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Delta variant spreads across California as battle against COVID-19 enters uncertain phase

The Delta variant of the coronavirus is beginning to spread in California, offering a sneak peek at how the battle against the pandemic will change as authorities move to protect a shrinking minority who remain at risk for not having been vaccinated.

The Delta variant can be twice as transmissible as the conventional strain. But California and the rest of the country are far more protected than ever from COVID-19. California has one of the highest vaccination rates in the country, and the United States has one of the highest per capita inoculation rates in the world.

And the vaccines available in the US are believed to be effective against the Delta variant, as they have been for all known variants. But that continues to leave tens of millions of potentially vulnerable unvaccinated people.

“If you’re vaccinated, nothing will happen,” UC San Francisco epidemiologist Dr. George Rutherford said of the Delta variant. “If you are not vaccinated, you are lost.”

Authorities do not expect another deadly wave of COVID-19 similar to those that struck the country three times in the past 15 months. Rather, the risk is that the Delta variant takes root in foci of non-immunized communities that have not previously been infected with the coronavirus.

This is the future that experts hope: one in which the majority of the population, who are vaccinated, are well protected against the world’s worst pandemic in the last century, while risks remain for those who are not vaccinated.

Now, “almost all deaths from COVID-19 are especially tragic,” said Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, “because almost all deaths – especially among adults – due to COVID-19 are, at this time, totally preventable ”.

California is especially well placed to deal with the Delta variant, as 73% of the state’s adults have received at least one dose of the vaccine – even better than the respectable national rate of 66% – and because many other Californians have survived COVID-19 from previous waves.

“We will not see the waves that overwhelmed our hospital system,” said Dr. Robert Kim-Farley, a medical epidemiologist and infectious disease expert at UCLA’s Fielding School of Public Health. “There just aren’t enough susceptible people right now to create those magnitudes of increase.”

Across the country, the average number of new coronavirus cases reported daily has fallen to about 11,000, one of the lowest figures since the beginning of the pandemic and a 96% decline from the peak of more than 252,000 daily cases registered in early January. At the peak, some 3,500 Americans died each day from COVID-19, and now, fewer than 300 Americans die each day.

Dr. Anthony Fauci, the US government’s leading infectious disease expert, said he did not believe the national daily death toll would come close to previous peaks.

“I don’t think … you are going to see things like 1,000 deaths a day. I think that’s too much. But there is a danger – a real danger – that if the reluctance to get vaccinated persists, localized spikes will occur, ”Fauci said. “All of this is totally and completely avoidable by getting vaccinated.”

Experts are not expecting a return of stay-at-home orders that shut down wide swaths of the economy due to the Delta variant, also known as B.1.617.2, which was first identified in India.

“No. Absolutely not. No, no, no, no, ”said Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla. “We are not going back. Really good vaccines, very powerful and safe, have put us in a solid position ”.

That optimism is especially welcome in California, which last week finally reopened its economy after more than a year of limitations and shutdowns motivated by the coronavirus.

During the height of last winter’s surge, about 550 Californians died daily from COVID-19. Now, California registers about 20 daily deaths from COVID-19.

But just as important as the number of new cases that are registered is the type of variants that are spreading through these additional infections. The Delta variant is popping up with worrying frequency, setting off alarms at both the state and federal levels.

“The Delta variant is currently the greatest threat in the United States to our attempt to eliminate COVID-19,” Fauci said.

Across the country, between May 9 and 22, the Delta variant accounted for less than 3% of genomically sequenced coronavirus samples. But between June 6 and 19, that proportion increased to more than 20%.

The United Kingdom, where authorities were recently forced to postpone the planned reduction of COVID-19 restrictions due to an increase in coronavirus cases, offers an example of caution about the extraordinary infectivity of the Delta variant.

At the end of March there were only a small handful of cases of the Delta variant in the UK, but by early May the number of cases had risen by as much as 25%. As of mid-June, 95% of the cases were related to the Delta variant.

However, the recent increase in cases and hospitalizations in the UK is still very slight compared to the increase in winter. Daily coronavirus cases in the UK are down more than 80% from the winter peak, while the number of people hospitalized with COVID-19 remains 97% lower.

Although the Delta variant is known to be considerably more infectious, experts differ as to whether they believe it causes more serious illness than other coronavirus strains.

Fauci said this week that the variant is associated with a greater severity of the disease, as reflected in the risk of hospitalization.

Topol agreed: “More and more young people are getting infected and ending up in hospital. That is not a good sign. ” In contrast, with conventional strains, young people – which according to Topol refers to those under 40 years old – rarely ended up in the hospital.

But, Topol added, there is no evidence that the Delta variant is more likely to cause death than other variants.

The UK continues to report fewer than 15 COVID-19 deaths a day since early May, down from the 1,300 deaths per day at the height of the pandemic.

Not everyone is convinced that the Delta variant is more likely to cause more serious illness.

COVID-19 hospitalizations in the UK are growing more slowly than new cases, meaning the chance of an infected person being hospitalized has been reduced, said Dr Monica Gandhi, an infectious disease expert at UC San Francisco.

Another promising sign, according to Gandhi, is that there does not appear to be an increased risk for young children. Young children are already less likely to contract the coronavirus because they have far fewer proteins called ACE2 receptors in the nose that the coronavirus needs to access to infect the body.

In California, the Delta variant has gone from representing 1.8% of coronavirus samples analyzed in April to 4.8% of them in May.

The Delta variant is now the fourth most identified variant in California. The Alpha variant, identified for the first time in the United Kingdom (also known as B.1.1.7), which represents 58.6% of the samples, follows in the lead.

Some counties report this data individually. The most populous county in Northern California, Santa Clara, for example, has confirmed 58 cases of the Delta variant.

And in Los Angeles County, authorities say they have identified 64 cases of the variant among residents from late April to early June, most of them confirmed in recent weeks.

Delta “is the most infectious variant that has been identified to date here in California,” Los Angeles County Director of Public Health Barbara Ferrer said Tuesday. “And that means that, for those people who are not vaccinated, it is going to pose a great risk.”

Ferrer noted that much of the documented transmission in the county appears to be occurring in homes, with 34 of the confirmed cases of the variant living with one or more people linked to other cases.

When the county updates its sequencing results again, Ferrer said she is “confident that we will see a significant increase in specimens that test positive for the Delta variant because … it actually proliferates very rapidly.”

Vaccines that have been shown to be effective against the Delta variant include the two-dose vaccine from Pfizer-BioNTech and the two-dose inoculation of AstraZeneca – which is not yet licensed for use in the United States but is widely used in the United Kingdom. and is similar to the one made by Johnson & Johnson.

“We have the tools. So let’s use them and squash the sprout, ”Fauci said.

Among the vaccines available in the United States, both Pfizer-BioNTech and Moderna require two injections, administered several weeks apart. Johnson & Johnson’s has a single dose.

A recent study found that receiving both doses of the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease caused by Delta variant and 96% protective against hospitalization.

Although 73% of adult Californians have received at least one dose, only about 59% are fully vaccinated at this time, according to data from the Centers for Disease Control and Prevention.

Walensky warned that the Delta variant “represents a set of mutations that could lead to future mutations that evade our vaccine,” and added that “that is why it is more important than ever to get vaccinated now to stop the chain of infection, the chain of mutations.” .

Some experts are optimistic that this coronavirus will not mutate to the point of outgrowing our vaccines.

“After these 18 months of evolution, we have not seen anything that has evaded the protection of our vaccines,” said Topol, who recently wrote on the subject for the journal Nature Medicine. But, he added, “we have to hurry in the vaccination process, because that is our best defense to prevent this from happening.”

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