Iowa Specialty Hospital

COVID-19 Update from Dr. Michael McLoughlin 8/4/2021

August 4, 2021

Everyone is well aware that the Delta variant is spreading throughout the United States. Many people have had questions about what this means for them. Hopefully, I can answer some of those questions.

What is different about the Delta variant that makes it such a concern?
The Delta variant has acquired a mutation that makes it spread much more easily.  It appears to replicate more quickly than prior variants and there are much higher amounts of virus present in the airways of people infected with Delta. Thus, someone infected with Delta is going to breathe more virus into the surrounding air and make it more likely that close contacts become infected. If everyone was going about their usual activities and no one had immunity, a person infected with the original strain of COVID might infect 2-3 other people on average. Someone infected with the Delta variant in those circumstances would infect 5-8 other people on average. When you consider that those newly infected people would also themselves infect more people, this is an enormous difference in the spread. 

That change in transmission is a huge deal, particularly for unvaccinated people. We were seeing cases decline all across the United States because we had essentially reached herd immunity for the variants that spread less easily. But herd immunity is dependent on how easily a virus spreads. A virus that spreads more easily requires many more people to be immune for herd immunity to be reached. That’s why we are seeing Delta spread when other variants can’t anymore. Additionally, we are seeing that some people who have been fully vaccinated are getting infected with the Delta variant and are able to spread it to others. Because of those details, it is going to be incredibly difficult to reach herd immunity for the Delta variant.

If I can still get infected after getting vaccinated, why should I bother?
Here is the most important part of all this – even though people who have been vaccinated can get infected and spread the Delta variant, vaccinated people are less likely to get it and almost always have MILD infections if they do. Very few of the hospitalizations and deaths are occurring in vaccinated individuals. The big risk is for unvaccinated people who are now almost certain to get infected with the Delta variant at some point. Every unvaccinated person who gets infected with the Delta variant has a significant chance of being hospitalized, having long-term side effects of the infection, or dying. The benefits of getting vaccinated outweigh the risk of side effects for nearly everyone over 12 years old. We’re still waiting for studies of children younger than that to know whether the benefits outweigh the risks in those age groups.

What’s all the hubbub about masking again?
The CDC has again recommended that everyone mask in indoor spaces, whether vaccinated or not. The CDC’s goal is to prevent severe illness and death – it’s clear that if everyone wears masks we will have less people get infected and end up severely ill. The hard thing at this point is that it is mainly unvaccinated adults who are at risk of severe illness anyway. Some immune suppressed adults don’t have the same benefit from vaccines, so masking helps protect them, but most unvaccinated adults have simply chosen not to get a vaccine. Whether it is worth it to mask to protect adults who haven’t chosen vaccination, children who haven’t had the opportunity, and the immune-suppressed is a question of values. We know that it will decrease the likelihood of spread to all of those at-risk people if everyone does it, but how much inconvenience are we willing to bear as a society to do that? Where is the endpoint? Because it is a question of values, science can’t answer those questions but only can tell us what is likely to happen based on the choices we make.

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