Internal CDC document urges new messaging, warns delta infections likely more severe

[BumRushDaShow]

Last edited Thu Jul 29, 2021, 08:44 PM - Edit history (1)

Source: Washington Post

The delta variant of the coronavirus appears to cause more severe illness than earlier variants and spreads as easily as chickenpox, according to an internal federal health document that argues officials must “acknowledge the war has changed.” The document is an internal Centers for Disease Control and Prevention slide presentation, shared within the CDC and obtained by The Washington Post. It captures the struggle of the nation’s top public health agency to persuade the public to embrace vaccination and prevention measures, including mask-wearing, as cases surge across the United States and new research suggests vaccinated people can spread the virus.

The document strikes an urgent note, revealing the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, leaping from target to target more swiftly than Ebola or the common cold. It cites a combination of recently obtained, still-unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with delta may be able to transmit the virus as easily as those who are unvaccinated.

Vaccinated people infected with delta have measurable viral loads similar to those who are unvaccinated and infected with the variant. “I finished reading it significantly more concerned than when I began,” Robert Wachter, chairman of the Department of Medicine at the University of California at San Francisco, wrote in an email. CDC scientists were so alarmed by the new research that the agency earlier this week significantly changed guidance for vaccinated people even before making new data public.

The data and studies cited in the document played a key role in revamped recommendations that call for everyone — vaccinated or not — to wear masks indoors in public settings in certain circumstances, a federal health official said. That official told The Post that the data will be published in full on Friday. CDC Director Rochelle Walensky privately briefed members of Congress on Thursday, drawing on much of the material in the document.

Read more: https://www.washingtonpost.com/health/2021/07/29/cdc-mask-guidance/

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Full headline: ‘The war has changed’: Internal CDC document urges new messaging, warns delta infections likely more severe

Link to the document referenced - https://www.washingtonpost.com/context/cdc-breakthrough-infections/11fc6a11-20d7-466e-a654-c6bc8426f688/ (goes to a PDF reader of a slide deck)

[Eliot Rosewater]

1. SHIT, this is bad, we have to fight this deadly virus and a terrorist organization with over 60

million members all trying to kill us with the virus.

[regnaD kciN]

2. Republicans: "It's Biden's fault" and "See, we told you the vaccine doesn't work!"

[Pobeka]

3. I'm sure that's been the motive for the antivax messaging.

It's disgusting.

The GOP has never cared about public health though, it's part of their MO if you are paying attention.

[wnylib]

4. I wish they would recommend indoor masking

everywhere, not just in high infection areas. It would be proactive in preventing other areas from getting worse.

In high vaccination areas, the delta variant will still spread and reach vulnerable people and children since vaccinated people can spread the virus. The infection rates wouldn't get as high as in unvaccinated areas, but would still increase unnecessarily unless everyone wears masks again regardless of where they live.

My county went from 0 new cases for days at a time in June to occasional 1 or 2 cases this month. Then last week there were 3 cases that went to 10 cases over the weekend. Since Monday that rose to 19 active cases today. It will get worse because our vaccination rate is only 43% and the delta infections of bordering counties are rising.

[LeftInTX]

7. Agree....what's a high infection area?

I found out that I'm in one and didn't know it.

[wnylib]

10. The CDC has 4 designations.

Low - numbers are low (don't know the exact number cutoff) AND they are isolated in their location, e.g. 1 person in one town and maybe 1 or 2 people in another town within a county.

Moderate - higher numbers, but again, I don't know the cutoff.

Substantial - cluster infections associated with a school, workplace, etc. that spreads into the surounding community.

High - I read that this means 50 cases per 10,000 people, but someone else said that it is 50 per 100,000 people.

[deurbano]

5. Crap. I live in SF, and gave birth to my son at UCSF. Dr. Wachter has been one of the experts I've

followed on Twitter since this nightmare began to unfold.

[LeftInTX]

6. You didn't include link to original article:

I know it's behind a paywall, but I subscribe...

Walter A. Orenstein, associate director of the Emory Vaccine Center, said he was struck by data showing that vaccinated people who became infected with delta shed just as much virus as those who were not vaccinated. The slide references an outbreak in Barnstable County, Mass., where vaccinated and unvaccinated people shed nearly identical amounts of virus.

“I think this is very important in changing things,” Orenstein said.

A person working in partnership with the CDC on investigations of the delta variant, who spoke on the condition of anonymity because they were not authorized to speak, said the data came from a July 4 outbreak in Provincetown, Mass. Genetic analysis of the outbreak showed that people who were vaccinated were transmitting the virus to other vaccinated people. The person said the data was “deeply disconcerting” and a “canary in the coal mine” for scientists who had seen the data.

Link to article:

https://www.washingtonpost.com/health/2021/07/29/cdc-mask-guidance/

[BumRushDaShow]

8. Oh shoot thank you!

Just added it when I got back on DU and saw your post.

Have been tracking tornadoes in my area the past couple hours and trying to juggle that and this.

Link to tweet

TEXT

NWS Mount Holly
@NWS_MountHolly
7 PM Thursday Update: There remain two tornadic storms in the area. One is on the NE Philly/Bucks County line moving SE, another is in SW Mercer County moving into Western Monmouth and northern Ocean Counties. For the latest info: http://weather.gov/phi
Image
7:15 PM · Jul 29, 2021

[LeftInTX]

9. Stay safe!

[BigmanPigman]

16. Yikes...I grew up next to Bryn Athen.

[BumRushDaShow]

28. There were 2 tornados that eventually touched down in that area

and one of them hit a car dealership (one of the Faulkner ones), injuring 5.

They hit around Bensalem, Trevose, & New Hope, on their way across the river to Jersey.

https://www.buckscountycouriertimes.com/story/weather/2021/07/29/tornado-damage-watch-warning-bucks-solebury-philadelphia-pa-weather/5423883001/

[orleans]

17. i subscribe too & apparently you don't need a subscription for this article:

PLEASE NOTE
The Washington Post is providing this important information about the coronavirus for free. For more free coverage of the coronavirus pandemic, sign up for our Coronavirus Updates newsletter where all stories are free to read.

so.. that's cool. and thanks for the link

[Yo_Mama_Been_Loggin]

11. K&R

[DallasNE]

12. The Numbers Are Skyrocketing

All courtesy of the anti-vaxxers,

https://www.bing.com/search?q=covid+19+in+usa&cvid=8de0aa1d19d14c8cb06f7b70294657c5&aqs=edge.3.69i60j69i59l3j69i57j0j69i65.5385j0j1&pglt=43&FORM=ANNTA1&PC=HSJS

[bucolic_frolic]

13. Mother Nature is cleaning house

Some guy told me the apocalypse was coming a good 5 or 6 years ago. Said it was in the Book of Enoch. "God is pissed," he would say. He was no scholar, just someone who read everything. Can't say as I paid much attention.

[JoeOtterbein]

14. K n R ! Thanks for posting! And...

...F...!!!!!!!

[Raven123]

15. Ugh. Just as schools are readying for the academy year.

And all those states that passed laws denying Governors and Health Departments the authority to develop and enforce preventive measures. They all have DeSantis Syndrome.

[LeftInTX]

29. Worst time of the year for this....

Hubby is a school admin and we're in Texas

[Larissa]

18. WaPo Covid articles are free

Just as it did during the darkest days of the first wave of Covid-19, The Washington Post is providing all articles relative to the virus for free. Just go to the home page.

[yaesu]

19. and just in time for the super duper spreader event called Sturgis. nt

[Javaman]

33. and Lollapalooza. that's happening in Chicago. nt

[littlemissmartypants]

21. Kicked and recommended. ❤

[PSPS]

22. r0 of original strain was 2.7. r0 of delta is between 4 and 9

From two weeks ago:

https://unchartedterritories.tomaspueyo.com/p/delta-variant-everything-you-need

The original Coronavirus variant has an R0 of ~2.71. Alpha—the “English variant” that caused a spike around the world around Christmas—is about 60% more infectious. Now it appears that Delta is about 60% more transmissible yet again. Depending on which figure you use, it would put Delta’s R0 between 4 and 9, which could make it more contagious than smallpox. Just to give you a sense of the dramatic consequence of such an increase in R, this is what two months of growth get you with the previous transmission rate of 2.7 vs. with an R of 6:

[orleans]

23. k&r n/t

[PSPS]

24. The same CDC document says that 35,000 vaccinated people are getting infected daily

[LisaL]

26. Not daily, weekly.

NT

[PSPS]

35. Yes, you are correct. I misstated the figure.

[dalton99a]

25. .

[Deminpenn]

27. This is apparently based on data from an outbreak

in Provincetown, Mass. It's a relatively small sample size. TBH, I just put that in the category of what's happened each time a new activity starts up ala 4th of July gatherings. There has a been a spike every single time that's occurred. Further, how can something that's "aerosolized" as SARS-CoV2 is supposed to be, be more contagious since aerosolized viruses are the most contagious known?

That 35,000 number is someone's guess or estimate.

Again, a lot of small studies here and there, none coordinated or designed, just random events that analysts are trying to pull together to develop some kind of pattern.

There is real data out there on the thousands of participants in all the clinical trials who have been followed since the day they enrolled and will continue to be followed for 2 years, maybe more. That's where the CDC should be getting its data.

Jmho, but overall the CDC hasn't done a good job with information. They are zig-zagging all over the place trying to respond to each study or whatever that purports to show some dire outcome. They are not inspiring confidence with that approach.

I do, however, give Biden high marks for his presser today that was covered by ABC and CBS in real time. Biden was clear, get vaccinated.

[LisaL]

30. Well, if we tested more people, we wouldn't be guessing.

Our testing rate is low.
So the only thing we can do is guess.

[Deminpenn]

31. That is not true

Again, the clinical trial participants, thousands of them, are being regularly monitored. Some of them may already be being tracked by the CDC given the government's involvement in the development of the Moderna vaccine.

There is no reason Moderna, Pfizer, AZ, J&J cannot be asked to share their ongoing data with the CDC for more definitive and standarized data with which to work. Then these different and random studies can be compared to that data to determine if they are outliers or trends.

CDC is trying to give advice in realtime and is creating more confusion because of it. Until there is or are better and controlled studies, the advice should be simple: Get vaccinated. If you don't feel safe, it's ok to keep wearing a mask.

[LisaL]

32. If you don't feel safe it's o'key to keep wearing a mask?

But you are stupid, right, cause you should feel safe?
If you are vaccinated, you can still get infected, but your viral load is as high as that of un-vaccinated person. But if you feel safe, it's o'key for you to run around with your high viral load?

[Deminpenn]

34. Not at all

Everyone has a different tolerance for risk. If you are one of those people who have a low tolerance for risk, by all means keep abiding by the original CDC guidance. Speaking only for myself, I am fine with you doing what makes you feel safe(r).

However, I do think there needs to be more explanation of exactly what a positive PCR test tells and what it does not. Doing a little searching for credible research and information and reading up a bit, my layman's understanding is that there are several critical things to know:

First a PCR test can only detect the virus RNA by making many, many copies of it so that a marker attached to the sample becomes visible.

Second, the PCR test cannot tell if the detected virus is viable or not. Only by doing a culture can that be known.

Third, the number of times the PCR test has to make copies in order to arrive at a positive result is important. The higher the number of times (or cycles) copies have to be made, the less virus there is. The fewer times the RNA has to be copied, the more virus there is. It's not an exact substitute for viral load, but it seems to me the number of cycles could give a fair representation of viral load.

In all, imho, there is much more information the CDC could put out to the public that would enhance understanding of what everything really means.

[hueymahl]

36. The US is not ready to remask and re-social distance

Just sayin'. If you think the objections were bad the first time, you ain't seen nothin yet.