By Mahlon Meyer
Northwest Asian Weekly
The COVID-19 Delta variant likely accounts for most cases in King County, posing a significant threat to the unvaccinated and raising questions about masking policies even for the vaccinated, according to Public Health—Seattle & King County.
Cases have been steadily increasing for the past several months, and for the two weeks ending in June 20, the Delta variant made given that county data has a three-week time lag, it’s likely that Delta now represents the majority of cases, said Gabriel Spitzer, communications specialist for the department.
The Delta variant is much more infectious than other strains because it has a powerful protein in the spike that allows it to attach easily to cells.
Dr. Jim Boonyaratanakornkit (Credit: Fred Hutchinson)
“Think of it like an airplane coming in for a landing on your cell. Your cell is the runway. All the other variants have landing gear, too. But the Delta landing gear is really sticky,” said Jim Boonyaratanakornkit, a research associate at the Fred Hutchinson Cancer Research Center who specializes in infectious diseases.
As a result, said Boonyaratanakornkit, “If you’re unvaccinated and you’re near someone who is infected, you’re more likely to get sick compared with other variants.”
New threats
The invasion of the Delta variant into our region also affects the vaccinated. While experts agree vaccines are highly effective, people must be fully vaccinated to be protected against the new strain.
“One shot of Pfizer or Moderna is not enough.The second shot is important,” said Boonyaratanakornkit.
There is a small chance that fully vaccinated people could be at risk of contracting a mild infection, according to a July 5 tweet by Jeffrey Duchin, a health officer at Public Health—Seattle & King County. A study out of Israel shows that the Pfizer vaccine has excellent protection against serious infection. But it may have decreased effectiveness for infection overall, he said.
Duchin repeated calls for everyone to be vaccinated. He said that “we may have to rethink our masking guidelines.”
The actual numbers of people stricken appear low, but Delta presents a series of complications and unknowns.
During the two-week period reported by the health department, there were 75 cases of Delta. Among these, there was one hospitalization and no deaths (there were also cases related to other variants).
However, before Delta appeared, if a person had recovered from COVID, there would usually be enough antibodies so that the patient was considered relatively safe from future infection. But studies are now showing that antibodies built up from previous forms of the coronavirus may be less effective against Delta, according to Boonyaratanakornkit.
In other words, if you’ve gotten sick from the coronavirus and recovered, you may not be fully immune to the Delta variant.
Dr. Grace Lee (Credit: Stanford University)
Researchers still don’t have enough data about “long-haul” COVID—a term applied to a range of persistent post-viral symptoms—to make firm conclusions about its lingering effects. But since Delta is more contagious and could potentially mildly infect people who are vaccinated, it could bring about more cases of long-haul COVID, said Grace Lee, professor of pediatrics at Stanford University School of Medicine. Lee is a member of the COVID-19 Vaccines Workgroup and chair of the COVID-19 Vaccine Safety Technical Subgroup.
Still, vaccines are highly effective against the variant.
“They’ve turned out so much more powerful and efficient than I ever could have imagined. I thought at first they might only block out about 40% to 50% of cases. But take the mRNA vaccines, they’re effective in the upper levels of 90% in preventing serious infection, death, and in most cases even mild infection,” said Lee.
There are a few notable exceptions.
People experiencing immunodeficiency need to be especially careful, said Boonyaratanakornkit.
Cancer patients sometimes have suppressed immune systems. Treatments such as chemotherapy, for instance, can knock down the immune system. And some cancers, like lymphoma, also impair the immune system. Sometimes it’s both.
“About half of patients with blood cancers may not respond to vaccination due to a suppressed immune system,” according to Boonyaratanakornkit.
The immune system is also weakened in those receiving bone marrow transplants. It takes months for the stem cells introduced into the body to learn to become immune cells.
Those who’ve had transplants of organs, such as kidneys, hearts, or lungs, are vulnerable, as are those with some common diseases, including rheumatoid arthritis, Crohn’s, intestinal disease, and lupus. Some medications may also lower the immune system. So it is important to check with your doctor, said Boonyaratanakornkit.
Many transplant patients need a caretaker. And since Delta is so much more transmissible than other variants, “it amplifies the risk for everyone,” said Boonyaratanakornkit.
The future
Another concern is the reopening of schools. Lee said we may see a surge in the fall due to the increased infectiousness of Delta. But we still don’t know if it will cause a more serious disease.
“So protecting kids is going to have to continue to be an important part of prevention strategy,” she said.
However, as the Delta variant has emerged, advances in distributing vaccines have also given researchers room for optimism.
At the beginning of the pandemic, researchers thought that the mRNA vaccines needed to be kept only at ultra-cold temperatures, and that there was a very limited time they could survive outside of that range, said Lee. Now, researchers found that the vaccines can survive for up to a month in normal refrigeration. That means the vaccines can get to places that in the past weren’t able to handle all the earlier restrictions.
In addition, Lee added, mRNA technology can be adapted quickly to match new variants. Still, she said we should not let our guard down.
“It would be a mistake if everything were simply back to normal. We must remain vigilant. Everyone wants to move on and be done with the pandemic. But COVID-19 is here to stay. We want to make sure we continue to dynamically adapt and sustain attention to it, which requires continued funding. We need to make sure we have the resources to collaborate with others to deliver vaccines,” said Lee.
In order to protect our communities, we also need to take new approaches to data, she said.
For instance, it seems Asian Americans have higher vaccination rates. But it is important to disaggregate the data because some communities may have issues and challenges with accessing vaccines, she said.
As for vaccine hesitancy, Lee said the key would be to engage community leaders so that people have the information they need to protect themselves, not only from Delta but from “whatever it is that emerges in the future,” such as another variant.
“I believe everyone should get vaccinated, but you need to meet people where they are at, work together with communities to make sure you can protect them as much as possible,” Lee said.
“All you can do is really just communicate what you know and don’t know, and be transparent.”
Booster shots may be recommended at some point, according to the county department of health. But the data does not currently support the need.
“A third priming dose (not a true booster) may be needed for certain immunocompromised people. This is under active discussion, but there is no recommendation yet,” said Duchin in his July 5 tweet.
Finally, another way to protect yourself is to evaluate your travel plans.
“If you’re traveling to go visit your family, for instance in Asia or anywhere else, do your homework,” said Boonyaratanakornkit. “Check the vaccination rates. Find out how widespread Delta is. Ask yourself: is it really necessary to go?”
Mahlon can be reached at info@nwasianweekly.com.
This health series is made possible by funding from the Washington Department of Health, which has no editorial input or oversight of this content.