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| Kevin Kavanagh, M.D. |
This Fourth of July I was able to celebrate with my immediate family, all but the children have been fully vaccinated. We are still extremely careful with our grandchildren, since they are not eligible for vaccination and although they are unlikely to develop “severe” disease regarding hospitalization and deaths, they can still develop mild disease with associated long-term complications.
Over the past year, our public health expectations regarding Covid-19 have markedly decreased. Recently Tyson Foods recalled 8.5 million pounds of chicken over possible contamination with listeria. There were three hospitalizations and one death. There appears to be universal support of this action with little or no controversy being generated. But strategies to decrease deaths with Covid-19 create a huge uproar.
Watching our nation’s Fourth of July celebration one could only conclude that we have decided to will Covid-19 away and ignore its presence, similar to American televangelist Kenneth Copeland, who proclaimed, “I blow the wind of God on you. You are destroyed forever, and you’ll never be back.”
Copeland was not successful, almost a year later, televangelist Frederick K.C. Price died of Covid-19. And it probably will not work for our mainstream leaders this summer. Mass gatherings on the Mall of our capital, of closely packed, maskless individuals including unvaccinated children, is not a good strategy for warding off an impending surge of the Delta variant.
Many do not want to trust science and argue over the validity and meaning of the data, but determining what will happen is actually quite easy. Just look at the United Kingdom, where 99% of coronavirus infections are from the Delta variant. The U.K. is spiking cases, and Prime Minister Boris Johnson predicted there could be 50,000 cases by July 19, in a country whose population is approximately 20% of the United States’.
Cases are starting to spike in Arkansas, a state that as of July 6 had only 34% of its population fully vaccinated. Kentucky’s rate is 44%, the U.K.'s is 50%. Covid-19 outbreaks are expected to be regionalized within states, since vaccination rates vary widely between counties and communities.
Luckily for the U.K., hospitalizations and deaths have not risen nearly as much, but this is not much consolation to those who have developed long Covid. Long haulers’ syndrome is occurring commonly, even in those with mild to moderate disease. A recent study published in Nature Medicine found that 52% of home-isolated young adults aged 16 to 30 had symptoms six months later; 28% had loss of taste/smell, 21% fatigue, 13% shortness of breath, and 13% impaired cognition and 11% memory problems.
The Delta variant is spreading rapidly in the United States. It is reported to be more deadly and can evade immunity. The evasion is from both its ability to block antibody attachment, but also may be due to increased viral load and ability to attach to cells. An invader can win a war, both by evading bullets but also by having more soldiers who are increasingly more effective.
Israel has recently reported that the Pfizer vaccine is only 64% effective in preventing both symptomatic disease and infections, but was 93% effective in preventing hospitalizations. Other variants exist which may be even more effective at evading immunity.
With variants looming, it is of utmost importance to become fully vaccinated, including those who have been previously infected with the wild type of virus. Over 99% of Covid-19 deaths are in those who have forgone the jab. Vaccinated individuals who become infected tend to avoid severe illness. It is not known if they will also be less likely to develop long Covid, but hopefully this will also be the case.
In areas with high viral cases and low vaccination rates, such as much of rural Kentucky, many experts, including the World Health Organization, are advising the continued use of masks by all — especially in crowded, poorly ventilated settings. Unfortunately, this would include much of rural Kentucky.
Luckily for the U.K., hospitalizations and deaths have not risen nearly as much, but this is not much consolation to those who have developed long Covid. Long haulers’ syndrome is occurring commonly, even in those with mild to moderate disease. A recent study published in Nature Medicine found that 52% of home-isolated young adults aged 16 to 30 had symptoms six months later; 28% had loss of taste/smell, 21% fatigue, 13% shortness of breath, and 13% impaired cognition and 11% memory problems.
The Delta variant is spreading rapidly in the United States. It is reported to be more deadly and can evade immunity. The evasion is from both its ability to block antibody attachment, but also may be due to increased viral load and ability to attach to cells. An invader can win a war, both by evading bullets but also by having more soldiers who are increasingly more effective.
Israel has recently reported that the Pfizer vaccine is only 64% effective in preventing both symptomatic disease and infections, but was 93% effective in preventing hospitalizations. Other variants exist which may be even more effective at evading immunity.
With variants looming, it is of utmost importance to become fully vaccinated, including those who have been previously infected with the wild type of virus. Over 99% of Covid-19 deaths are in those who have forgone the jab. Vaccinated individuals who become infected tend to avoid severe illness. It is not known if they will also be less likely to develop long Covid, but hopefully this will also be the case.
In areas with high viral cases and low vaccination rates, such as much of rural Kentucky, many experts, including the World Health Organization, are advising the continued use of masks by all — especially in crowded, poorly ventilated settings. Unfortunately, this would include much of rural Kentucky.
With the Delta variant, some vaccinated individuals are at risk of spreading the virus. Thus, wearing a mask will also help protect others. We should remember that about one in 30 individuals, including those who have had organ transplants, are immunocompromised and the vaccines may not be effective in mitigating or preventing Covid-19.
We also need to learn to live with this disease; the virus is fast becoming endemic in our society. The Delta variant is twice as infectious as the original virus with an basic reproduction number estimated to be between 5 and 8, meaning over 80% of the population will have to be immune before Covid-19 will stop.
We need to pay as much attention to airborne spread of disease as we do to spread by food, water and objects. Buildings need to have their ventilation systems upgraded to increase air exchanges and sanitization. In addition, even after the pandemic passes, mask wearing needs to become socially acceptable, especially for individuals having minor colds or infections, and in those who are immunosuppressed.
Both Gov. Andy Beshear and Sen. Mitch McConnell agree that everyone who can should become vaccinated. And when those two agree on something, one should listen.
We also need to learn to live with this disease; the virus is fast becoming endemic in our society. The Delta variant is twice as infectious as the original virus with an basic reproduction number estimated to be between 5 and 8, meaning over 80% of the population will have to be immune before Covid-19 will stop.
We need to pay as much attention to airborne spread of disease as we do to spread by food, water and objects. Buildings need to have their ventilation systems upgraded to increase air exchanges and sanitization. In addition, even after the pandemic passes, mask wearing needs to become socially acceptable, especially for individuals having minor colds or infections, and in those who are immunosuppressed.
Both Gov. Andy Beshear and Sen. Mitch McConnell agree that everyone who can should become vaccinated. And when those two agree on something, one should listen.
Kevin Kavanagh of Somerset is a retired physician and chair of Health Watch USA, which focuses on infection control. This was initially published in the Louisville Courier Journal.
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