Glossary

• Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
• Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines. Variants that substantially increase harm are now listed by Greek letters, the most troublesome one now is Delta.

• Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
• SARS-CoV-2– the specific name of the new coronavirus
• COVID-19-the name of the illness that the new coronavirus is causing
• Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
• Epidemic– a sudden burst of an illness that comes and goes over a limited time
• Pandemic– an epidemic that bursts across the world not just one region
• Spreadability– how contagious is the disease, how many people will end up infected
• Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
• Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
• Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
• Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
• Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
• Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
• Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
• Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
• Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
• Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.
• Vaccine Terms
• Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
• Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
• mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
• mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
• Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

Infected Immunized Are Contagious

Readers of Real Answers who have read recent posts on this new COVID Pandemic, the Delta COVID Pandemic, have been waiting to hear the answer to the central question of this new epidemic:  Are those immunized who come down with COVID contagious?

Yesterday, the CDC released new data that establish a very firm answer to this important question, and tragically the answer is Yes.

To be clear, we now know based on firm evidence that if like me, you are fully immunized, and you get infected with the Delta COVID virus, you will be contagious.  Even worse, it appears that those of us in such a position may very well be as contagious as someone never immunized with COVID.

How do we know this?  Enough people who have been fully immunized have come down with COVID to allow scientists to measure the amount of COVID virus in their nose and throat.

We now know the levels of COVID virus in the nose and throat of 3 groups of people:  people infected with the original COVID before vaccinations were available, people infected with the original COVID virus after being fully immunized, and now people infected with the Delta COVID virus after being fully immunized.

Here is what we now know about the levels of COVID virus in those infected with COVID:

• The reference group is those with COVID before vaccinations were around.
• For those infected with the original COVID virus after being fully vaccinated, those levels of virus were far, far lower.
• But for those infected with the Delta COVID virus after being fully vaccinated, their levels of virus were the same as in the original, unvaccinated group!
• Keep in mind that if you are unvaccinated, the Delta COVID virus leads to levels of virus in your nose and throat 1000 times greater than from the original COVID virus.

Now, one may reasonably ask, if we who are fully immunized develop as much COVID virus in our nose and mouth if we catch COVID, how come we don’t get as sick?  It’s a great question, because if you are immunized you clearly do not get as sick.  Today, even with all the immunized infected with the Delta COVID virus, 99.7% of those dying of COVID in the US today, are unimmunized.

We know the answer to this question too.  The lung is much easier to protect than the nose and throat.  COVID virus grows far more easily in the nose and throat than the lungs in the face of protective antibody created by COVID vaccination.

So when I got my COVID vaccine, I made tons of antibody, but the wily Delta COVID virus, which as we see, makes tons more COVID virus in your body when you get infected, gets past antibodies in the nose and throat, but not lungs.

The result is that unimmunized people who get Delta COVID are far, far more contagious than in our original COVID epidemic, and the immunized people who get Delta COVID are truly contagious, as contagious as the unimmunized were last year.

Why Is This Such Bad News?

Think for a moment about this situation now.  We have about half the nation fully immunized.  Until about 2 weeks ago, we had good reason to believe that they could not spread COVID.  That meant that the immunized could, as we said then, see themselves as outside the Pandemic.  They were very unlikely to catch COVID, or to spread it, no matter their situation- with the possible exception of very densely packed, indoor crowds, for many hours.

The Delta variant changes all this, and now knowing if you are fully immunized you are very contagious, makes these changes very upsetting.  And that is because, if a very healthy immunized person gets Delta variant and stays healthy, and still spreads this virus, if it lands on an unimmunized person, including a child, that unimmunized person can get dramatically sicker than the immunized person.  The virus may not kill the immunized, but it does not lose its ability to kill the unimmunized while in the immunized.

Now consider the scenario of over 100 million Americans, fully immunized, walking around.  And many of them get infected with Delta COVID, now about 90% of all COVID cases in America.  The vast majority of these good people will feel fine, and have no idea they have COVID.  So they will not isolate, they will not quarantine, they will not know they need to.  And as they walk around, we now know they can and will infect others.

One example is especially upsetting, and now a clear problem Delta challenges us all with.  That example is school.  Imagine any school where all the teachers are immunized.  We now know some will have Delta COVID.  We now know many will not know they have it.  And today we now know they will be contagious, and if any child who is not immunized, and that includes all our children under 12 years old, they can infect those children.  Now add the fact that Delta COVID is caught far more readily in children and spread far better in children, and makes children far sicker, than the original COVID virus, and you see the situation we now face.

As far as I can tell, there is only one path out of the danger all our children now face- to boost the number immunized

The 100 Million

As of today, there are 100 million Americans who have had no COVID vaccine, at all.  I am upset, and perplexed to inform you that a full 22 of these 100 million unimmunized are health care workers.

We know for a fact that if enough people get the Moderna or Pfizer COVID vaccine, Delta spread will drop dramatically, and it could be enough to make sure in-person schooling is safe next month.

How do we know?  Check out state levels of immunization for COVID and look at the level of spread of Delta.

Some states are at 50% vaccination or more.   They have seen Delta COVID case numbers go up, but not much.  In the good old days of June 2021, before Delta, these states saw days of 0 COVID cases, and tended to hover at about 2 cases per 100,000 population (2 per 100k).   Now with Delta these states are seeing numbers rise, but relatively little.  Ohio is now at about 6 per 100k.  Ohio is one such state, so is NY.   Vermont is over 80% immunized and as of today their COVID case numbers are slightly up, but only to 4 per 100k.

Then some states are at 42% or so immunization, their COVID rates have gone up far more dramatically, up to about 16 per 100k.  These include Texas.

But at the top are Florida and Missouri, with immunization rates dipping below 40%, and their COVID case rates are huge at about 50 per 100k.

As you get towards 20 or more per 100k, you begin to see hospitals pack and tragedies multiply.

Notice anything in these numbers, all from our current days of COVID?

I hope you see that the more people in your state are immunized, the less COVID is circulating.

Here is the key point- if a state or nation drops COVID rates low enough- it won’t matter if Delta COVID is contagious in the immunized, because there won’t be any COVID circulating for that to happen!

And so here we are, the fate of so many of us, of all our children, of the school year next month, lies entirely in the hands of the  millions of Americans who can get COVID vaccine for free just about anywhere and just about anytime.  And it won’t take many to go get the shot.  The range of immunization rates in America is a low of about 38% and we see COVID slow at about 50%.  It is not a large gap.

So we once again plead to all who are able to be COVID vaccinated, get vaccinated, and do it today.  Every American, adult and child, will have their fates determined by your choice.  Lives hang in the balance, school hangs in the balance, and all our jobs hang in the balance, get the shot, please!

Bottom Lines:

1. The COVID Pandemic in America is now the Delta epidemic.  It is a far more deadly, far more contagious form of COVID, enough that this is a new disease experience.
2. We now know that the Delta COVID virus makes the immunized infected contagious, even if they feel great.
3. This opens the door to healthy, immunized people spreading COVID, a dire finding.
4. The only way out of a terrible Delta epidemic is for enough of the 100 million Americans who have decided not to get vaccinate, to change their minds.
5. The data is clear, if they do, the Delta epidemic and all the grief it promises to bring us, can be blunted, even stopped completely.

My One Takeaway Sentence:

The situation is clear, we plead with the unimmunized to change their minds, all our lives will be protected if you do, including yours.

To All Our Health,
Dr. Arthur Lavin