Aug 13, 2021 Covid update

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I’m going to start with a personal note. A close family member of mine was admitted to the hospital last night with Covid19 pneumonia, and this person’s spouse also has Covid19. Both these family members were vaccinated and wearing masks regularly when out of the house. They were limiting trips outside the home, yet they did not stay at home completely.

This is a serious case which will develop one way or the other over the next few days. It is also a reminder that this delta variant is highly contagious and causing a huge number of infections even in those who are vaccinated. This surge is very real, and the numbers are now approaching those seen at the beginning of the year, when things were at their worst. In Tucson, the hospitals had been relatively spared (unlike some other parts of the country), yet just this week the number of patients admitted with Covid19 has almost tripled at TMC.

I do believe the number of breakthrough cases is being under reported right now, yet I also believe the number will continue to be extremely low. Currently, less than one percent of new Covid19 cases are officially due to breakthrough infections. Despite my family member’s case, hospitalizations among those who have been vaccinated remain rare.

There is no proof that an earlier Covid19 infection will protect against reinfection. I am intrigued by the number of professional athletes testing positive again for Covid19 despite either having infections in the past or being vaccinated. For the time being, I feel a prior Covid19 infection only provides a limited window of protection. How long that protection will last has yet to be discerned.

Likewise, there are strong opinions that vaccines also offer only a limited duration of protection. Unfortunately, no strong data exists to support giving a third booster shot of the Pfizer or Moderna vaccines to the population as a whole. For immunocompromised individuals, such as those who have received an organ transplant or who are on chemotherapy for cancer (or other immunocompromising medications) the FDA is now recommending a third shot. Israel and Germany have started giving third shots to older individuals, yet while the current vaccine protects against the delta variant, a different formulation is being developed which may work even better.

I suspect some of the hesitancy to recommend a third dose in the US for everyone may center around the concern the current formulation will not effectively boost protection against the delta variant. However, I do not know this for a fact.

Interestingly, Covid19 can have several symptoms, and not everyone gets the classic upper respiratory presentation of congestion, cough, and so on. Some patients have been reluctant to get Covid tested when advised, yet given the current situation, any symptoms which could even be remotely related to Covid require a Covid test so we can know better what we may be dealing with.

No one wishes to return to what we experienced last year, yet not taking a mask off in public is one way to reduce the risk of getting infected. Masks can be uncomfortable, yet many individuals in many different professions have been required to wear masks for decades to protect themselves. Depressingly, Covid19 and the prevention recommendations have become increasingly politicized and the messaging from public health officials is constantly attacked. More rational discussion needs to occur.

Thank you.