Healthy Body

Your Pressing COVID-19 Delta Variant Questions, Answered by an Epidemiologist

Erin Bunch

Photo: Stocksy /Santi Nuñez
COVID-19 vaccines have provided considerable relief in the United States over the past few months, as case counts, hospitalizations, and death counts have fallen. While "normal" is not exactly the objective right now, everyday activities have become a bit safer. As businesses open up and masks come off, things might even feel less stressful than they did one year (or even four months) ago. However, no one would blame you if the Delta variant (a highly infectious form of the virus that causes COVID-19) has you feeling confused, uncertain, and scared yet again.

To help you navigate the ever-shifting pandemic landscape, Timothy Brewer, MD, professor of medicine and epidemiology at UCLA, has answered some of the most pressing present-day concerns around the virus and safety. Keep reading to hear his take on what the Delta variant means for your health, your summer plans, and America's overall pandemic recovery.

1. What is the COVID-19 Delta variant?

We’ve written about the Delta variant before, but here’s a quick recap: The Delta variant is a SARS-CoV-2 virus mutation that is more transmissible than the original strain first detected in Wuhan, China. Evidence suggests the variant brings an increased risk of hospitalization, too.

Variants occur naturally as viruses jump from person to person, mutating slightly in the process. The Delta variant was first detected during the recent surge in India but is making its way around the world. It currently accounts for more than 20 percent of cases in America, according to Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

Public health experts attribute the current COVID-19 spike in Missouri to the Delta variant (along with the population's relatively low vaccination rate). They also predict that other states with low vaccination rates—e.g., Alabama, Arkansas, Louisiana, Mississippi, and Wyoming—will have "dense outbreaks" due to Delta.

2. There are mixed messages about whether or not vaccinated people should wear masks. What gives?

Due to the Delta variant’s high transmissibility, the World Health Organization (WHO) recommends vaccinated people continue to wear masks and take other pandemic precautions when indoors. However, the Centers for Disease Control and Prevention (CDC) says vaccinated people can discontinue wearing masks. To complicate matters more, some U.S. regions—like Los Angeles, California—are reinstating mask recommendations for vaccinated people as Delta cases rise. So if you’re confused about whether or not to mask up, it’s understandable.

When advising on this topic, Dr. Brewer points out that COVID-19 vaccines are highly effective against the Delta variant. "That having been said, because the Delta variant does seem to be more readily transmissible, it probably makes sense to be wearing a mask in situations where you're more likely to be exposed," he says. Why? You may not get super sick if you are vaccinated (though it is possible), but you can spread the infection to others.

3. Okay, so when should I mask up?

Dr. Brewer suggests continuing to mask up in the following situations: when you're indoors in public or with people you don't know, when you're with larger numbers of people (especially when you don't know them), and when people are close together. "I tend to still wear a mask indoors in stores, and certainly if I were going to a movie theater or any indoor event,” he says. However, Dr. Brewer says he likely would not wear a mask in an outdoor setting, particularly if able to maintain physical distance from others.

Overall, Dr. Brewer SP says practicing good hygiene—e.g., regular hand-washing—and staying home when sick are still essential. And if you are unvaccinated, you should be wearing a mask consistently, maintaining social distance, and taking other pandemic precautions such as staying home.

4. Should I avoid indoor dining since I can't wear a mask while I eat?

If you’re vaccinated, the short answer is no, says Dr. Brewer, though he suggests looking for restaurants that distance their tables and wearing your mask when away from your seat. It’s also wise to take into account COVID-19 case counts in your region. If you live somewhere with high vaccination rates and low case counts, you might feel comfortable eating indoors if you're vaccinated. If you live in a place with low vaccination rates and high case counts, you may want to play it safe by eating outdoors instead. "And certainly, I would not go to a restaurant if you're not feeling well," Dr. Brewer adds.

5. I live in an area with low vaccination rates and high case counts. Should I take more precautions?

To Dr. Brewer's point above, you should consider the vaccination rates in your town, city, and state when making decisions. "If I were in places where there's more transmission and less vaccination, then yes, I would be doing more to try and protect myself," he says. And remember, in doing so, you're not just protecting yourself. You're also protecting people who are vulnerable, including the immunocompromised and younger children who have not yet become eligible for vaccines.

6. What about travel this summer? I'm vaccinated, but should I change my plans?

You should keep an eye on your destination and its current case count and circumstances before you embark on any trips. And continuing to wear a mask on planes, buses, and trains is required. Dr. Brewer says he would recommend doing so in airports and other transit hubs as well. The CDC agrees with this advice and further recommends adhering to all state and local recommendations and requirements at your destination.

Common-sense precautions should continue to prevail throughout your trip, Dr. Brewer explains. If you're going to a show in Las Vegas, for example, he says he'd wear a mask throughout the program. However, he wouldn't personally feel compelled to wear one on a beach.

7. I've heard stories about fully vaccinated people getting sick and even dying from the Delta variant. How worried should I be about that?

This is a good time to reiterate that the COVD-19 vaccines are instrumental in preventing illness, but they aren’t 100-percent effective, says Dr. Brewer. "So, there are going to be breakthrough infections, including infections that are serious enough to cause hospitalization and potentially even death," he says. "But the data have been very consistent—that the vaccines remain highly effective in preventing serious disease, hospitalization, and death from all of the variants of concern that they've identified so far." This includes the Alpha variant first detected in the UK, the Gamma or P1 variant out of Brazil, the Epsilon variant out of California, and the Delta variant out of India, Dr. Brewer explains.

More specifically, data out of the UK, where Delta is now the dominant variant, does show that a relatively small number of deaths due to the Delta variant have occurred in vaccinated individuals over 50 years old (none in individuals younger than that). And about half of the cases in Israel's recent Delta-fueled outbreak were among vaccinated individuals; however, Israeli officials say there has not been a correspondent rise in hospitalizations, which suggests that the jabs are protecting from severe illness.

8. Is the Delta variant more dangerous for children under 12 years old who are not yet eligible for the vaccine?

Dr. Brewer says he hasn't yet seen any data to suggest that the Delta variant is more dangerous or deadly for children than other variants have been. With that said, children are more likely to become infected from the Delta variant, according to Dr. Fauci, simply because it's more transmissible. This means immunocompromised, or otherwise vulnerable individuals, should continue to take precautions around unvaccinated children. And, children should continue to mask up and social distance when possible until they’re eligible for the vaccine.

9. What should I tell my unvaccinated friends and family members about the Delta variant?

Unvaccinated people are at a much higher risk of becoming infected from the Delta variant and experiencing severe disease, hospitalization, and death as a result. "So if there were one take-home message, it would be, 'Go get vaccinated if you haven't already,'" Dr. Brewer says. "It doesn't really matter which vaccine—whether you want to get Johnson & Johnson, Moderna, or Pfizer—just make sure you go and get one."

If your loved ones are still vaccine-hesitant (and feeling confident that they've navigated the pandemic thus far), it may help to present them with some statistics. A recent study in Lancet looked at demographics, hospitalizations, and vaccinations in Scotland. Researchers found that the hospitalization rate for those with the Delta variant was 85 percent higher than it is for those with the Alpha variant. That means that they are significantly more likely to end up in the hospital if they catch this version of the virus, which they are also way more likely to catch than the original strain. They are also more likely to transmit it to someone who cannot be vaccinated.

10. Wait, will variants force us into a fall or winter lockdown?

It's possible, says Dr. Brewer, but a widespread lockdown is unlikely at this point. While there's still a lot of work to do around raising overall U.S. vaccination rates, Dr. Brewer says vaccination numbers continue to climb. "It's estimated now that about 66 percent of adults in the United States have had at least one dose of the vaccine, and there is partial protection even after one dose of Pfizer and Moderna, he says, adding that the one-dose Johnson & Johnson vaccine also provides protection.

The other reason to be hopeful? So far, vaccination seems to protect against existing variants, Dr. Brewer says. "Obviously, the longer this virus continues to be transmitted, the higher the probability that new variants—including those that do escape vaccination—can emerge," he says. "But, at least so far, that hasn't happened." 

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