Some Experts See a Peak, Steep Decline of Delta Variant Coming

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Brace yourselves for a rough August in the United States, infection preventionists. But come September the country might see a sharp decline in Delta variant cases.

The ups and downs of COVID-19 that has battered health care systems since March 11, 2020 will continue, say most medical experts. It’s going to be a rough August in the United States, but in September we might see a sharp decline in Delta variant cases. The highly infectious Delta now accounts for an estimated 93.4% of COVID-19 cases in the US, with the vast majority of those occurring among the unvaccinated.

The Centers for Disease Control and Prevention (CDC) ensemble forecast predicts that “350,000 to 1,800,000 new cases will likely be reported in the week ending August 28, 2021.” In addition, the ensemble forecast predicts that over the next 4 weeks, 2300 to 9100 Americans will die from COVID-19, bringing the total of deaths in the pandemic to 624,000 to 642,000.

The CDC’s ensemble forecast, found on the agency’s website, the COVID-19 Forecast Hub, collects data from modeling teams throughout the world for its repository. The agency then crunches the numbers and offers the public palatable science-based forecasts.

So, come September, we’ll finally be rid of COVID-19?

Well, no. As Infection Control Today® (ICT®) has reported, the disease is endemic, presenting further challenges to health care professionals, including infection preventionists (IPs). As Saskia v. Popescu, PhD, MPH, MA, CIC, and a member of ICT®’s Editorial Advisory Board (EAB) wrote last August—that is August 2020—“As we move to a sustainable COVID-19 response and potentially living with it in a more endemic nature, what will contact tracing look like?”

The fact that COVID-19 infects animals as well as humans could make contact tracing look a lot different. Meanwhile, the US health care system needs to survive the next 4 weeks.

As experts have been telling ICT® for months now, we control our destiny. Kevin Kavanagh, MD, another member of ICT®’s EAB member, puts it this way: “I am convinced this virus is about one or two iterations away from completely avoiding the vaccine. And remember, we have the lambda variant and the kappa variant which are sitting out there in the wings, waiting for immunity to drop and possibly cause another wave.” Other experts echo Kavanagh’s “we the people” approach to getting back to some semblance of our pre-pandemic lives.

For instance, Nicholas Reich, PhD, an associate professor of biostatistics at the University of Massachusetts Amherst, tells The Hill this morning that what happens in the next few weeks is “really hard to predict and really hard to control.” Reich continues: “This is the sliver of optimism that we have is that the reason it's hard to predict is because it's sort of in our control as a society to change the trajectory. But it requires everybody being careful and being vigilant and looking out for each other.”

The primary message that IPs must communicate to the public and to fellow health care professionals alike: Get the vaccine.

As Popescu put it last December, there must be “a focused effort on vaccine education…. IPs have always played a significant role in education and answering questions while rounding on the units and clinics. Vaccine distribution will involve information for those acquiring it, but it’s also important we continue to address concerns, questions, and reiterate that even with the two doses, staff will still need to follow infection prevention measures at work and at home.”

Of course, the CDC is all in on the need for vaccinations, again because so much rides on them. CDC Director Rochelle Walensky, MD, tells CNN that “our vaccines are working exceptionally well. They continue to work well for Delta, with regard to severe illness and death—they prevent it. But what they can’t do anymore is prevent transmission.”

Walensky refers to a study that the agency release last week that suggests that people who’ve been vaccinated but who are then hit with a breakthrough transmission can spread COVID-19 just as easily infected unvaccinated people.

As Walensky tells CNN: “If you're going home to somebody who has not been vaccinated, to somebody who can't get vaccinated, somebody who might be immunosuppressed or a little bit frail, somebody who has comorbidities that put them at high risk, I would suggest you wear a mask in public indoor settings.”

The focus on vaccination has overshadowed another subject that must be addressed: testing.

Linda Spaulding RN, BC, CIC, another ICT® EAB member says that “with the ongoing changes of COVID variants it’s more important than ever to increase testing people for COVID-19. The Delta variant has now taken over as the dominant variant of COVID but right behind Delta is the lambda variant of COVID that was first identified in Peru and now identified in South America. lambda is like Delta highly infectious and more resistant to vaccines. This virus has had human incubators for almost 2 years and that is giving it a chance to mutate in a very effective way.”

Spaulding, of course, hasn’t forgotten about vaccinations and other COVID-19 mitigation measures. “Continued testing of as many people as possible is very important to keep track of the new and very concerning variants,” she says. “It’s so simple get vaccinated and wear a mask and continue living. So simple yet so difficult to accomplish.”

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