Fauci: Delta variant more contagious, even among vaccinated

WINDOW ROCK

After months of declining COVID-19 numbers, the easing of restrictions and a bit of a summer reprieve, the virus’ trajectory once again looks uncertain at best.

In the face of a major COVID-19 surge, fueled by the more transmissible and infectious Delta variant, on Monday Dr. Anthony Fauci told Navajo Times that now is the time to make a push for the remaining unvaccinated to get vaccinated and to double down on COVID-19 safety precautions, including masking.

“If you see people in your community or in your immediate surroundings who are not vaccinated, I would strongly encourage them to get vaccinated,” said Fauci, the country’s top infectious disease expert and chief medical advisor to President Joe Biden.

“They should get vaccinated for their own safely,” he said, “for that of their family, and that of their community.”

According to the Centers for Disease Control and Prevention, vaccines for the virus authorized in the United States are highly effective at preventing severe disease and death, including against the Delta variant, but they are not 100% effective and a “small percentage” of vaccinated individuals experience “breakthrough” infections.

Fauci said that because we are dealing with such a “serious situation” with the Delta variant, people should avoid unnecessary travel and congregating in crowded indoor spaces. And if one must do so, to wear a mask, whether vaccinated or unvaccinated.

Fortunately on Navajo, wearing a mask in public continues to be mandatory, per public health emergency orders, but even with about 75% of the Navajo Nation vaccinated, President Jonathan Nez suggested on Tuesday he is considering tightening virus restrictions again.

As in 2020, Fauci said as we approach fall and winter, it could be challenging to address influenza season coupled with a surge in COVID-19.

“What will happen in the fall and winter will depend on whether we can get a vast majority of the 93 million people who are not yet vaccinated vaccinated,” he said.

‘Protect the children’

According to the CDC, 50.2% of the U.S. population is fully vaccinated with those 65 and older at 80.4%, 18 and older at 61.1% and 12 and older at 58.7%.

Fauci said that with fewer younger people vaccinated than older adults, they are seeing a relative increase in young people who are getting seriously ill from the Delta variant.

“It appears that children can get very sick from this particular variant,” he said.

While researchers are rapidly collecting immunogenicity and safety data on vaccine trials in children under 12, Fauci is not yet sure when the vaccinations will be readily available.

“The ultimately decision is going to be a regulatory decision,” he said. “We have to wait for the FDA to give us that information.”

For the rest of the population, Fauci has said he is hopeful that the COVID-19 vaccines (Pfizer, Moderna, Johnson & Johnson) will be officially approved for use by the Food and Drug Administration very soon, which is likely to spur additional vaccine mandates that he supports.

In the meantime, as students go back to school, Fauci recommends that in order to “protect the children,” they be surrounded with vaccinated persons as best as possible.

“That includes teachers and personnel assigned to the school,” said Fauci. “Having said that, if you are in an area where there is a high or substantial degree of transmission, everybody in the school needs to wear a mask whether you are vaccinated or not.”

Currently, there over 100,000 COVID-19 cases per day are being reported in the United States, with higher numbers in unvaccinated areas.

According to the CDC, about 90% of all counties in the United States are experiencing a “high” or “substantial” number of COVID-19 cases, with the Delta variant being the dominant strain.

Delta viral load ‘very high’

Concerning “breakthrough” COVID-19 infections, Fauci said those will continue to increase simply by virtue of more people getting vaccinated.

He said it is unusual for vaccinated individuals to get a severe course of the disease, even with the Delta variant, and only a small proportion of breakthrough infections will lead to hospitalization.

“They are usually minimally symptomatic or without symptoms,” he said.

However, as compared to the Alpha variant (B.1.1.7.) and earlier strains of SARS-CoV-2, the level of Delta variant virus in the nasal pharynx of a vaccinated person who gets a breakthrough infection is actually “very high” and similar to the level of virus in an infected unvaccinated person, Fauci said.

This strongly suggests an infected person who is vaccinated, even if asymptomatic, can likely spread the infection as efficiently as an unvaccinated person, he said.

“What we know for sure is that it is clearly much more easily transmissible,” said Fauci. “The level pharynx of virus in a person who is infected with the Delta virus is about a thousand times higher than the level of virus that we used to measure in the nasal pharynx of someone who is infected with the Alpha virus.”

The CDC has estimated that Delta variant is about twice as contagious as the Alpha variant.

In a bit of good news, Fauci said recent data indicates that that high level of virus diminishes more rapidly when you are vaccinated compared to an unvaccinated person.

Fauci believes the impact of the Delta variant will be the same for tribal communities as for the rest of the country.

“If Indian Country gets well vaccinated, they should be protected against severe disease and hospitalization, but not completely,” he said. “You’re still going to see hospitalizations, but the chances of a severe outcome are considerably less if you are vaccinated than if you are not vaccinated.”

‘Following the science’

As far as booster vaccinations are concerned, Fauci said we need to be “following the science.”

For immunocompromised individuals, including people who have had organ transplants, are on chemotherapy for cancer, or have autoimmune diseases, there is an active consideration to modify emergency use authorizations to get them a booster vaccination “sooner than later,” he said.

But as far as the general population is concerned, Fauci they are still collecting data and working to measure the durability of vaccine protection.

When it gets below a certain threshold, it will be appropriate to go ahead and vaccinate people, he said.

In the meantime, except for the elderly and immunocompromised, there is no recommendation now for the general population who have been fully vaccinated to get an additional dose.

Fauci has also said to the extent that more people get vaccinated, the chance of another dangerous variant emerging through replication and mutation is reduced.

In the meantime, as the virus changes, safety recommendations will likely continue change too, which is to be expected, he said.

“When we have a virus like the Delta variant, you have to realize that recommendations will change with the changing scientific information,” said Fauci.

“Right now,” he said, “the recommendation of the CDC is that if you are in an area of high or substantial transmission, you need to wear a mask, even if you are vaccinated, when you are in an indoor public setting.”

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