Delta variant can infect families from exposed children, even vaccinated adults.

[MichaelB]

An article from the FT this morning, may be behind paywall https://www.ft.com/content/b6a80442-a566-43ca-b23d-7793d417eddb

Israel is announcing plans for a booster in response to declining vaccine effectiveness on vulnerable population.

Israel will offer a third shot of BioNTech/Pfizer’s vaccine to its elderly population, turning the nation into a test-case for the safety of Covid the booster dose.

The decision to offer the jabs to people over 60 comes as Israel, which was the first country in the world to start mass inoculation in mid-December, faces a surge in new infections from the Delta variant of the coronavirus. New cases have shot to over 2,000 a day, up from a few dozen a day just a month ago.

Hospitalisations have remained comparatively low, with 160 patients in serious condition, up by eight overnight.

Most recently, the Israeli health ministry has indicated that the two-shot vaccine regime’s efficacy drops over time, twice lowering its estimate for the protection that the Pfizer vaccines offers against new infections.

But data examined by the government this week indicated that the vaccine’s effectiveness in protecting the elderly against severe illness had also dropped to as low as 81 percent, compared to 97 percent in the month after full inoculation, Ha’aretz newspaper reported.

 

[RAE]

The point of this thread is that breakthrough infections seems to be far more likely with the delta variant compared to the original or alpha variant. Which is why the CDC changed their recommendations this week (particularly because transmission even from an asymptomatic vaccinated person is now possible). So be aware, not surprised..

Breakthrough infections are becoming more common across the country (and world), there is no doubt about that. In my rural county, there were 8 new cases last week, and 4 were breakthrough. Granted, that is a very small sample size, but I'm reading about similar stories around the country. And in the UK, it looks like nearly half of recent COVID cases are people that have received at least one vaccination:

https://www.businessinsider.com/uk-half-covid-19-cases-had-vaccine-study-zoe-delta-2021-7?op=1

It's still best to get vaccinated, as most cases in people who have been vaccinated tend to be milder, with fewer hospitalizations required.

I find it amazing (and disappointing) that CDC is not tracking these breakthrough cases. There is a lot that could be learned from this, but with no reliable tracking we are shooting in the dark here.

 

[ExFlyBoy5]

Breakthrough infections are becoming more common across the country (and world), there is no doubt about that. In my rural county, there were 8 new cases last week, and 4 were breakthrough. Granted, that is a very small sample size, but I'm reading about similar stories around the country. And in the UK, it looks like nearly half of recent COVID cases are people that have received at least one vaccination:

https://www.businessinsider.com/uk-half-covid-19-cases-had-vaccine-study-zoe-delta-2021-7?op=1

It's still best to get vaccinated, as most cases in people who have been vaccinated tend to be milder, with fewer hospitalizations required.

I find it amazing (and disappointing) that CDC is not tracking these breakthrough cases. There is a lot that could be learned from this, but with no reliable tracking we are shooting in the dark here.

I am also curious as to testing rates. I have to assume over the last few months, there has been a marked reduction in testing.

My DW is an example; about a month ago, she had "cold like symptoms" but assumed that it was allergies since we have both been fully vaccinated since late March. So, was it COVID? She didn't even consider getting tested because there were so few cases (relatively speaking).

 

[Alan]

So, why does the UK have such a well organized plan compared to here in the USA?

My guess is that they have realized corona virus will be with us for a long long time, and it needs to be managed as public health problem. IOW, the emergency is over, and a longer term plan is now in effect to deal with corona virus over the years. Am I right or wrong

I believe you are correct, they are determined not to let the virus make a comeback. We have already experienced 3 waves resulting in one of the highest death rates in the world and scientists expect a potential 3rd wave this winter.

https://www.england.nhs.uk/coronavi...accination-autumn-winter-phase-3-planning.pdf

The Joint Committee on Vaccination and Immunisation have now published their interim guidance on booster vaccinations which states:
‘JCVI advises that any potential booster programme should begin in September 2021, in order to maximise protection in those who are most vulnerable to serious COVID-19 ahead of the winter months. Influenza vaccines are also delivered in autumn, and JCVI considers that, where possible, a synergistic approach to the delivery of COVID-19 and influenza vaccination could support delivery and maximise uptake of both vaccines.
Any potential COVID-19 booster programme should be offered in two stages: Stage 1. The following persons should be offered a third dose COVID-19 booster vaccine and the annual influenza vaccine, as soon as possible from September 2021:
• adults aged 16 years and over who are immunosuppressed;
• those living in residential care homes for older adults;
• all adults aged 70 years or over;
• adults aged 16 years and over who are considered clinically extremely vulnerable;
frontline health and social care workers.

Stage 2. The following persons should be offered a third dose COVID-19 booster vaccine as soon as practicable after Stage 1, with equal emphasis on deployment of the influenza vaccine where eligible:
• all adults aged 50 years and over
• adults aged 16 – 49 years who are in an influenza or COVID-19 at-risk group. (please refer to the Green Book for details of at-risk groups)
• adult household contacts of immunosuppressed individuals’
We still expect readouts from several clinical trials over the course of the summer and, therefore, plans will need to flex as new information becomes available.

 

[Lienlord]

DS got married last week, large wedding (250 guests). Not sure about vax/unvax ratio (DS & DD not vaxxed), and few masks at the reception.
I was concerned about Delta variant risks/breakthrough (DW & I recovered from covid last year, so felt secure in natural immunity).

We're a week out, and no positives! DS & DD fly from Mexico honeymoon today, and both had negative tests allowing return to US.

So either cheap booze kills Delta variant (and brain cells!) or nobody brought it in! Thankful!

 

[Chuckanut]

I am confused. What constitutes a breakthrough case?

In some articles I read if a person has had only one of two shots and gets Covid, it is a breakthrough case. So, is a person with two shots and who gets Covid more than 15 days after the 2nd shot. They seem to get mixed together leaving me wondering what is what.

The first thing I would like to see is a list of definitions so we can easily identify those who are partially vaccinated from those who are fully vaccinated. Then perhaps something to give us an idea of age, and any comorbidities.

It's one thing to discover 15 people are breakthrough cases, and 14 of the 15 are partially vaccinated, over 70 and have at least one comorbidity. That' a lot different from 8 out 15 breakthrough cases, but those eight were under 50, fully vaccinated and no comorbidities.

The first situation is not very threatening to me. The second is positively scary.

 

[ls99]

I am confused. What constitutes a breakthrough case? ........

+1
I too would like to see definition and breakdown of fully vaxxed and partially vaxxed details.

IMHO breaktrough is euphemism for the stuff did not work fully as intended.
Until covid don't recall ever hearing the expression, even though there are instances of flu vaccinanted yet getting the flu or some variant.
Wonder what the ratio of infection in flu v covid vaccines

 

[harllee]

+1
I too would like to see definition and breakdown of fully vaxxed and partially vaxxed details.

IMHO breaktrough is euphemism for the stuff did not work fully as intended.
Until covid don't recall ever hearing the expression, even though there are instances of flu vaccinanted yet getting the flu or some variant.
Wonder what the ratio of infection in flu v covid vaccines

I don't think the flu shot is very effective. Most years it is only 50% effective. DH and I get the flu vaccine every year but we still get the flu on occasion. Three years ago we had a very bad case of the flu, doctor told us that the flu variant we had was not covered by the flu vaccine that year.

 

[tmm99]

We all know (I think) that breakthrough cases have been happening. What we didn't know is that those breakthroughs (who are infected with delta variant) are transmitting COVID to other people, infecting other people with COVID even when they (the breakthroughs) have no symptoms. This is a new finding. This wasn't the case with the other strains/variants.

I used to think that I can get close to young children because I'm fully vaccinated. I don't feel the same way after hearing this news, unless I have been and my DH has been socially distancing from everyone else and know for sure that we haven't picked up COVID somewhere.

 

[Gumby]

+1
I too would like to see definition and breakdown of fully vaxxed and partially vaxxed details.

IMHO breaktrough is euphemism for the stuff did not work fully as intended.
Until covid don't recall ever hearing the expression, even though there are instances of flu vaccinanted yet getting the flu or some variant.
Wonder what the ratio of infection in flu v covid vaccines

Connecticut defines "vaccinated" as having received both shots more than 14 days ago. Everyone else is counted as unvaccinated. Among the fully vaccinated in Connecticut, breakthrough infections are 0.06% (1133/2,099,870). This is an interesting report that the state sends out every Thursday with this and other details. https://portal.ct.gov/-/media/Coronavirus/CTDPHCOVID19summary7292021.pdf

 

[audreyh1]

Walensky calls breakthrough infections "rare", which is the point I made.

The Delta variant is overwhelmingly an issue for the unvaxxed. That is what the data show.

Personally, I maintain distance from people for whom vax status is not known by me, even though we are fully vaxxed. We have known the vax does not prevent illness since the start. Who wants to get sick?

I really don’t believe the language “rare”. I expect hospitalized breakthrough infections are rare. But some states and counties are tracking all breakthrough infections and I saw a graph from LA county that showed by June breakthrough infections had risen to 20% of total infections. How can that be considered “rare”?

And since the CDC stopped tracking all breakthrough infections a while back, and is now only tracking breakthrough infections resulting in hospitalization, how would they know?

I expect we’ll know more in coming weeks.

 

[ivinsfan]

I am confused. What constitutes a breakthrough case?

In some articles I read if a person has had only one of two shots and gets Covid, it is a breakthrough case. So, is a person with two shots and who gets Covid more than 15 days after the 2nd shot. They seem to get mixed together leaving me wondering what is what.

The first thing I would like to see is a list of definitions so we can easily identify those who are partially vaccinated from those who are fully vaccinated. Then perhaps something to give us an idea of age, and any comorbidities.

It's one thing to discover 15 people are breakthrough cases, and 14 of the 15 are partially vaccinated, over 70 and have at least one comorbidity. That' a lot different from 8 out 15 breakthrough cases, but those eight were under 50, fully vaccinated and no comorbidities.

The first situation is not very threatening to me. The second is positively scary.

It's worrisome but in your second example, but I'm interested in knowing how many of the 15 were asymptomatic, barely felt ill, went to the doctor or ended up in the hospital that concerns me more then the stats you are concerned about.

 

[audreyh1]

I am confused. What constitutes a breakthrough case?

In some articles I read if a person has had only one of two shots and gets Covid, it is a breakthrough case. So, is a person with two shots and who gets Covid more than 15 days after the 2nd shot. They seem to get mixed together leaving me wondering what is what.

+1
I too would like to see definition and breakdown of fully vaxxed and partially vaxxed details.

Connecticut defines "vaccinated" as having received both shots more than 14 days ago. Everyone else is counted as unvaccinated. Among the fully vaccinated in Connecticut, breakthrough infections are 0.06% (1133/2,099,870). This is an interesting report that the state sends out every Thursday with this and other details. https://portal.ct.gov/-/media/Coronavirus/CTDPHCOVID19summary7292021.pdf

In general in the US breakthrough infections are referenced to fully vaccinated and 2 weeks from final dose. Certainly the recent news.

Israel may use 11 days from final dose.

 

[Montecfo]

I really don’t believe the language “rare”. I expect hospitalized breakthrough infections are rare. But some states and counties are tracking all breakthrough infections and I saw a graph from LA county that showed by June breakthrough infections had risen to 20% of total infections. How can that be considered “rare”?

And since the CDC stopped tracking all breakthrough infections a while back, and is now only tracking breakthrough infections resulting in hospitalization, how would they know?

I expect we’ll know more in coming weeks.

I think the word "rare" is arrived at via the true denominator, which is total vaccinated people i.e., 161 million. So hospitalized 6000/161M. That qualifies as rare I think.

If you are trying to reach a conclusion about asymptomatic or mild infections, you are not going know that anytime soon since it is not tracked, and I think that is for pretty good reason: our medical powers that be find that the cost to track that exceeds the benefit.

So if at risk, take precautions. Overwhelmingly, this is not a major concern for vaccinated people. And if Dr. Scott Gottlieb is correct, we can begin worrying about something else within a few weeks.

ABC News called symptomatic breakthroughs "rare" in a story filed 3 days ago. It put the percentage at .098% of the fully vaccinated, citing some unpublished CDC documents it reviewed.

So there is that.

https://abcnews.go.com/US/symptomatic-breakthrough-covid-19-infections-rare-cdc-data/story?id=79048589

 

[MichaelB]

Dr Gottleib isn’t saying there’s no need to worry. He did say he believes the current Delta variant outbreaks may begin to peak in a few weeks, based on their evolution elsewhere.

In the meantime Covid continues to evolve and mutate and has plenty of opportunity to do so among the still unvaccinated population in the US and elsewhere in the world. Will the next mutation be easier to more difficult to deal with? We now have the first solid evidence of breakthrough. We’re still on the lower end of the learning curve so there’s no way to really predict what comes next, but IMO it’s folly to let down our guard now.

Here’s an interesting article from Kaiser Heslth News (link here) titled “Unraveling the Mysterious Mutations That Make Delta the Most Transmissible Covid Virus Yet”

 

[Montecfo]

MichaelB,

Moral of the story is to get vaccinated and if at risk, take precautions.

I do think we can stop worrying about the Delta variant when cases begin declining. Just as we did with prior variants. I do not think people are continuing to worry about the alpha, the UK, the South African, etc.

I continue to suggest taking appropriate precautions and following data, not anecdotes (same point made in the ABC news story I linked above).

 

[tmm99]

Thank you for the great article, Michael!

 

[audreyh1]

I think the word "rare" is arrived at via the true denominator, which is total vaccinated people i.e., 161 million. So hospitalized 6000/161M. That qualifies as rare I think.

IMO it is not appropriate to say breakthrough cases with delta are rare when what you actually mean is that hospitalized breakthrough cases are rare.

And the CDC changed their guidance for high covid transmission areas because now they are concerned that breakthrough cases, including asymptomatic cases, can pass on the virus. If they were so “rare”, why would that even be a concern?

ETA: it looks like their new data is going to be published tomorrow.

 

[teetee]

I believe you are correct, they are determined not to let the virus make a comeback. We have already experienced 3 waves resulting in one of the highest death rates in the world and scientists expect a potential 3rd wave this winter.

https://www.england.nhs.uk/coronavi...accination-autumn-winter-phase-3-planning.pdf

It is sad that the population in the US as a whole was not smart / determined enough to set the goal of virus elimination from the start. We did not even manage to suppress it. We just saw the hospitalization rate went down and went ahead to open.

The virus and math does its own thing. Many of us have mistaken minor inconvenience with violation of freedom which paved the way for the Delta /+ and other variants to happen. We as a population has a tougher battle ahead. I would say it (again), this is a fight between the covid and human intelligence (and we are losing).

The winter vaccination planning is helpful but the virus will not go away if anyone including children capable of taking the vaccine refuse to do so because the vaccinated population can no longer be the barrier to defend those without. The only difference is the vaccinated won't die from getting infected. This means more sick people with long term tissue damage before the herd immunity is achieved. Will the vaccine-resistant and more deadlier variant surface before that happens? Very likely. Highly transmissible variant we see now is paving the way for the next variant considering how short (3-10days) the viral replication cycle and high mutation rate is. By this time next year, the glycan composition on the dominant virus surface can be completely different from the Delta strain we have now.

 

[ivinsfan]

IMO it is not appropriate to say breakthrough cases with delta are rare when what you actually mean is that hospitalized breakthrough cases are rare.

And the CDC changed their guidance for high covid transmission areas because now they are concerned that breakthrough cases, including asymptomatic cases, can pass on the virus. If they were so “rare”, why would that even be a concern?

I agree completely and in the beginning they said two vaccinated people could safely be together like "two spoons in a drawer". What I'd like to know is how many cases of Delta pass from one vaccinated person to another.


A poster here had a non vaxxed spouse and two vaccinated people test positive,.. did both cases come from the original non vaxxed person or did the vaccinated people pass it between each other.

 

[audreyh1]

Iceland is another example. They have 70% of the population vaccinated. Around 70% of the current infections are breakthrough cases.

https://www.covid.is/data You may have to pick English under languages - although it worked for me.

 

[REWahoo]

From the Washington Post: Internal CDC document urges new messaging, warns delta infections likely more severe

The Post doesn't say how they got their hands on an internal Centers for Disease Control and Prevention slide presentation, shared within the CDC. This presentation is why the CDC changed their mask recommendations.

From the article:

The delta variant of the coronavirus appears to cause more severe illness than earlier variants and spreads as easily as chickenpox...

[the Delta variant is] ...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.

...there is a higher risk among older age groups for hospitalization and death relative to younger people, regardless of vaccination status. Another estimates that there are 35,000 symptomatic infections per week among 162 million vaccinated Americans.

Looks like we still have a very long way to go to get a handle on this virus.

 

[audreyh1]

Thanks! I was looking for that. I can’t get behind the paywall and I couldn’t find it in the Apple News app yet.

I did find a NYTimes article that seems to be breaking the same story, although it doesn’t include the above points. https://www.nytimes.com/2021/07/29/health/cdc-masks-vaccinated-transmission.html

According to the reporter

The CDC is expected to release data on Friday showing that vaccinated people may transmit the Delta variant, a finding that prompted its new masking advice.

 

[Montecfo]

IMO it is not appropriate to say breakthrough cases with delta are rare when what you actually mean is that hospitalized breakthrough cases are rare.

And the CDC changed their guidance for high covid transmission areas because now they are concerned that breakthrough cases, including asymptomatic cases, can pass on the virus. If they were so “rare”, why would that even be a concern?

I have provided my sources and attempted to be clear. We all know the CDC is not tracking asymptomatic breakthrough infections.

The CDC called symptomatic breakthrough infections "rare" as reflected in the article I linked from ABC news above. The headline was "Symptomatic Breakthrough Covid-19 Infections Rare, CDC Estimates". The symptomatic breakthrough infection rate was estimated by CDC at .098%, according to the article.

Breakthrough infections that require hospitalization are 6000/160M and they are called "rare' on the CDC website, which I linked earlier in the thread. I'm not quibbling with what they are saying.

As far as exactly why CDC changed their guidance, they have not provided any data I can find supporting this. Perhaps you have found that in your research and can share it.

 

[REWahoo]

Thanks! I was looking for that. I can’t get behind the paywall and I couldn’t find it in the Apple News app yet.

WaPo gives free access to Covid coverage but placed this in the "Health" category, which is apparently behind a paywall. Sorry bout that...