Vaccinated “undead” are getting infected, carrying the virus to the unvaccinated, getting sick and incubating new strains. But better “Zed” than dead!
(Originally published Aug. 16 in “What in the World“) The director of the U.S. National Institutes of Health has reportedly warned that the U.S. could see new Covid cases rise back to as high as 200,000 a day, and pleaded for those Americans who haven’t yet gotten vaccinated to do so.
Dr. Francis Collins is in some ways stating what is patently obvious. The U.S. is already racking up more than 120,000 new cases a day amid a surge in infections by the extremely infectious delta variant of Covid-19. A gander at the chart below is enough to deduce that the U.S. is well on its way back to the 200K mark, though given the slightly slowing rate of increase, that may be an overly pessimistic projection. The trend look as though cases could level off around 150K before the delta surge abates. If India is any guide, the delta surge should be behind the U.S. by mid-October.
Of course, the main worry with the delta variant is that it may kill the unvaccinated, and the U.S. has roughly 134 million of those. Some may disagree, but it remains preferable to keep unvaccinated Americans alive whatever their misgivings about the merits of inoculation. But the larger problem with the delta variant is that it still manages to infect vaccinated individuals, even though being vaccinated provides their bodies with sufficient defenses to reduce the severity of the infection. Still, there have been cases of vaccinated people falling ill, being hospitalized and, in extremely rare instances, dying of Covid-19. The takeaway here is that getting vaccinated is still better than not getting vaccinated if your goal is survival. But it also means that vaccinated people can still carry the virus, transmit it to the unvaccinated and smuggle it across borders.
The implications of that are that a) social distancing and wearing masks remain important means for reducing transmission, b) it may remain necessary to quarantine even vaccinated travelers who might be carrying delta and c) we’re going to need booster shots eventually. Also, the higher infectiousness of the delta variant makes herd immunity much more difficult (if not impossible) to attain. The best we can probably hope for now is that we can minimize transmissions until enough people have been vaccinated to reduce the overall mortality rate to the point that the delta variant is no longer a serious health threat or until the virus manages to mutate into a less virulent form.
For the record, the only places at the moment that have managed to fully vaccinate more than 70% of their populations are: the Cayman Islands, Gibraltar, Iceland, the Isle of Man, Malta, Pitcairn Island, and the United Arab Emirates. That puts them (a group comprising a mere 11 million of the planet’s 7.7 billion people) in good shape to “reopen,” i.e. cancel restrictions on movement and gathering, since they are reasonably well-protected against most serious infections. It doesn’t, however, eliminate the risk to their populations of contracting Covid, falling seriously ill or dying. If you want proof, look at Iceland, where infections are surging to record levels despite its enviable vaccination rate. Luckily for Iceland, that vaccination rate has helped keep its Covid death toll in the latest outbreak to one.
The rest of us, meanwhile, should really still be masking up, avoiding crowds, quarantining after travel and isolating if we’ve been near a confirmed case. As for the vaccine-agnostic, they should be treated like unhelmeted motorcycle riders: either be required by law to get the vaccine or compelled to bear the cost to the system of not doing so.
The country we should in theory worry most about is India, which still has the largest population of unvaccinated individuals. But since India has already been exposed to a deadly outbreak of the delta variant—India is where delta was first identified, after all—the country that faces the greatest risk is probably China. Not only does China still have more than 662 million unvaccinated individuals, but the vaccines China has been using have demonstrated questionable efficacy against the delta variant, meaning China has potentially 1.4 billion vulnerable individuals. That explains perhaps why China is responding so aggressively to its own outbreaks of delta.
The official incidence rate in China still remains admirably low, however: only about 1 per million residents. The dubious honor of “epicenter” of the pandemic today remains the U.S., which now has roughly 1.6 million known, active infections—the largest pool of cases anywhere. This column did warn that the U.S. was opening prematurely. The pandemic is most intense right now, however, in the nation of Georgia, where roughly 13,800 people per million are infected, and in Botswana, with almost 13,000 infections per million.
Just remember: the bigger worry in these rising infections—beyond whether those infected live or die, alas—is that each is a new incubator for the virus to mutate. Hopefully, it mutates into something more benign, but the risk remains that lying within every asymptomatic, vaccinated person with Covid, a more virulent new strain is lurking.