The bottom-line verdict on the Delta variant of the coronavirus is this: it is far more transmissible than its predecessors. It is more virulent. Vaccinated people, while not immune, are extremely unlikely to be gravely sickened by it. Unvaccinated people remain susceptible to easy infection, a greater chance of serious illness, and death.
There’s also the lesser-known Gamma variant, with similar attributes. And cases of hospitalization are again increasing in hospitals in Central Florida, says Dr. Khaled Fernainy, director of Adventhealth Orlando’s Intensive Care Unit. There are 310 people hospitalized with a primary diagnosis of covid in AdventHealth’s hospitals in the central region, up from last week.
Though the number of reported variant cases in Florida was still relatively low as of last week, Delta is going to be the predominant one within a few weeks to a month in the U.S.,” says Dr. Stephen Bickel, the medical director at the Flagler County Health Department. But none of the new strains have shown the ability to break through the vaccines and render them ineffective. “If I was a sane person I’d be thinking long and hard about maybe I should get vaccinated. We don’t have herd immunity.”
“We do need to be concerned about it simply because it’s 50 to 60 percent more transmissible than the Alpha variant, which was the one that was headlining in England, and was dominant here in the US,” says Bob Snyder, head of the Flagler County Health Department. “So it definitely is more transmissible. Just from that standpoint alone, we need to be concerned.”
The variants are emerging just weeks from the full reopening of schools in Flagler and across Florida, with no remote-learning options anymore other than the standard virtual school system that was in place before the pandemic. Flagler campuses are being readied for school’s resumption with a series of post-pandemic adaptations, from reconfigured cafeteria breakfast and lunch lines to more outdoor dining and learning spaces to minimize close interactions between students. But masks are expected to be voluntary, not required, as they were for the entirety of the previous school year.
For children, Delta “raises the concern because they’re going to be facing a more contagious variant. So all the risks of spread are going to be heightened,” Bickel said.
Young people continue to be much less likely to fall gravely ill, but children 9 or 10 and older can transmit the virus just as adults can, and at least 50 percent of those who carry the virus show no symptoms. That, combined with the hyper-transmissibility of the Delta and Gamma variants, is a recipe for rapid transmission that eventually places unvaccinated, older people at risk of serious illness or death.
“The preparation boils down to one thing: get vaccinated. Get vaccinated,” says Snyder, who has at times betrayed a hint of exasperation at the contrast between the demonstrated, life-saving benefits of the vaccine and the still-stunning proportion–to him and other health officials–of people who have not been vaccinated, including in Flagler. Only 58 percent of those 12 and older have been vaccinated in Flagler, while the actual vaccination of the entire population is 53 percent, and 51 percent in Florida. The state Health Department has stopped issuing detailed, public reports on infections and vaccinations, now limiting its reports to one weekly batch and far fewer details, which limits analysis or understanding of the pandemic in its parts.
“The data is just looking us all right in the face,” Snyder continues, “and what that data is telling us is, nearly all hospitalization and deaths related to Covid now are individuals who are unvaccinated, nearly all, and that is true here locally. Right now we have eight patients in the hospital with covid.” Snyder was providing the numbers as of the end of last week. On July 9, the number had risen to 14, with two in intensive care. “They are younger than before, and just like around the country, nearly all are unvaccinated, so that really is the bottom line. If someone is wavering and they’ve got questions about the vaccine safety and efficacy, all you need to do is ask your local physician, your primary care doctor, call the local health department so we can answer your questions.”
Meanwhile, vaccine doses, once in short supply and sought after like the world’s most precious commodity, are in ready supplies at the county’s 18 pharmacies and the Health Department. But vaccination “is down to a trickle,” Snyder said. His department has been calling the pharmacies to get a sense of who is still coming in for vaccines, and in what numbers. But the numbers have been low. At the Health Department’s after-hours vaccine clinic last week, just 62 people turned up, and most were for second doses to complete their cycle, not new candidates.
Younger people, Blacks and Hispanics are all lagging behind (just 6.9 percent of total vaccinated people are Black, compared to a Black population almost double that in Flagler.)
The variants are different forms of the virus that emerged from different places around the world. Delta and Gamma in particular “are much more easy to transmit between persons,” says Dr. Steven R. Smith is Senior Vice President and Chief Scientific Officer of AdventHealth Research Institute. “You could be a little bit further apart and be infected, you could have a lower dose and be infected with both the Delta and the Gamma variants. We also know that Delta produces a more severe case of Covid and we are beginning to understand the science behind that. It looks like it replicates in the body a lot faster, builds up the the virus load in the body then reacts to that, as you would expect for having more virus in your body. So we’re learning the science. The key to this though is that you’re still protected from the Delta and Gamma variants if you get vaccinated, with a few exceptions.”
The variants, also referred to as mutations, are the normal progression of viruses. Variants used to be identified by their presumed country of origin. But since that tends to be both highly imprecise and prejudicial, the medical community has moved to Greek alphabet terms (just as the National Hurricane Center abandoned using the Greek alphabet in busy hurricane seasons, because it confused people.)
One other concern that people generally don’t take into account–as physicians do–is that the more the coronavirus circulates in whatever form or variant, the more variants there will be: that’s the nature of the beast. So the more people resist getting vaccinated, the more room they’re giving the virus to propagate, mutate, and of course infect. “We’re going to continue to hear about Delta, but it may be delta 4, Delta 47, I mean this is a constant evolution of the virus, and we’ll continue to see new strains out there,” Smith said. (Smith and Fernainy spoke this morning in the context of a Facebook briefing on the virus.)
So all that raises the question: is it time to mask up again? Smith put it this way, referring to the Centers for Disease Control: “The CDC has taken, I think, a very balanced and measured approach to try to answer this question and make those recommendations and right now the CDC guidance has not changed. And that is that if you’re vaccinated, unless you have one of these health conditions, or you’re at very high risk of complications, the vaccine gives us the freedom to go out into our communities without a mask. I think that’s prudent right now. Again, we need to watch background rates, we need to be vigilant against some of the new strains that we expect we’re going to see in the near future.”
Studies have shown that the effectiveness of the vaccine drops against the variants, but it does not eliminate immunity altogether. The result is infection and illness, but far less severe illness. The greater concern is that vaccinated people who catch the virus can carry it asymptomatically, and spread it that way.
“The thing to me that is the most potentially persuasive of the data is that virtually all the people who are in the hospital these days are unvaccinated, almost all of them,” Bickel said. “It’s so drastic.”