We Might Ignore the Delta Variant, but It’s Not Ignoring the U.S.

Article

Far too few have been fully vaccinated in the U.S.to ward off a run on our hospitals, and avoiding hospitalizations is an extremely low bar for public health, since 10% to 30% of the patients even with mild to moderate disease will develop long COVID.

It has been two weeks since Infection Control Today® sounded the alarm that the Delta variant (B1617.2, Double Mutation Indian Variant) was spreading rapidly in the United States. On June 15, the Centers for Disease Control and Prevention (CDC) issued a warning regarding the variant and declared it a “variant of concern.”

England has postponed its full reopening and in areas where the Delta variant is prevalent, recommending that everyone (and I mean everyone) be tested twice a week. In the U.S., we decided to stick our head in the sand with false reassurances regarding the mRNA vaccines stating they are approximately 90% effective if both doses are taken (data is still out on the Johnson and Johnson vaccine).

Kevin Kavanagh, MD

Kevin Kavanagh, MD

According to President Biden the Delta variant “is more easily transmissible, potentially deadlier and particularly dangerous for young people.” More transmissible means 60% more infectious than the Alpha variant (B117, UK Variant) which is up to 70% more infectious than the wild type or original virus.

According to Outbreak.info, the Delta Variant is rapidly spreading. A seven-day rolling average currently has this variant at 29% of newly sequenced cases. One must keep in mind this data has wide error bars, since we are sequencing far too few cases and those that we do sequence are often reinfections or vaccine breakthroughs. But what is clear is that the numbers are rapidly increasing. In the United Kingdom the Delta variant now comprises 99% of the cases. The Gamma (P1, Brazilian) variant appears to have stabilized at 8% of the sequenced specimens. The Delta variant appears to have easily overtaken the Gamma variant.

Unfortunately, far too few have been fully vaccinated to ward off a run on our hospitals. As of June 20, 2021, the U.S. has 45.1% of its population fully vaccinated with 53.5% of its population having at least one dose.

Stating that the vaccines are 90% effective is somewhat misleading, since with the wild type (original virus) this was defined as not having symptomatic disease. With the Delta variant, “effective” means avoiding hospitalizations. At first, one may think this is acceptable, but this is an extremely low bar for public health with COVID-19, since 10% to 30% of the patients even with mild to moderate disease will develop long COVID.

The need to avoid developing long COVID-19 has been made even more of an imperative with two recent publications. A study out of the United Kingdom by Douaud G, et al., evaluated 394 brain scans from COVID-19 patients who also had a pre-COVID scan, and matched them with controls. Three hundred and seventy-nine of the patients had not been hospitalized. The researchers found “…. loss of grey matter in limbic cortical areas directly linked to the primary olfactory and gustatory system.” They also postulate that the proximity of the changes to the hippocampus raises the possibility of long-term consequences of SARS-CoV-2 and may be a contributor to dementia in later life.

In other words, this study found brain scan evidence of loss of grey matter which may represent viral entry into the CNS and explain the symptoms of “brain fog” and “memory” problems so many long COVID-19 patients are experiencing.

The second paper was published in Human Reproduction. This paper found that 25% of SARS-CoV-2 patients had impairment of semen quality with abnormal sperm or low sperm counts. The specimens were taken 4 to at 8 weeks after temperature normalization. It is known that the testes have an elevated expression of the ACE receptor and there is concern it may be a primary target of the virus. Needless to say, in a country whose reproduction rate is already under water (1.6 lifetime births per female) this possibility is not good news.

And there is now a Delta Plus variant (AY.1 & AY.2) which has emerged in India which is more resistant to monoclonal antibodies, including antibody cocktails and has also entered the United States. Outbreak.info reports that there have been 82 cases of AY.2 (May 13 to June 8) and 12 cases of AI.1 (April 22 to May 29) in the United States.

As Australia and Singapore have adopted a zero tolerance to COVID-19, closing down sectors of the country with even 2 or 3 cases, we have adopted a wait-and-see policy, largely ignoring the potential dangers posed by these new variants. For now, I would strongly advise every person (even those who have had COVID-19) to be fully vaccinated to boost one’s immunity to the highest possible level and wear masks when indoors in poorly ventilated buildings. It is far too soon to be fully reopening our society.

Related Videos
Jill Holdsworth, MS, CIC, FAPIC, CRCSR, NREMT, CHL, and Katie Belski, BSHCA, CRCST, CHL, CIS
Baby visiting a pediatric facility  (Adobe Stock 448959249 by Rawpixel.com)
Antimicrobial Resistance (Adobe Stock unknown)
Anne Meneghetti, MD, speaking with Infection Control Today
Patient Safety: Infection Control Today's Trending Topic for March
Infection Control Today® (ICT®) talks with John Kimsey, vice president of processing optimization and customer success for Steris.
Picture at AORN’s International Surgical Conference & Expo 2024
Infection Control Today and Contagion are collaborating for Rare Disease Month.
Rare Disease Month: An Infection Control Today® and Contagion® collaboration.
Related Content