Distress over delta

When lawmakers and journalists have pressed for a bright line for declaring victory over the COVID-19 pandemic, Anthony Fauci has given one number: 10,000.

That’s the number of average daily cases the country’s top infectious disease expert recommended in early March as the United States began lifting health restrictions. He repeated the number during an April 15 congressional hearing, when Republican Rep. Jim Jordan of Ohio pressed for a target: “What is low enough? Give me a number.”

“That would be that the number of infections per day are well below 10,000,” Fauci told lawmakers. “At that point, and up to that point, there would be a gradual pulling back of some of the restrictions you’re talking about.”

While single daily new cases dipped below 10,000 on May 30 for the first time since the beginning of the pandemic, according to counts by The New York Times and Johns Hopkins University, the seven-day daily average stubbornly remains just above that cutoff. News about a new, more contagious strain of the coronavirus, known as the delta variant, has raised questions about whether the country is ready to remove pandemic restrictions. Experts say the delta variant’s effect on public health will depend largely on regional vaccination rates and what ongoing research reveals about the mutated virus.

On June 28, the United States recorded 15,570 new cases of COVID-19, pushing the seven-day daily average over 11,000 by The New York Times’ count. (Johns Hopkins recorded a higher count of just under 12,500 new cases.) That’s still down dramatically from daily averages in excess of 250,000 in January. It matches numbers not seen in the United States since March 2020 at the beginning of the pandemic.

Steadily increasing vaccination and declining positivity rates have led many states and private businesses to loosen restrictions. California relaxed social distancing requirements and ditched its mask mandate on June 15. But as reports surfaced of the delta coronavirus variant spreading, officials with the Los Angeles County Department of Public Health reversed course, urging even vaccinated locals to voluntarily don a mask when indoors. The department reasoned that since available shots might be slightly less effective against the delta variant, vaccinated people should wear a mask to keep from unknowingly spreading the new strain to an unvaccinated person.

Epidemiologists first identified the delta variant in India. Researchers aren’t yet sure whether the strain causes more severe illness than the original virus. Early research from Public Health England found one dose of a two-dose vaccine had a 35 percent efficacy rate at preventing symptomatic illness from the delta variant compared to 49 percent efficacy against the original virus, or the alpha variant. After a second dose, the vaccines were 79 percent effective against delta and 89 percent effective against alpha.

According to research published June 14, two doses of mRNA vaccines like those manufactured by Pfizer and Moderna still provided 96 percent protection against hospitalization from the effects of either variant. Oxford’s AstraZeneca vaccine provided 92 percent protection.

In the United Kingdom, almost all new reported infections are of the delta variant, and daily new cases in the country have been climbing. According to COVID-19 data aggregator Worldometer, the seven-day daily new case average in the United Kingdom reached 3,441 on June 1. By Wednesday, that same seven-day average climbed to 18,959. Hospitalization rates remain low compared to their January highs despite the rising case load. “We are still hardly seeing anybody who’s fully vaccinated going to hospital—it’s a really tiny fraction,” British epidemiologist Tim Spector told CNN.

U.S. Centers for Disease Control and Prevention Director Rochelle Walensky said she expects the delta variant to become the dominant strain among unvaccinated people in the United States within weeks or months. And in an interview on the CBS show Face the Nation, former Food and Drug Administration Commissioner Scott Gottlieb warned a delta variant outbreak could occur in the United States, especially in regions with low vaccination rates.

While the CDC reports that 46.4 percent of the total U.S. population has been fully vaccinated against COVID-19, regional and age-specific differences persist. Southern states like Mississippi and Alabama lag far behind national averages. Mississippi has vaccinated just 29.7 percent of its population, while Alabama has vaccinated 32.5 percent, according to federal data.

“It’s going to be hyper-regionalized, where there are certain pockets of the country [where] we can have very dense outbreaks,” Gottlieb told CBS.