THE DELTA VARIANT AND BEYOND--EXPERT COVID-19 UPDATE

I just sat in on a Covid-19 update presented by the Newswise science news service featuring three experts:

Perry Halkitis, a public health psychologist and applied statistician at New Jersey's Rutgers University,

Eleanor Wilson, a medical doctor and infections disease specialist at the University of Maryland, and

David Souleles, Director of UC Irvine's Covid-19 response team, recently retired .Orange County Public Health Director

Delta is for Dangerous . . .

Credit: The Spinoff/ISO FORM LLC

The focus of the update was the emergence and trajectory of the delta variant and what that implies for the US.

Here are some of the key points the three experts made:

--The delta variant is a serious threat in the US and worldwide.

--As recently reported, the level of viremia--the viral load in the bloodstream--from a delta-covid infection is 1,000 times higher than from previous versions of the virus. That's probably what is making it so infectious.

--According to Dr. Wilson, the infectiousness, or "R-nought" value, of the original version of Covid-19 was estimated to be between 1 and 3. Statistically that means that one infected person would pass the virus to one to three others. The beta version's R value was between 4 and 6. The delta variant is 8 or 9. The only virus known to be more easily transmitted is measles, with an R value of 13.

--Unfortunately, the current vaccines appear to offer less protection against delta than against earlier versions of the virus. However, even though they may not completely protect against catching the virus, they are still highly effective at preventing serious illness, hospitalization and death. As such, vaccines remain our most important and urgent line of defense. "If we want to get back to normal life, we need our vaccination rates to be much higher," Souleles says. "That's priority number one to get our lives closer to what they were in January of 2020."

--That doesn't just include the US. The billions of people worldwide who are still not vaccinated are not just at risk personally, but represent a huge reservoir of current and future Covid-19 cases and so a huge opportunity for the virus to continue to mutate and spin off even more dangerous variants. "It's a global problem," says Wilson. "We have to vaccinate everyone. If we give the virus fewer opportunities to replicate, we win."

--All three of the experts were very concerned about the portion of the US population that are not yet vaccinated. They emphasize the importance of recognizing that this is not a monolithic group of dedicated vaccine refusers. Instead, these are individuals with many different issues, including very real medical, scheduling or other practical issues, normal anxieties and fears, such as a fear of needles, along with exposure to partial or incorrect information, and, unfortunately, a substantial number of people with politicized resistance to the vaccine and other protective measures. 

--They advocate both continued public education and persistent one-on-one outreach, aimed at recognizing and addressing each person's specific issues. "The media need to help people figure out what's real and what's not real, people who are being bombarded by misinformation," says Halkitis.  

"It takes a lot of conversation, but you have to keep doing it," says Wilson. To which Souleles adds, "Not just one conversation, maybe three, four or five."

--However, when education and patient one-to-one persuasion don't work, stronger steps may need to be taken. "I'd take a "tough-guy-from-New-York" approach," says Halkitis. "If you live in a civil society and you want to navigate spaces like concerts, restaurants, jobs and schools, you need to be vaccinated. Macron did it in France. If you want your children to go to school, they have to be vaccinated."

--All three agree that we need to track the course of the delta variant and any new variants that emerge with great attention, and that they could easily force a re-instatement of controls that have only recently been lifted. "Where we were six weeks ago is not where we are today," says Halkitis. "The next week will be very significant."

To summarize, the delta variant is highly contagious, surging rapidly, and is a potential game-changer. Everyone is eager to get back to something like the old normal, or on to a less restrictive new normal, but ultimately, it's the trajectory of the virus that will determine that. That trajectory is at least partly under our control through vaccination and other public health measures that we're all too familiar with. 

"We've got the tools," Souleles says. "We've just got to apply them on a broad scale."

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REA 7/23/21

HOW MUCH IS A FACE MASK WORTH? TRY $3000.

 Every face mask worn consistently in public in the US is worth at least $3000 to society, a new study shows. Or, to put that differently, every American who chooses not to wear a mask is costing the rest of us at least that much.

Every face mask saves society $3000-$6000 / Every refusal to wear one costs society $3000-$6000

Photo Credit: Chad Davis

This eye-opening calculation comes to us from a team of medical, public health and economic experts at Yale University. You can find a preprint of their paper here.

The researchers cite several lines of evidence to arrive at their economic estimate:

--As of the date of their study, countries with pre-existing norms for mask-wearing by sick people experienced a 44 percent slower growth rate in Covid-19 cases and a 48 percent slower growth in the number of deaths than countries without such norms. These effects remained significant even when other possible factors were controlled for statistically.

Although the above statistics indicate that universal mask-wearing would reduce the rate of viral transmission by much more than 10 percent, the authors decided to use a 10 percent reduction as an extremely conservative estimate.

When they plugged that relatively minimal reduction into a widely used model for the progress of the pandemic along with commonly used estimates of the costs to society of premature or excess deaths, the result was a conservative estimate of $3000 to $6000 of benefit to society for every person who wears a mask consistently.

They add that this estimate is extra-conservative since it only looks at excess deaths and doesn't include the costs to society of hundreds of thousands or millions of sick people. ". . . our estimates . . . suggest that the effect of masks could be 5-6 times as large," they write.

The authors provide a separate analysis for the benefit of highly effective N95 masks for front-line health care providers, who, as we've learned, are at particularly high risk of contracting the SARS-NCoV-2 virus and passing it on. In addition, they are absolutely necessary to treat the sick and save lives. "Multiplying these factors together," they write, "the social value of each N95 mask for a healthcare worker could easily be more than a million dollars per mask."

The researchers conclude by pointing out that the availability of this simple, cheap and effective intervention is a rarity. "Outside of crises, policies do not exist where a few dollars of expenditure per person can produce thousands of dollars in benefit. We are in a rare moment when such benefits are achievable--this is an urgent crisis and action is necessary."

As we know, there is still no universal mask-wearing mandate from the federal government, nor is there likely to be one as long as Trump remains in office. However, according to a National Geographic assessment, 44 states have mandated mask-wearing under at least some conditions, and 74 percent of Americans polled say they "always" wear a mask when out. Unfortunately, many Republicans continue to receive the opposite message from the President and from conservative media. As a result, while 84 percent of self-identified Democrats say they always wear a mask, just 66 percent of Republicans say they do. 

The largest gap--a 22 percent difference--is between Democratic and Republican women, reporting 89 and 67 percent mask wearing respectively.

Once again, if every missing mask is costing the rest of us $3000 to $6000, not to mention needless illness and, tragically many lives lost, those differences in willingness to wear face masks in public are costly indeed.

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REA