What we now know about how to fight the delta variant of COVID

[phylny]

https://www.tampabay.com/opinion/2021/08/10/what-we-now-know-about-how-to-fight-the-delta-variant-of-covid-column/?fbclid=IwAR3_3BGFgaa3aSNGmWnp0q8p9t35IOHOjfLESULYs6F_BSkevbkNg_cHT7Y

Dr. J. Stacey Klutts

1. Like Gorilla Glue. The delta variant (lineage B.1.617.2) has a particular collection of mutations in the spike protein (that knob-like projection you see in renderings of the virus) that make it extremely effective in attaching to human cells and gaining entry. If the original COVID strains were covered in syrup, this variant is covered in ultrafast-drying Gorilla Super Glue (industrial strength).

2. 1,000 times higher. There are two recent publications which demonstrate that the viral loads in the back of the throats of infected patients are 1,000 times higher with the delta than with previous variants. I can tell you from data in my own labs, that is absolutely true. We are seeing viral signals we never saw last year using the exact same assays.

3. Much more infectious. This much higher load plus the ultra “stickiness” of the delta strains for adhering to human cells makes it remarkably more infectious than previous strains. You may have heard of R0 (Pronounced R naught) which is, in a nutshell, the number of people to which an infected person would be expected to transmit the virus. Early versions of the virus had a 2 to 2.5 R0 value. So one infected person would infect two or so people on average. Delta has an R0 of about eight! In the infectious disease world, that’s almost unheard of. Chickenpox and measles are about all we have ever seen that spread that efficiently from human to human. This changes the story line completely from earlier in the pandemic and makes this surge, in many ways, like a completely different pandemic event.

4. Five days. There is another recent publication out of Singapore with data that confirms something we suspected. I will explain more about the “why” on this below when I talk about vaccines, but the gist is this: The viral loads in the throats of vaccinated persons who become infected with delta rises at identical rates as in unvaccinated persons, but only for the first few days. After five days or so, the viral loads in the vaccinated person start to quickly drop whereas those in the unvaccinated person persist. This key set of observations is important for several reasons relating to vaccinated persons serving as vectors for spread.

More good info at link.

[dalton99a]

1. An important article

5. Young people. This pandemic, Round 2, is primarily being observed in younger patients than in Round 1. Our children’s hospitals are even already filling up or full. Because of the delta viral dynamics, it is much more capable of causing severe disease in a larger swath of the population. You spew enough of any human pathogen on someone without immunity, and it’s not going to end well. This sets up very poorly for the beginning of the school year — which has already started in Florida — and it scares me. Check that. It is actually terrifying. I sure hope we have vaccines for the 5- to 11-year-olds soon.

6. Vaccines work! Speaking of vaccines. Are they working? Yes! They are absolutely doing their expected job. We know a lot about vaccines for upper respiratory viruses, as we have been giving the population one every year for decades (influenza). To explain all of this, I need to provide some biological context. When you get a vaccine as a “shot,” the “antigen” in the vaccine leads to formation of an antibody response. You probably knew that. What’s important, though, is that it primarily leads to a specific Immunoglobulin G (IgG) response. That’s the antibody type that circulates around in really high numbers in the blood, is located some in tissues and is more easily detectable by blood tests, etc.

What that shot does not do is produce an Immunoglobulin A (IgA) antibody response to the virus at the surface of the throat mucosa. That’s the antibody type that could prevent the virus from ever binding in the first place. As such, in a vaccinated person, the virus can still attach like it’s about to break into the house, but it doesn’t realize that there is an armed homeowner on the other side of the door. When that virus is detected, the IgG beats it up and clears it before the person gets very ill (or ill at all). (Sidebar: Anyone ever had their kid — or themselves — get the “Flumist” vaccine as their annual flu booster? The idea there is to introduce the antigens at the surface of the throat mucosa leading to that IgA response that will prevent infection from happening at all. Sounds good and still has a place, but it isn’t quite as effective overall as the shot.)

7. Preventing disease and death. The COVID-19 vaccines are designed to prevent disease/death through that IgG response (though it does also reduce infections somewhat). How good are the vaccines at doing all of this with delta? The Centers for Disease Control and Prevention has just released data addressing that very question. Punchline: They’re remarkably good! The vaccine shows an 8-fold reduction in the development of any symptomatic disease secondary to delta. For hospitalization, it is a 25-fold reduction. That’s 25 times! Remarkable. For death, it is also 25 times! This is a very effective pharmaceutical class when looking at overall efficacy toward the intended/expected purpose. When looking at the very tiny side effect profile, I’d personally consider it one of the best overall pharmaceuticals on the market in any class of drugs.

[LeftInTX]

21. What that shot does not do is produce an Immunoglobulin A (IgA) antibody response to the virus at

the surface of the throat mucosa

[Hugh_Lebowski]

2. Excellent information here, thanks! (nt)

[phylny]

4. I appreciate learning why wearing a mask

is still recommended.

[crimycarny]

3. Love the description of the intruder and Homeowner with a gun

I feel like that description is a perfect analogy to get through the thick skulls of those who try to claim the vaccine “doesn’t work” because vaccinated people are still becoming infected. Trying to explain that just because vaccinated people are still getting infected doesn’t mean the vaccine isn’t working—because the vaccinated cases are FAR less severe—seems to fall on deaf ears. The intruder and homeowner analogy explains this in terms those most likely to spout the “vaccine doesn't work” would understand. Scary intruder and good guy with a gun...

[StarryNite]

5. Really good, easy to understand information.

Thank you for sharing!

[Wednesdays]

6. He does a good job of explaining

However, the "how to fight the delta variant" boils down to getting the vaccine and wearing a mask, which we already knew.

[phylny]

7. We did (most of us, anyway)

but I really like how it’s explained.

[Ms. Toad]

9. The 5 days is helpful -

One of my students (before the first day of classes - when I had 120 of the not-so-little darlings) was dignosed with COVID - after eating with his peers unmasked, inside (an huddling unmasked with another student in the classroom before we came in and caught him).

I've been in contact tracing hell - I wasn't exposed to him closely enough to be directly impacted, but I coordinated the course - and the students weren't responding to the tracers.

At least I know a shorter time frame to be concerned (and extra cautious) about infecting others - and my employee who was involved - is past any 5-day window.

[SleeplessinSoCal]

13. My brother is caring for our 97 year old mother...

...who wants to live to be 100. They both had mild Covid and both are vaccinated. He is careless about his own health. I texted this article to my entire family. Some are not vaccinated. I hope they read it and understand how we interact with each other and therefore need to be thinking about our resistance to vaccine is actually dangerous for the family.

[Quakerfriend]

8. Great post! Thanks for this.

[nilram]

10. Excellent article, worth clicking into it. Thanks for posting it.

In other words: K&R

[stage left]

11. Very informative.

Thanks for posting.

[amuse bouche]

12. Saving for a friend

[Farmer-Rick]

14. Yeah, but vaccinated people over 60 are still getting sick

And are still dying. A vaccinated person over 60 is still more likely to get a breakthrough infection, get sick and die then a vaccinated 30 year old.

Yeah, get vaccinated but some idiot anti-vaxxer can still get you infected and put your life at risk.

So, be careful.

Unvaccinated younger people are getting seriously sick and dying much like with the 1918 pandemic. But at least we have the vaccine with this pandemic.

[JudyM]

15. K&R

Good info!

[Pinback]

16. Special Assistant to the National Director of Pathology and Lab Medicine for the entire V.A.

Important information from an expert with an inside view of the current state of the SARS-COV-2 pandemic.

Recommended.

[Martin68]

17. Thanks for the update!

[calimary]

18. This IS a lot of good info. Thanks, phylny!

[momta]

19. K&R

Great article.

[BComplex]

20. Great post, phylny! That is great information about the Delta variant.

Thanks!

[LeftInTX]

22. Very informative and easy to read!

BTW: Greg Abbott tested negative after four days of positive tests. However his 3rd booster and Regeneron muddy the equation.

[mrsadm]

23. Great information, thank you!

[MustLoveBeagles]

24. K&R