8/13/21 – 70th update
*Recommends Dr. John Campbell on YouTube
Gives daily lectures. Evidence based educator, goes into detail about many aspects.
What is going on with the Delta variant?
Has now become 99% of the cases in the U.S. This has only taken a few months. Shows that transmissibility is the most important factor that determines which variant becomes dominant.
In California, 95% of cases are the Delta variant.
The good news is the effectiveness of the vaccines are holding up well. The vaccines significantly reduce the incidence of infection and dramatically reduce the risk for hospitalization and death. You are about 5X more likely to get infected if you are not vaccinated. You are about 10X or more, likely to end up in the hospital and 10X more likely to die.
Near Ananda Village, the clinic has given about 3000 vaccinations. There have been 3 cases of a positive test after being fully vaccinated. These are “breakthrough infections”. They were mild cases without hospitalization and no significant issues and no transmission to others in their households. This is the result of vaccination that we were hoping for. 90 – 95% of hospitalized patients are unvaccinated.
This shows us the vaccines are working (better than Dr Peter had hoped for). They reduce transmission. The Delta variant is so infectious and has a very high viral load The Delta R0 is in the 6-9 range. (Most infectious viruses, like measles, are 11- 15 R0 range). The cases are skewing toward the younger population because they are more socially active. “Younger, sicker, quicker” –
In Nevada County, the cases are going up in schools and classes are being affected because the whole class has to quarantine (those who are not vaccinated). One benefit of being vaccinated is that if you are exposed you don’t have to go through the same quarantine process. About 75% of the NC educators are vaccinated.
*Most important take-away about the Delta variant is that it is so highly transmissable that we are all going to be exposed to it. This is different than we were thinking about the Alpha variant. The Delta variant is becoming “endemic” – it’s everywhere. Being vaccinated and taking precautions with your behavior will determine if the viral load you are exposed to is enough to make you really ill.
Very difficult to predict even one week out – what the illness levels will look like. One thought was that the surge would peak quickly, but that is not what is happening. Cases have decreased a little bit, but Labor Day holiday and school starting may result in more cases 2 weeks later.
Dr Peter assumes everyone he comes in contact with is carrying the Delta variant and takes all precautions. The hope is that for vaccinated people, exposure might help their immune system actually get stronger.
Hospitals in Crisis
Significant mandates about healthcare workers being vaccinated. In NC have to be fully vaccinated by Sept 30th. Some people are just quitting to avoid that. Many hospitals are having staffing crisis. In northern Idaho, they have had to ration care because they can’t handle all ICU cases. Other areas this is reality as well.
Locally, in NC, the hospitalizations have gone down a bit, but the ICU admissions have gone up. This is the delayed effect that we have seen with Covid.
This has subtle effects on care in other situations. People are afraid to go to the ER for fear of being infected. They may be sent home from the hospital sooner or not admitted because of the Covid situation. Some services are closed down – such as respiratory therapy and pulmonary function testing.
One thing that has helped the hospitals in the NC area – they were early adaptors of the Regeneron Polyclonal antibody therapy. This is given in the very early stage of Covid illness. Have given 200 treatments locally. These are people who most likely would have gone on to be hospitalized and keeping them out of the hospital is significant. Deaths have gone up in NC – now up to 89. Case fatality rate is 1.1% for diagnosed cases with positive test.
Study in Bangladesh about masking
340,000 people in a huge study. Does masking affect the course of the SARS II virus. Found masking of all types is beneficial. Surgical masks slightly better. Better to use surgical masks in higher risk situations, or N95 masks.
Also significant that influenza didn’t happen last year, not in any way that it has been seen in the past. Behaviors and masking changed that. People may continue to mask when out in public, even after Covid is past. It is clear masks help transmission of respiratory infections.
US still lags behind in vaccination rates.
No new information about vaccine risks. Risk of pericarditis/myocarditis that has been seen in some young men, is about 1 in 40,000. (Those cases have been mild, with only a few hospitalizations and most all resolved quickly). Risk of getting the same thing when infected with Delta variant is more like 2-3% and the damage is more severe and persistent problems. All the risks seen with the vaccines are 2-10X more likely when infected with Delta. And everyone is going to be exposed.
In US about 95% of physicians are vaccinated. This is a positive sign. Some are probably not vaccinated due to health problems.
Unfortunately, so much vaccine issues are caught up in politics and personal freedom issues and personal ideas about health care. Information was not distributed clearly or directly.
About 64% in US have had one dose. 54% are fully vaccinated.
In California, 66% are fully vaccinated. Slightly more women than men.
Over age 65 in US the rates are better – 80% have had 1 shot and 90% are fully vaccinated.
Younger ages have lower percentages. 12 – 15 yrs 41% are fully vaccinated.
Polarizing – mandates and masking issues are highly polarizing everywhere. In NC the board of supervisor meetings have members who will not meet in person because of personal safety concerns and the Health Care Director has seen posters of his face with targets painted on it. There are crazy things happening. The public health workers have been threatened and they get threats against their life and their safety is in jeopardy. Many are retiring to protect themselves and their families.
India is catching up to the rest of the world in their vaccines – 50% of population has had at least one vaccination.
What about boosters?
Some parts of the world – such as Israel, a third vaccination is underway. There was some evidence of waning immunity, where the antibodies decrease in 6 months are so in MRNA vaccines. Perhaps not that soon with Johnson and Johnson. Probably will see booster injections recommended for all vaccines. CDC has not informed health care providers until in the last few days that boosters will be given. Have not clarified the population yet. Most likely 8 months after your last vaccine.
Not clear how a third vaccination would affect how things will happen. Whether more boosters will be needed, or if exposure to the virus may help immunity. Break-through infections will most likely decrease with a third shot.
Denmark and UK looking at dropping vaccine passports. They feel their vaccine rates are high enough and so many have had the virus, they are experimenting with dropping the vaccine passports. This is where we were all hoping things would go, but for now, you should protect your vaccine card. It would be a long while before we have enough people vaccinated to do this.
Two other variants:
Columbia variant and Lamda (Peru) variant – neither can compete with the Delta variant. We will continue to watch.
Taking 1-4000 units daily of Vit D has been shown to be helpful. Zinc may be beneficial in preventing viral transmission. Taking a small amount of Zinc (15 – 25 mg per day) may help prevent contracting respiratory illness. Vegetarians don’t get much in their diet. Still some evidence that Vit C may help and okay to take.
Will be offered this year. Will probably be offered in the next few weeks. Over age 65 – can get the high dose vaccine. CDC recommends getting a flu vaccine – any of them.
Nevada County – Case positivity rate 7 – 8%, which is down from 15.1% This is a good sign.
ICU admissions up. Ananda Village zip code area: 1170 cases, up from 820 at last update.
Sierra county – very rural. Case positivity rate has gone up to 18.8%, which is a huge jump from 7.1% last month.
Yuba County – CPR staying level
Placer County – CPR down to 8.2% Hospitalizations and ICU up.
USA as a whole – broke 40 million cases. ICU cases 26,000 up from 16,000
Eastern Europe – surging cases of Delta variants
Jyotish and Devi – case rate in India is dropping, but very strong on mask mandates. If you get caught without a mask in Delhi there is a big fine.
No other news.
Next Update Oct 4