The rise of Delta, a highly contagious variant of coronavirus, has led to an explosion in new cases almost everywhere in the United States.
Almost everywhere, that is, but Vermont and its neighbors. With an almost 84 percent vaccination rate among eligible residents, there’s no doubt the Green Mountain State’s collective immunity has kept a significant case surge at bay. The state’s modest rise in cases has also meant that large gatherings sans masks are still allowed, but elsewhere, even corporations, cities and states are reimposing their own indoor mandates.
Coupled with the CDC’s new guidelines for indoor masking and the revelation that Delta may be more contagious than previously thought, exactly how Vermonters should keep themselves safe isn’t as straightforward. VTDigger asked three infectious disease experts for guidance on this latest development in the pandemic.
Here’s what they had to say.
What’s the deal with Delta?
The coronavirus is similar to the flu in that it can change or mutate. Its first mutation of note was when a member of the coronavirus family moved from being able to infect animals to spreading in humans. That new virus, SARS-Cov-2, was first documented in Wuhan, China. Since then, several different subtypes of SARS-Cov-2 have emerged.
The Alpha variant was first identified in the United Kingdom in fall 2020. Beta was first detected in South Africa in spring 2020, while the Brazilian Gamma variant was first detected in November. Delta, originally detected in India and now the dominant strain in the U.S., is the most concerning because it’s better than other strains at moving from person to person, said Gabriela Andujar Vazquez, an infectious disease specialist at Tufts Medical Center.
Delta appears to cause more severe infections and is associated with higher rates of hospitalizations, with unvaccinated people being at higher risk. A CDC internal document released earlier this week also says Delta is more contagious than Ebola, SARS, the common cold, seasonal flu and smallpox.
The three approved vaccines in the United State — Johnson & Johnson, Pfizer and Moderna — offer some protection from severe illness, but a small number of breakthrough infections have been documented in vaccinated people. But the vaccine does not appear to prevent viral shedding in vaccinated people with the disease, the CDC document said.
Vermont Health Commissioners Mark Levine said this week that Delta caused a slight uptick in cases in the state. Unvaccinated people, he added, make up the bulk of new infections in the state.
I’m fully vaccinated. Should I worry?
It depends. In general, fully vaccinated people in Vermont are relatively protected because nearly 84 percent of eligible residents in the state are immunized, said Tim Lahey, an infectious disease expert at the University of Vermont Medical Center. But Vermonters should still remain vigilant when coming in contact with vulnerable people.
“Personally, I do not wear a mask in the grocery store, and I do go out to eat,” he said. “But I have to wear a mask at work, where I’m surrounded by vulnerable people.”
A person’s general health may also affect the degree of immunity from the vaccines, Lahey said. People who have had a transplant, for example, take powerful immune suppressants that lower their overall resistance to all disease, including coronavirus. The same is true for people with autoimmune diseases or people who are otherwise medically fragile.
Family members of people with these conditions, or family members who aren’t vaccinated, may also want to wear masks indoors to minimize the risk of transmission at home.
Do I need a booster shot?
Not yet. Studies about the need for a third shot are still underway, said Aalok Khole, infectious disease doctor at Cheshire Medical Center in Keene, New Hampshire.
Some studies are looking at vaccinating all adults, while others are focused on using a third shot to bolster immunity in vulnerable people, he said. For now though, he said, regulators have not yet approved additional shots for fully vaccinated people.
With coronavirus on the rise elsewhere, can I still travel?
Sure, but with caveats. Other areas of the country and the world have much higher infection rates than Vermont, so vaccinated people are more likely to catch breakthrough infections there. The Centers for Disease Control and Prevention recommended this week that vaccinated people in communities with significant coronavirus spread wear masks indoors. The agency created a tool to help residents gauge the risk of infection at locales across the nation and the world.
Khole, the New Hampshire expert, agrees.
When visiting communities with a lot of new infections, masking up in grocery stores, movie theaters and indoor concerts can offer another layer or protection.
Some vaccinated people are asymptomatic but still contagious, so Lahey, of UVM Medical Center, said travelers should get tested when they return to Vermont.
Are there vaccine-resistant variants out there?
Not that we know of. The vaccines the FDA has approved for use in the United States offer significant protection against all of the prevalent variants. However, the efficacy of these shots is slightly lower for the Delta variant.
For example, Pfizer’s vaccine series is 93 percent effective at offering protection from the Alpha variant, and 88 percent effective against Delta. The Moderna shot is 72 percent effective, and a preliminary study that’s not peer-reviewed yet suggests the J&J vaccine may be less effective with the variant.
Correction: One instance of Vermont’s current vaccination rate has been corrected.
