So, I’m back sooner than expected. Damn you, Delta Strain! There has unsurprisingly been a lot of questions as the CDC guidance has once again changed. Let me guide you through the guidance:
1) the vaccines are still working great. 99.5% of COVID-19 deaths last quarter were among unvaccinated - some 50,000 tragically unnecessary deaths.
2) if you are vaccinated (or if you have previously been ill with covid, or both), your protection is from *systemic disease* (COVID is an anagram for COronaVirus Disease). Your nose and upper airway, where IgG antibodies are not present, remains vulnerable to SARS-CoV-2, or any other coronavirus. Coronaviruses cause about 1/3 of our common colds.
3) Because Covid is a *cold virus*, it is unlikely that there will ever be herd immunity. Because it is a cold virus, you and I, vaccinated or not, will probably get a *cold* from SARS-CoV-2 many times in our lives.
4) vaccination also seems to strongly prevent disability from COVID, such as long-term organ dysfunction, or the autoimmune condition known as Long-Covid. 10% of COVID-19 patients (after initial infection) have long term symptoms including an IQ drop of 5-10 points if their cases were severe.
5) We *thought* that the vaccines would prevent superspreader events. The episode in Massachusetts proved us wrong. However, it should be known that few of those vaccinated patients suffered anything more than basically a URI. (Only 1% were hospitalized)
6) if Delta has viral loads as heavy as they say, I suspect that masking will have even less benefit than the 30-50% transmission reduction that it had before. Ditto social distancing, surface sanitation, and contact tracing. Vaccination, while imperfect at preventing illness, appears to be a more important defense than ever.
7) the “breakthrough” cases that are hospitalized in Chattanooga are typically not COVID pneumonia, but either among vulnerable people who are unable to tolerate colds or bronchitis regardless of the cause, or they’re hospitalized for something else and just have a positive test.
8 ) the FDA delays are, in my opinion, unforgivable. We have literally more data and greater scrutiny about these new mRNA vaccines than any other medicine ever.
9) No telling when the vaccines will be available for kids. The number of kids that’d need to be tested to prove meaningful benefit would be very high. I suspect licensing will come too late to help much.
10) Having an outbreak *now* rather than in November as I previously predicted, is actually a good thing. It hastens our move from PANdemic virus to ENdemic virus. Once we all have antibodies, it will live among us as a nuisance forever. Like other respiratory viruses, it will continue to have an annual death toll among the highest risk, but as Great Britain (who had a >90% antibody rate going into the Delta outbreak) is demonstrating, the lethality of the virus is WAY less on the second go-around, regardless of immunity was acquired naturally or via vaccination. The end game is near.
