President’s Message

A Message from the President

by Cindy L. Russell, MD

SCCMA President

Variants and Variables

Entering the Fall of 2021, we have all become tired of surfing the large COVID waves that keep breaking. But we need to keep our feet firmly planted on the longboard for a bit longer ride on these swells. The latest surge, as we all know, is the highly contagious Delta Variant (B.1.617.2) that made its way from India to Britain to the U.S. to Israel and now dominates the original Alpha (B.1.1.7) strain here. The total deaths to date just surpassed 4.5 million with highest deaths per country in the U.S. at 666,000.

Delta: A More Virulent Viral Variant

A recent Nature article explains that Delta variant enters the cell more easily. Researchers at the Guangdong Provincial Center for Disease Control and Prevention reported in a recent study that the Delta virus also multiplies more readily inside the respiratory tract. On average, people infected with the Delta variant had about 1,000 times more copies of the virus in their respiratory tracts than those infected with the original strain of the coronavirus. They also found that it took only four days for Delta to reach detectable levels when a person is first infected versus six days for the original strain.

Breakthroughs…for the Virus

A Yale report highlights that even vaccinated people can get Delta but the original COVID vaccines do give significant protection against severe illness and hospitalizations. Delta may spread more rapidly among young persons as well. In the U.S. most hospitalizations now are for unvaccinated persons; however, in Israel the statistics are changing.

Israel is now an important country to study the pandemic as they have a robust health care system, excellent data collection and have fully vaccinated 78% of those 12 years and older (mostly with the Pfizer). Breakthrough infections are now occurring at a high rate in Israel, and over half of the infections now are the Delta variant. Studies indicate that the vaccines are still effective in preventing most cases of serious illnesses or death, but only 59% of those now hospitalized for severe COVID were vaccinated (41% were vaccinated). Israel is now offering booster shots to try and reduce the burden of hospitalizations as staff are once again reaching the point of exhaustion.

Lambda has entered the fray, along with the Mu variant in Columbia that has a constellation of mutations that may allow immune escape. Will vaccines continue to be effective as COVID mutates? Will this virus and variants eventually fade away?

Variables: Playing it Safe with Community Transmission

The WHO and public health officials worldwide are calling for governments to continue basic preventative health measures – wash hands frequently, wear a mask and socially distance – regardless of vaccine status, to reduce the spread of this evolving group of viruses. In a news briefing in Geneva, Dr. Mariangela Simao, WHO assistant director-general for access to medicines and health products, said “People cannot feel safe just because they had the two doses. They still need to protect themselves…Vaccine alone won’t stop community transmission. People need to continue to use masks consistently, be in ventilated spaces,

[use] hand hygiene, physical distancing, avoid crowding. This still continues to be extremely important, even if you’re vaccinated when you have a community transmission ongoing.”

Research Continues

We are still learning about variants, vaccines and variables that will help the situation. While vaccines remain the best way to prevent serious infection, public health measures never go out of style. We also have many other environmental and public health issues that are important for our patients, communities and our planet to tend to. While COVID dominates the stage, it is still imperative we keep an eye on the horizon for other emerging issues of concern that compete, intersect and influence the pandemic and could overshadow COVID’s effect on our health and economy, i.e. air pollution, toxic exposures and climate change. Prevention still matters.

Join the SCCMA as we continue to work on these issues. The Wellness, Diversity and Inclusion, External Affairs and the Environmental Health Committees welcome your participation.

Stay positive, test negative.

Cindy Russell, MD SCCMA President

About the Author

Dr. Cindy Russell is a board-certified plastic surgeon with the Palo Alto Medical Foundation, and the current Santa Clara County Medical Association President. She has also served as the Chair of the SCCMA Environmental Health Committee, and as a Delegate in the CMA’s House of Delegates. Dr. Russell is the Executive Director of Physicians for Safe Technology and is determined to bring environmental health issues and concerns to the attention of both physicians and the public.

How the coronavirus infects cells — and why Delta is so dangerous Scientists are unpicking the life cycle of SARS-CoV-2 and how the virus uses tricks to evade detection. Nature. July 28, 2021. https://www.nature.com/articles/d41586-021-02039-y

How the Delta variant achieves its ultrafast spread Viral load is roughly 1,000 times higher in people infected with the Delta variant than those infected with the original coronavirus strain, according to a study in China. Nature. July 21, 2021. https://www.nature.com/ articles/d41586-021-01986-w

5 Things To Know About the Delta Variant Yale Medicine. Aug 26, 2021. https://www.yalemedicine.org/news/5-things-to-know-delta-variant-covid

Notes from the Field: Transmission Dynamics of an Outbreak of the COVID-19 Delta Variant B.1.617.2 — Guangdong Province, China, May–June 2021. http://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2021.148

A grim warning from Israel: Vaccination blunts, but does not defeat Delta With early vaccination and outstanding data, country is the world’s real-life COVID-19 lab. Aug 16, 2021. Science. https://www.science.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta