Covid Will Not Be Forever

 Covid-19. Some say the playing field has changed with the advent of the Delta variant. I think the playing field remains the same but in baseball terms, the minor league club we were playing was switched out for the San Francisco Giants or the Chicago White Sox. Delta is a fitter virus, with both greater transmissibility and data that suggests greater lethality. We need to play the game with the tools we have, which are very good. Nonpharmaceutical interventions (especially masks and improved ventilation) along with vaccines work. If they are applied.

In the 12 August edition of The Atlantic, Ed Yong wrote that the pandemic will end but just not the way we all hoped for. This means the virus, SARS-CoV-2, will become endemic, as other cousin coronaviruses have become. This will happen when we can disconnect the virus infection with SARS-CoV-2 with the disease Covis-19. That road will heavily depend on a vaccinated population and Yong correctly points out that means a globally vaccinated population. It is a worthwhile read for everyone.

In the 28 August edition of The Atlantic, Celine Gounder makes important points about how vaccines protect not only individuals but populations. Current vaccines do not produce sterilizing immunity. They protect against the disease Covis-19 caused by SARS-CoV-2. They are not like an armor plate off which the virus rebounds, unable to interact with the host. Too many people have denigrated the vaccines as worthless since even vaccinated people may be infected. Simply put, they do not get it. The vaccines work but as the level of neutralizing antibody raised immediately after vaccination wanes, the risk of infection does increase. But they remain effective at reducing the risks of severe disease, hospitalization, and death.

Eric Topol (@EricTopol) is a person to follow on Twitter for access to current data with a great analysis. Today he posted data from Israel (a preprint, not yet peer-reviewed) which showed Israelis older than 60 clearly benefited from a booster dose of vaccine with a more than ten-fold reduction in severe illness and an ~11-fold reduction in infection compared to a cohort that was fully vaccinated but not boosted:

Further data from another Israeli study documents that the risk of waning immunity is clearly highest in the age >60 group with more waning the longer the time interval is from their second dose. The vaccines used were mRNA vaccines.

Take-home for today? A nasty, wily viral opponent whose Delta variant is a game-changer. Use masks and I recommend KN95 or KF94 masks rather than surgical or cloth masks. Never use an N95 mask with a valve. Get vaccinated if you have not been for the protection of yourself and your community. Use all methods possible to increase ventilation, probably the most under-recognized countermeasure but with a virus spread by aerosols, critical to success. The best ventilation is outdoors. While the crazy governors of Texas and Florida push the Regeneron cocktail rather than vaccines (“An Ounce of Prevention Is Worth a Pound of Cure”, Benjamin Franklin), if you have a real exposure or early Covid-19, they are indeed quite useful. For me, I look forward to a booster to allow my own immune system to raise the level of circulating neutralizing antibodies.

Finally, no cruises and better to avoid crowded indoor spaces. We all have pandemic fatigue. That is better than Covid-19.