Covid19 Update 7-23-21

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Covid19 has unfortunately become a major focus again. The hope that the pandemic was gone is now giving way to the realization that we are entering another surge like last summer. Nationwide, the number of cases and hospitalizations is increasing dramatically. Deaths have not risen quite as much, yet the death rate often trails the increase in case numbers by 2-4 weeks.

Here in Arizona, our seven-day averages have gone from just under 400 cases a day in early June to over 1000 cases a day this past week. Thankfully, so far hospitalization numbers have not increased quite as dramatically, yet they are up from June. Both here and nationwide, almost all hospitalized Covid19 patients have been unvaccinated.

The efficacy of the vaccines has been questioned recently, with several reports of people testing positive for Covid19 despite being vaccinated. This development is not surprising, as vaccines do not necessarily prevent people from developing a disease. The goal of a vaccine is to prevent someone from getting a more serious case or dying from that disease, and so far, the Covid19 vaccines are working well in achieving that goal.

The fear however is that somewhere in time, the vaccines will become less effective either due to “wearing off” or because a new variant will develop which will not be responsive to the current vaccine formulations.

With regards to the first issue, there has been an ongoing debate over the last month about whether a booster shot will be needed. As mentioned previously, both Pfizer and Moderna have been working on boosters and have discussed with the FDA about approving a booster dose. However, currently the FDA and the CDC do not feel the available evidence supports doing a mass booster vaccine.

The emergence of a variant that will ultimately be resistant to all our current vaccines is also being heavily discussed in the news right now. This concern stems from the inability to achieve over 70% immunity in the population through vaccine. This inability allows the virus to spread and potentially mutate. If herd immunity had been achieved by now, this concern would be lower.

The reluctance of many people to getting vaccinated is contributing to the potential for a totally resistant variant. I am firmly convinced that the Pfizer and Moderna vaccines will receive full FDA approval in the next year, which may help some to feel more comfortable getting vaccinated. However, all the recent variants including Delta and now Lambda have originated outside of the US, so herd immunity will be necessary worldwide to ultimately stop the emergence of variants. Nevertheless, just like a brush fire can not expand if it is denied fuel, the expansion of Covid19 in the US would be significantly reduced if we achieve herd immunity.

Finally, the need for masks continues to be discussed. Officially, the CDC still states vaccinated people do no need to wear masks in public. However, many physicians (including myself) are recommending that when in a place where unvaccinated people may be, you should wear a mask. Since we are still concerned vaccinated people may be able to infect others, at the very least it may help slow down the spread of the Delta variant.

Take care.