Creighton expert: Battle Against Delta Variant requires strategy

July 28, 2021, midnight ·

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Fighting the COVID-19 pandemic requires understanding the latest developments and thinking strategically, a Creighton University public health expert says.

When talking about the changing advice people are getting about COVID-19 pandemic, like the Centers for Disease Control’s new recommendation for even vaccinated people to wear masks in some situations, Dr. Maureen Tierney uses a military metaphor.

“The reason that information and guidance is changing is because the virus is changing. So it’s as if we’re fighting an enemy and the enemy all of a sudden gets a better weapon. And so we have to either use our weapons more effectively and/or develop newer strategies,” Tierney said.

Tierney, assistant dean of public health and clinical research at Creighton University’s School of Medicine, said the enemy’s new weapon is the Delta variant.

“The overwhelming majority of coronavirus that we’re seeing in Nebraska right now, and in the nation – and when I say overwhelming, I’m talking 90 percent -- is the Delta variant. And it is a more contagious virus, meaning that if someone gets sick, the chances they’re going to infect a number of people -- that number of people has gone up at least twofold, if not more,” she said.

Tierney said some people are at greater risk from the new strain of the virus, and some less, than in the worst days of the pandemic late last year.

“I think for people who are unvaccinated, that they’re at greater risk than back in the dark days. For the people who are vaccinated, they’re at much less risk, particularly for serious disease and hospitalizations and death,” she said.

The CDC now recommends even vaccinated people wear masks in crowded outdoor spaces or indoor public spaces in areas where there’s significant spread of the virus, which include 40 counties in Nebraska. Tierney said that reflects studies of vaccinated people who are infected with the Delta variant.

“Most of those infections are asymptomatic or extremely mild. But when they measure the amount of virus in…their upper respiratory area – they find that it’s very similar to the people who are actually unvaccinated. And so it means that people who are vaccinated, get an infection but are asymptomatic, that they can transmit the virus at almost the same rate as someone who’s unvaccinated,” she said.

But she says that doesn’t mean the vaccines are ineffective.

“So when people say ‘Oh my goodness – we’re seeing vaccine breakthroughs, the vaccine’s not working,’ well, it depends on what your measure is of working and not working. If you’re looking at how effective is this vaccine at preventing serious disease, hospitalization and death, it’s very effective. Ninety seven percent of the hospitalizations right now are in the unvaccinated,” she said.

Tierney was asked what approach she would take to people who are still hesitant to be vaccinated.

“It’s important to be honest that there are some rare risks associated with the vaccinations. And they’re a little bit different for each of the different vaccinations. But the level of those risks – it’s not zero, but it’s extremely low. It’s in the range, depending on the side effects, of one in a couple of hundred thousand. Clearly the risks of getting COVID – its complications and deaths – far outweigh the risks associated with the vaccine,” she said.

She advised people who are hesitant to take advice from the government or large organizations to talk about it with their primary care providers. And when it comes to masking, while some, like Gov. Pete Ricketts, are critical of the latest CDC recommendations, Tierney said masks help protect both the person who wears one, and others they come in contact with.

“It protects the individual who’s wearing the mask in terms of how much exposure they have. And it protects the other person who’s sitting across from you or standing across from you from you. It’s not just to protect the vaccinated. It’s to protect the unvaccinated from the vaccinated, asymptomatic infected person who might be spreading virus but who thinks they’re okay and they’re not going to spread any virus because they’re vaccinated,” she said.

But Tierney said that’s not the main front in the fight against the virus.

“We have a really effective weapon that we’re not using as well as we should. That’s the number one issue is that, as was said yesterday by Dr. Walensky at the CDC, if we’d had 85 to 90 percent of the population vaccinated, we wouldn’t see this rise in Delta that we’re seeing now. And that is going to get worse over the next one to two months,” she said.

Tierney said over time, different vaccines or boosters may be developed. In the meantime, she said, monoclonal antibody treatment can lessen the impact for people, especially older people or those with underlying health conditions who do get infected.

“You know, they come back from wedding and they know they were exposed and they start to fear poorly and they’re 67, I say call your doctor and talk to your doctor about whether or not getting combination monoclonal antibody therapy might help you develop a less serious event of disease,” she said.

And so, the battle continues.