated 6:35 PM ET, Wed June 30, 2021

The 3 Simple Rules That Underscore the Danger of Delta

The Atlantic 01 July, 2021 - 06:00am

Fifteen months after the novel coronavirus shut down much of the world, the pandemic is still raging. Few experts guessed that by this point, the world would have not one vaccine but many, with 3 billion doses already delivered. At the same time, the coronavirus has evolved into super-transmissible variants that spread more easily. The clash between these variables will define the coming months and seasons. Here, then, are three simple principles to understand how they interact. Each has caveats and nuances, but together, they can serve as a guide to our near-term future.

The vaccines have always had to contend with variants: The Alpha variant (also known as B.1.1.7) was already spreading around the world when the first COVID-19 vaccination campaigns began. And in real-world tests, they have consistently lived up to their extraordinary promise. The vaccines from Pfizer-BioNTech and Moderna reduce the risk of symptomatic infections by more than 90 percent, as does the still-unauthorized one from Novavax. Better still, the available vaccines slash the odds that infected people will spread the virus onward by at least half and likely more. In the rare cases that the virus breaks through, infections are generally milder, shorter, and lower in viral load. As of June 21, the CDC reported just 3,907 hospitalizations among fully vaccinated people and just 750 deaths.

Could the Delta variant (also known as B.1.617.2) change that picture? Data from the U.K. suggest that it is 35 to 60 percent better at spreading than Alpha, which was already 43 to 90 percent more transmissible than the original virus. (It may also be deadlier, but that’s still unclear.) It now causes 26 percent of new infections in the U.S. and will soon cause most of them.

But even against Delta, full vaccination—with a heavy emphasis on full—is effective.  Two doses of Pfizer’s vaccine are still 88 percent effective at preventing symptomatic Delta infections, according to a U.K. study, and 96 percent effective at preventing hospitalization. (A single dose, however, is only 33 percent effective at stopping symptomatic infection.) Israel, a highly vaccinated country, is experiencing a small Delta surge, but so far, none of the new cases has been severe. And while about 30 percent of those new cases have been in fully vaccinated people, this statistic reflects, in part, the country’s success at vaccination. Because Israel has fully vaccinated about 85 percent of adults, you would expect many new infections to occur in that very large group. “It does seem like the vaccines are holding their own against the variants,” Emma Hodcroft, an epidemiologist at the University of Bern, told me. “That’s something we can take some comfort from.”

But the coronavirus can cause serious problems without triggering severe infections. Because people can develop long COVID without ending up in the hospital, could Delta still cause long-term symptoms even if vaccines blunt its sting? The anecdotal reports of long-haulers whose symptoms abated after vaccination might suggest otherwise, but “we don’t know enough to say,” Bill Hanage, an epidemiologist at Harvard, told me.

Another crucial question that “we really need to understand is the nature of transmission from breakthrough cases,” Hanage said. Worryingly, a recent study documented several cases during India’s spring surge in which health-care workers who were fully vaccinated with AstraZeneca’s vaccine were infected by Delta and passed it on.

If other vaccines have similar vulnerabilities, vaccinated people might have to keep wearing masks indoors to avoid slingshotting the virus into unvaccinated communities, especially during periods of high community transmission. “That is unfortunately the direction this is headed,” says Ravindra Gupta, a clinical microbiologist at the University of Cambridge, who led the study. Israel has reimposed a mask mandate, while Los Angeles County and the World Health Organization have advised that vaccinated people should wear masks indoors. And such measures make sense because ...

Vaccinated people are safer than ever despite the variants. But unvaccinated people are in more danger than ever because of the variants. Even though they’ll gain some protection from the immunity of others, they also tend to cluster socially and geographically, seeding outbreaks even within highly vaccinated communities.

The U.K., where half the population is fully vaccinated, “can be a cautionary tale,” Hanage told me. Since Delta’s ascendancy, the country’s cases have increased sixfold. Long-COVID cases will likely follow. Hospitalizations have almost doubled. That’s not a sign that the vaccines are failing. It is a sign that even highly vaccinated countries host plenty of vulnerable people.

Delta’s presence doesn’t mean that unvaccinated people are doomed. When Alpha came to dominate continental Europe, many countries decided not to loosen their restrictions, and the variant didn’t trigger a huge jump in cases. “We do have agency,” Hodcroft said. “The variants make our lives harder, but they don’t dictate everything.”

In the U.S., most states have already fully reopened. Delta is spreading more quickly in counties with lower vaccination rates, whose immunological vulnerability reflects social vulnerability. Black and Hispanic Americans are among the most likely groups to die of COVID-19 but the least likely to be vaccinated. Immunocompromised people may not benefit from the shots. Children under 12 are still ineligible. And unlike in many other wealthy countries, the pace of vaccinations in America is stalling because of lack of access, uncertainty, and distrust. To date, 15 states, most of which are in the South, have yet to fully vaccinate half their adults. “Watch the South in the summer,” Hanage said. “That’ll give us a flavor of what we’re likely to see in the fall and winter.”

Globally, vaccine inequities are even starker. Of the 3 billion vaccine doses administered worldwide, about 70 percent have gone to just six countries; Delta has already been detected in at least 85. While America worries about the fate of states where around 40 percent of people are fully vaccinated, barely 10 percent of the world’s population has achieved that status, including just 1 percent of Africa’s. The coronavirus is now tearing through southern Africa, South America, and Central and Southeast Asia. The year is only half over, but more people have already been infected and killed by the coronavirus in 2021 than in 2020. And new variants are still emerging. Lambda, the latest to be recognized by the WHO, is dominant in Peru and spreading rapidly in South America.

Many nations that excelled at protecting their citizens are now facing a triple threat: They controlled COVID-19 so well that they have little natural immunity; they don’t have access to vaccines; and they’re besieged by Delta. At the start of this year, Vietnam had recorded just 1,500 COVID-19 cases—fewer than many individual American prisons. But it is now facing a huge Delta-induced surge when just 0.19 percent of its people have been fully vaccinated. If even Vietnam, which so steadfastly held the line against COVID-19, is now buckling under the weight of Delta, “it’s a sign that the world may not have that much time,” Dylan Morris, an evolutionary biologist at UCLA, told me.

With Delta and other variants spreading so quickly, “my great fear is that in not very long, everyone globally will either have been vaccinated or infected,” Morris said. He didn’t want to pinpoint a time frame, but “I don’t want to bet that we have more than a year,” he said. And richer nations would be wrong to think that the variants will spare them, because ...

Whenever a virus infects a new host, it makes copies of itself, with small genetic differences—mutations—that distinguish the new viruses from their parents. As an epidemic widens, so does the range of mutations, and viruses that carry advantageous ones that allow them to, for example, spread more easily or slip past the immune system to outcompete their standard predecessors. That’s how we got super-transmissible variants like Alpha and Delta. And it’s how we might eventually face variants that can truly infect even vaccinated people.

None of the scientists I talked with knows when that might occur, but they agree that the odds shorten as the pandemic lengthens. “We have to assume that’s going to happen,” Gupta told me. “The more infections are permitted, the more probable immune escape becomes.”

If that does happen, when would we know? This is the first pandemic in history in which scientists are sequencing the genes of a new virus, and tracking its evolution, in real time—that’s why we know about the variants at all. Genomic surveillance can tell which mutations are rising to the fore, and lab experiments can show how these mutations change the virus—that’s how we know which variants are concerning. But even with such work “happening at incredible speed,” Hodcroft told me, “we can’t test every variant that we see.”

Many countries lack sequencing facilities, and those that have them can be easily swamped. “Again and again, we have seen variants pop up in places that are under extraordinary strain because those variants are causing large surges,” Hanage said. Delta ripped its way through India, “but we only understood it when it started causing infections in the U.K.—a country that had plenty of scientists with sequencers and less to do.” So the first sign of a vaccine-beating variant will likely be an uptick in disease. “If vaccinated folks start getting sick and enter hospitals with symptoms, we’ll have a pretty good picture of what’s going on,” Maia Majumder, an epidemiologist at Harvard Medical School and Boston Children's Hospital, told me.

We’re unlikely to be as vulnerable as we were at the beginning of the pandemic. The vaccines induce a variety of protective antibodies and immune cells, so it’s hard for a variant virus to evade them all. These defenses also vary from person to person, so even if a virus eludes one person’s set, it might be stymied when it jumps into a new host. “I don’t think there’ll suddenly be a variant that pops up and evades everything, and suddenly our vaccines are useless,” Gupta told me. “It’ll be incremental: With every stepwise change in the virus, a chunk of protection is lost in individuals. And people on the edges—the vulnerable who haven’t mounted a full response—will end up bearing the cost.”

If that happens, vaccinated people might need booster shots. Those should be possible: The mRNA vaccines produced by Moderna and Pfizer should be especially easy to revise against changing viruses. But “if we need boosters, I worry that countries that are able to produce vaccines will do so for their own populations, and the division around the world will become even greater,” Maria van Kerkhove, an infectious-disease epidemiologist at the WHO, told me.

The discussion about vaccine-beating variants echoes the early debates about whether SARS-CoV-2 would go pandemic. “We don’t think too well as a society about low-probability events that have far-reaching consequences,” Majumder told me. “We need to prepare for a future where we are doing vaccine rollout again, and we need to figure out how to do that better.” In the meantime, even highly vaccinated nations should continue investing in other measures that can control COVID-19 but have been inadequately used—improved ventilation, widespread rapid tests, smarter contact tracing, better masks, places in which sick people can isolate, and policies like paid sick leave. Such measures will also reduce the spread of the virus among unvaccinated communities, creating fewer opportunities for an immune-escape variant to arise. “I find myself the broken record who always emphasizes all the other tools we have,” van Kerkhove said. “It’s not vaccines only. We’re not using what we have at hand.”

The WHO’s decision to name variants after the Greek alphabet means that at some point, we’ll probably be dealing with an Omega variant. Our decisions now will determine whether that sinister name is accompanied by equally sinister properties, or whether Omega will be just an unremarkable scene during the pandemic’s closing act.

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Editorial: Feels like we’re there, but we’re not. The Delta variant is in the way.

Chicago Tribune 30 June, 2021 - 03:54pm

Chicago feels refreshingly alive again. Restaurants across the city — the ones that managed to stay open — bustle with diners. Wrigley Field and Guaranteed Rate Field are once more inviting full capacity. Beaches, the lakefront path, city parks — specked with Chicagoans. That sense of normalcy the city craved for over a year — Chicago can feel it. Time to pop the Champagne?

Hold on. The delta variant is derailing party plans.

One lesson we’ve learned during the pandemic is the coronavirus’s capacity to mutate. Variants have emerged — gamma from Brazil, alpha from the U.K., and now, delta from India — that have caused new outbreaks in parts of the world and forced governments to reimpose lockdowns. In Australia, Sydney issued a two-week stay-at-home order over concern about the delta variant. Delta also prompted Israel to reimpose its mask requirement.

In the U.S., delta now accounts for half of all new cases in as many as 10 states, including Missouri, Iowa, Kansas and Nebraska, and for more than 20% of all new coronavirus infections in the country, according to the Centers for Disease Control and Prevention. In Illinois, cases attributed to the delta variant remain low — just 84 as of Sunday. However, Gov. J.B. Pritzker said this week that Illinoisans can expect delta to dominate cases statewide by the fall.

Delta’s especially concerning because it spreads faster than other variants. Dr. Tedros Ghebreyesus, director general of the World Health Organization, calls Delta “the most transmissible” variant as of yet. And, the CDC says the delta variant can result in “more severe disease.”

As daunting as delta is, the best firewall we can put up is obvious. Vaccinations are the biggest reason why Illinois’ seven-day rolling average positivity rate is now under 1%. On Wednesday, Illinois had 259 COVID-19 cases, compared with a peak of 17,608 last November. And yet, despite that progress, more than half of Illinoisans have yet to be fully vaccinated. The state’s daily average for vaccinations has dipped from more than 100,000 a day in the sprint to the current seven-day rolling average of 43,219 vaccines administered.

“The delta variant is currently the greatest threat in the U.S. to our attempt to eliminate COVID-19,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said at a recent White House briefing on the virus. “Good news: Our vaccines are effective against the delta variant. … We have the tools. So let’s use them, and crush the outbreak.”

Younger Americans, those in their late teens and early 20s, have been particularly reluctant to get vaccinated. Reasons vary from strong ideological opposition to vaccines to indifference about the need to get them. The Biden administration says it will redouble efforts to get younger Americans vaccinated.

In the meantime, everyone within earshot of a Gen Z individual — parent, grandparent, sibling, neighbor — should drive home the message. Want everything as it was? Pine for a time when masks stay in drawers? Want to turn back the threat of the delta variant? Get vaccinated. It’s free, it’s easy and it’s the best and only way to put the pandemic in our collective rearview mirror.

Copyright © 2021, Chicago Tribune

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