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Delta is dangerous and spreading -- but vaccination can stop it

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Delta is dangerous and spreading -- but vaccination can stop it

Posted: Jul 23, 2021 4:10 PM
Updated: Jul 23, 2021 4:10 PM

I'm hearing from vaccinated people who are frightened about breakthrough cases, the Delta variant and new waves of Covid. But people who are fully vaccinated are not the ones who should be most concerned. As new cases continue to climb almost everywhere, here's what I expect to happen over the coming weeks.

Globally, we're far from the end of the pandemic. Delta is at least two times more contagious than the original strain of the virus, which means that it will infect and kill more people.

Many countries that have avoided big surges so far don't have access to the vaccines they need to protect their populations. Many of these countries will likely see explosive spread of Covid over the coming weeks and months. Already stressed health systems will become overwhelmed with cases, and many people will get sick and die.

But in places with high rates of vaccination, including much of the United States, the worst is over. Though we'll likely also see big increases in US cases, future waves won't be as deadly. That's because 80% of the most vulnerable Americans -- people over age 65 -- are fully vaccinated.

Simply put: Fewer vulnerable people means fewer deaths. Whereas the US infection fatality rate before vaccines became available was 1 in 200, that rate could shrink to less than 1 in 500 or even as low as 1 in 1,000 in the coming months because of the strong protection provided by vaccines -- even if we see many breakthrough infections.

In places where disease continues to spread, deaths may increase, particularly among adults who are not vaccinated. Because the people most vulnerable to Covid have a high vaccination rate, the increase in deaths will be much smaller than the past horrific increases. But we have to prepare ourselves for the eventuality that more people will die -- some of whom will be young and otherwise healthy.

In the months ahead, more cases won't correlate to more deaths the same way as earlier in the pandemic. This graph from the UK shows why. Death rates have plummeted, especially among older groups, even as case rates have increased, because most of the elderly are vaccinated. But even though the rates are far lower than they were, people in all age groups are still dying.

Vaccines have saved hundreds of thousands of lives already and will save hundreds of thousands more, but they're not 100% effective. No vaccine is. They provide great protection -- not perfect protection. More cases will lead to more breakthrough infections, which is expected, but vaccines drastically reduce risk of hospitalization and death from Covid. People who are vaccinated are also less likely to spread the virus, so people around them are safer, although they aren't protected completely.

When breakthrough infections do occur among vaccinated people, the vast majority are mild. For most, Covid will be no more serious than the common cold. Unfortunately, some breakthrough infections will be less mild, requiring hospitalization and, in rare cases, resulting in death. That doesn't change the reality that vaccination is the best way to protect ourselves from Covid.

We need better data on severe breakthrough infections, but my guess is that they're more likely to occur in people of advanced age or who have serious underlying health conditions such as lung disease or immunosuppression, including immunosuppression from medications. It's possible that the mRNA vaccines are more protective against Covid than other vaccines; studies will determine whether this is the case.

It is neither necessary nor wise for our public health systems to attempt to track every single breakthrough case that causes no or only mild symptoms. There are simply going to be too many, and there is little benefit to tracking illnesses that are no worse than a cold. Instead, it makes sense -- as is being done -- to do special studies of all breakthrough infections as part of specific population-based studies, and also to try to track every severe Covid illness after vaccination. This should give us much better information about who is most at risk of serious illness from Covid after vaccination, and might lead to different dosing recommendations for some groups.

When you see headlines claiming that a significant proportion of hospitalized patients somewhere have been fully vaccinated, don't be alarmed. Most of those stories actually underscore the fact that vaccines are working exceptionally well against variants of concern, including Delta. Where most people are vaccinated, most cases will be among the vaccinated.

The worst is over in the United States, but, on average, 200-300 people are still dying every day from a disease that didn't exist 18 months ago. If that rate continues for the next 12 months, that would total 100,000 deaths -- more, even, than occur each year from diabetes or from the horrific opioid epidemic.

Delta is spreading, and in some areas is spreading rapidly. How the virus affects you when you encounter it depends on whether your body has been prepared to recognize and fight it -- or is caught off guard. People who remain unvaccinated should be especially concerned about the rapid rise of Delta, which now makes up at least 83% of sequenced cases in the United States.

The more cases there are, the more uncontrolled spread there will be, and the higher the risk that even more dangerous variants can emerge. Variants remain the wild card for the trajectory of the pandemic. Delta may not be the worst strain the virus deals us, but we can reduce the risk of other dangerous variants by vaccinating widely as well as continuing to tamp down spread. Vaccination, masks, ventilation and physical distancing can stop Covid, including Delta.

Our slow pace of vaccination has given the virus extra time to adapt and mutate, but we can wrest the advantage back by using the best weapon in our arsenal -- vaccines -- complemented by measures that slow spread of the virus including masking, ventilation and avoiding events that can amplify spread of the virus.

The-CNN-Wire
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Illinois Coronavirus Cases

(Widget updates once daily at 7 p.m. CT)

Cases: 1582392

Reported Deaths: 26884
CountyCasesDeaths
Cook60726610902
DuPage1026891351
Will862101080
Lake761221053
Kane65145838
Winnebago38503541
Madison37519564
St. Clair34621558
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McLean21470203
Tazewell19477326
Rock Island17502342
Kankakee16409232
Kendall15177104
LaSalle14258273
Macon14134230
Vermilion12805180
Adams12525147
DeKalb11460126
Williamson11116152
Whiteside7759176
Boone753381
Jackson748379
Coles7121109
Ogle699985
Grundy690481
Clinton673597
Franklin658994
Knox6439163
Marion6392135
Macoupin629997
Henry604172
Jefferson5933130
Effingham580980
Livingston560294
Woodford548291
Stephenson534088
Randolph517096
Monroe501098
Morgan477995
Fulton475369
Christian474980
Logan471373
Montgomery459776
Lee452456
Bureau421687
Perry407770
Saline393562
Iroquois389170
Fayette385256
McDonough350855
Jersey318753
Douglas301236
Shelby296943
Crawford294030
Union292445
Lawrence291031
Wayne263956
White259229
Richland254052
Hancock250934
Pike249456
Cass245628
Bond241524
Clark241038
Ford232755
Clay230547
Edgar226844
Carroll223637
Warren218655
Johnson207821
Moultrie206730
Washington203827
Jo Daviess201624
Greene197738
Mason194551
Wabash193715
Massac192643
De Witt191230
Piatt188314
Mercer185434
Cumberland172423
Menard154112
Jasper148718
Marshall132721
Hamilton125720
Brown10127
Pulaski96711
Schuyler9568
Edwards94015
Stark75426
Gallatin7214
Scott6885
Alexander66011
Calhoun6342
Henderson62614
Hardin55413
Putnam5414
Pope4685
Unassigned1192432
Out of IL80

Indiana Coronavirus Cases

(Widget updates once daily at 8 p.m. ET)

Cases: 918230

Reported Deaths: 15011
CountyCasesDeaths
Marion1252491952
Lake623371084
Allen52301746
Hamilton43009443
St. Joseph41155584
Elkhart32831485
Vanderburgh29698436
Tippecanoe26442247
Johnson23106414
Hendricks21708338
Porter21255340
Clark16988222
Madison16899378
Vigo15562272
Monroe14186190
LaPorte13961235
Delaware13613215
Howard13531258
Kosciusko11150134
Hancock10534159
Warrick10431174
Bartholomew10233166
Floyd10099202
Wayne9557216
Grant8858194
Morgan8654158
Boone8231109
Dubois7521123
Henry7391126
Dearborn734186
Noble7208100
Marshall7168127
Cass7060117
Lawrence6803150
Jackson638980
Shelby6386106
Gibson5999105
Harrison587984
Huntington586490
Montgomery5663101
DeKalb555691
Knox532999
Miami523183
Clinton522464
Putnam519067
Whitley509851
Steuben480267
Wabash470192
Jasper465760
Jefferson456091
Ripley439074
Adams435565
Daviess4008106
Scott389563
White383457
Decatur376895
Clay376455
Greene375589
Wells375183
Fayette363074
Posey351841
Jennings341756
Washington324046
LaGrange312074
Spencer310734
Fountain306553
Randolph302087
Sullivan294947
Owen275961
Orange269659
Starke268961
Fulton264451
Jay248134
Perry244950
Carroll239926
Franklin229337
Vermillion225850
Rush225530
Parke212020
Tipton205354
Pike200938
Blackford163834
Pulaski155250
Crawford140818
Benton138316
Newton138141
Brown130646
Martin124416
Switzerland122310
Warren112616
Union92211
Ohio75811
Unassigned0461