Dr. Roger Hicks: The Delta variant and vaccines
If you are like me, you wish we were done talking about COVID. But we’re not — variants and vaccines are still in the news, sharing the headlines with fires and drought. That’s because COVID is surging in all 50 states, rising more than 300% both in California and here in Nevada County since July 4. I was shocked to read in the LA Times that Nevada County has the 4th highest case rate in California — just behind Yuba, Stanislaus and Lake counties.
The Delta variant is one of the reasons for the rise in cases. Variants are imperfect copies, or mutations, of the original viral DNA or RNA formed when viruses multiply. Usually these changes have no impact on the virus, or even harm it, but occasionally an imperfection gives a variant an advantage over its predecessor. For example, some mutations allow the virus to evade our immune defenses while others are more transmissible.
People infected with the Delta variant have a viral load — the number of viral particles in the body — more than 1,000 times greater than those infected with the original SAR-CoV-2. This may be why the Delta variant spreads so much more quickly and is thought to be more than twice as contagious. Originating in India, the Delta variant was first detected in California in April. By June it accounted for about 50% of the new cases in the state. This has now increased to 83%. According to congressional testimony on July 20 by CDC Director Dr. Rochelle Wolensky, California’s Delta numbers mirror what is happening nationally. This variant is so prevalent and so much more infectious that wearing a mask indoors in public places is once again required in LA County and recommended in many other places around the nation.
Variants arise when viruses replicate. Here’s how it works: the more infected people there are in a community, the more virus there is, even if those people have mild or no symptoms. The bigger the pool of virus, the more replication there is, which results in more opportunities for variants to form. Reducing the number of people with COVID lowers the chances of even more dangerous variants to arise and, at the same time, helps our schools and businesses get back to normal.
I understand vaccine hesitancy. After all, vaccines are made by drug companies, which do not have a stellar reputation in this country. Some of the products they sell have serious side effects or are just not very effective, and many are outrageously expensive.
Furthermore, COVID infections in fully vaccinated people, or breakthrough infections, are on the rise, causing some to say COVID vaccines are useless. We have all heard reports of people who are fully vaccinated testing positive, and we are seeing that occur at our clinic.
I think it is helpful to keep the purpose of a vaccine in mind. The definition of an effective vaccine is one which prevents illness, hospitalizations and death. Fortunately, the COVID vaccines being given in the U.S. are very effective against the current variants. It is a fact that the vaccines are not 100% effective, and they are not 100% risk free. But let’s compare the risks and benefits of getting vaccinated versus getting COVID.
The case rates in the US are highest in those areas where the vaccine rates are the lowest. If you are unvaccinated and get COVID, you could become very ill, need to be hospitalized, or even die. More than 97% of COVID hospitalizations and over 99% of deaths from COVID are now in unvaccinated people. If you are unvaccinated, you can infect family, friends, and colleagues, and it is much easier to do that now with the higher viral loads and transmissibility of the Delta variant. You could also get “long COVID” — symptoms that last for weeks or months after the acute illness is gone.
The benefits of getting COVID are few – getting COVID will give you some protection against future infection, but less than if you were vaccinated, especially against the Delta variant.
There are risks from the vaccines, including an increased risk of myocarditis (inflammation of the heart muscle) after the mRNA vaccine, primarily in young males; blood clots after the J&J vaccine, primarily in young females; and Guillan Barre syndrome. All of these are extremely rare and are, in fact, much more likely to be caused by a COVID infection than by a COVID vaccine. For example, myocarditis after an mRNA vaccine has been reported in about two out of every million doses given, while studies show that COVID infection itself causes myocarditis in more than two out every 100 people infected.
The benefits of the vaccine are many. They dramatically reduce your chance of serious illness, hospitalization, ICU admission and death. They also lower your chances of getting a mild or asymptomatic COVID infection. And if you do get a breakthrough infection, odds are you will have mild symptoms.
We need everybody to help if we want this pandemic to end. When enough of us get vaccinated, community immunity will shrink the pool in which the virus can mutate. We have the tools to prevent transmission and save lives. The more people who get vaccinated, the more quickly we can get past this. Let’s turn back the tide in Nevada County and lead the table with the lowest case rate in California!
In the end, whether or not to get a COVID vaccine is a personal choice, but it is a choice that affects all of us. The pandemic won’t really end until enough people around the world are vaccinated. My advice is to get the vaccine now if you haven’t already. Do the right thing for yourself and those close to you, your community, and your country.
Dr. Roger Hicks is the Medical Director for Yubadocs Urgent Care in Grass Valley and the founding president and current Director of the California Urgent Care Association
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