COVID-19 Update: July 14, 2021

Delta and Lambda variants, J&J, and numbers/context.

I am getting more questions over the last few days so I thought I would answer some of the more common ones here for a quick update. Some of this is a little heavy today so do a mental health check before reading.

1. Some news sources really hyped the J&J vaccine and the risk of Guillain barre syndrome - but while the risk is true, the hype is hype. Guillian barre is a pretty common risk for most vaccines, it is in no way unique to COVID vaccines or the J&J COVID vaccine. In fact, it is a known risk for the Pfizer and Moderna vaccines as well - and is commonly listed as a possible risk with hosts of other, non-COVID-related vaccines. So this isn't anything to worry about. The numbers are very very small. (less likely than the bleeding issue and/or severe allergic reaction). Again, you need to know it is a risk, but some headlines were a bit alarmist which was just hype.

2. The Delta variant is indeed causing numbers to go up. It is about 225% more transmissible than the original version of COVID and attaches more to the lungs/respiratory system. Disease progression from sick to severe, to death is much faster than what we were seeing previously and we are seeing more cases in the 20-40-year-old group. Deaths among those hospitalized are increasing. HOWEVER....keep this all in perspective. We need to look at the numbers to really see what is happening.

   1. Over the last 7 days, we saw about 167k cases in the US. The 7 days before that we saw about 108k - so this week has seen about 60k more cases than the prior week. That is a notable increase. The increase in deaths has not been as dramatic (only about 8%). This means deaths are not keeping pace with severe cases - which is good. While the increase in cases is notable and an indication we are trending the wrong direction - it is still small numbers compared to what we were seeing a few months ago when we were easily seeing 167k+ cases a day - not a week. So numbers aren't huge for most places (outside some hot spots), the issue is we are trending the wrong direction. If we continue this way we may end up with a 3rd wave.

   2. The Pfizer and J&J vaccines are still about 84% effective on the Delta variant. So if you are fully vaccinated with either you are still very well protected. Moderna has not yet reported official numbers regarding their effectiveness with the Delta variant. Do remember that there is still a risk that you could get mildly ill even if you are vaccinated - and a smaller risk that you will become seriously ill. About 0.8% of total hospitalizations are in people who are fully vaccinated. Most of those are in people with pre-existing health conditions such as diabetes, heart disease, etc. But there is a risk, so if you are in a high-risk environment take extra precautions such as mask-wearing and distancing. Also, note that the effectiveness of the vaccines is dependent on you being fully vaccinated - meaning 2 weeks after the last required shot. With Pfizer, you only have about 34% protection after the first shot.

3. The Lambda variant - this one is considered a VOI (variant of interest) and has been reported in numerous countries although I still haven't seen any reports in the US yet. Both Canada and South America are reporting cases so it is probably here. If not, it will be. The "interesting" thing about the Lambda variant is that it seems to be evading the vaccines. That is early reporting only, people are doing continued testing around the world to determine precisely how much impact it may have. There are also some early reports that it may be able to evade some of our treatments (Delta also evades some treatments). This makes the variants harder to treat with current treatment options. If it is found to significantly evade treatment, vaccines, or spread more easily, etc. then it will be upgraded to VOC (variant of concern) so again, keep watching this one.

FINAL THOUGHTS: Do you like roller coasters? You know that part on a roller coaster where you are heading up to the big drop. You get to the critical spot where you are at the top of the highest peak but not yet plummeting towards the ground, the next curve, or that loop-d-loop that is sure to come. That part is the worst for me. You know the drop is coming but it isn't quite here yet. Making our way through COVID has felt a bit like that. Right now, it feels like a slow ascent to a point where the speed is going to pick up, our stomach is going to drop out through our toes and we are going to slam our eyes shut and scream like it's our job. Of course, some won't. Some will throw their arms up over their heads and smile for the camera. Some will clutch the bar for dear life but never let a single sound escape their lips, some will laugh in hysteria as they are whipped around like rag dolls and some will vomit. Responses will be different and varied despite the ride being exactly the same. Right now, collectively we get to decide just how wild this next section of the ride will be. If I were a betting man (or woman as the case may be), I would guess it is going to get pretty bumpy. I hope I am wrong. But no matter what - we also get to decide how we personally respond. That part isn't dependent on anyone else, it doesn't rely on the actions of the collective. That part is completely determined by each one of us. Individually. Choose well.