What You Should Know About the Latest COVID-19 Surge and Delta Variant 

PIH expert shares info on CDC’s masking guidelines, breakthrough infections, and impact on the unvaccinated 

Posted on Jul 29, 2021

nurse administers COVID-19 vaccine to staff at homeless shelter in Boston
Boston Health Care for the Homeless workers help to vaccinate the staff at St. Ambrose Shelter in the Dorchester neighborhood of Boston. Photo by Jodi Hilton for Partners In Health

In a sign that the current COVID-19 surge is escalating further, the U.S. Centers for Disease Control and Prevention (CDC) on Tuesday recommended that even people who are vaccinated against the virus wear masks indoors in some regions of the country. The guidance comes as case rates steadily rise across the nation, driven by the more contagious Delta variant.   

The CDC’s change of course on masking comes just days after Dr. Anthony Fauci, the nation's top infectious disease expert, described the current state of the COVID-19 pandemic in dire terms, telling CNN that the country is "going in the wrong direction."  

With more than half the U.S. not fully vaccinated, we asked Partners In Health's Dr. Bram Wispelwey, Senior Technical Lead for the U.S. Public Health Accompaniment Unit, to answer a few key questions about what's driving the current COVID surge, "breakthrough" infections, and what actions the public might take to protect themselves and their communities. 

Why did the CDC change its masking recommendations for people who are fully vaccinated? 

The virus is changing, and the CDC recognized that its guidance also needed to change to reflect that reality. COVID-19 transmission has increased throughout the United States in response to multiple factors: the dramatic increase of the Delta variant over the last few weeks, the lifting of masking requirements and other measures, more time spent indoors to avoid the heat, and vaccination rates that are too low to curb transmission in much of the country.  

Should I start wearing a mask all the time, again, even if I'm vaccinated?  

For most Americans, if you’re indoors, the answer is yes. The CDC just recommended masking indoors for anyone – regardless of vaccination status – living in areas of substantial or high spread, which currently describes almost 2/3 of the country. If you are older than 65, have a compromised immune system or a chronic disease, or are living with people who fit into one of these categories, you may also want to consider masking indoors, even if you’re not in a substantial or high transmission area. Getting COVID-19 while outdoors is very unlikely in most scenarios, but if you’re in a crowded space, it’s also a good idea to wear a mask. You can find your county transmission level here.   

Why are we suddenly hearing so much about “breakthrough” cases? I thought getting vaccinated was supposed to protect us from COVID-19.  

COVID-19 vaccines are primarily intended to lower your risk of severe illness and death from the virus, which they continue to do very well. No vaccine is perfect, and breakthrough cases are expected; the Delta variant is causing more breakthrough cases than other versions of the virus. However, it is encouraging to see that the vast majority of these cases are either asymptomatic or mild. If you’re not vaccinated, you continue to be at significant risk of serious illness or death. While about half of Americans are unvaccinated, they currently make up at least 97% of hospitalizations and deaths.  

What role, exactly, does the Delta variant play in the current COVID-19 surge? 

The Delta variant is more infectious, meaning that it spreads more easily than other variants. It is now causing the vast majority of COVID-19 cases in the U.S. This means that more people will be infected, especially those who are not yet vaccinated.  

COVID-19 cases and hospitalizations are rising in the U.S., but how many of these are among unvaccinated people and how many are breakthrough infections among vaccinated individuals? 

While approximately half the country is fully vaccinated, the majority of cases and the overwhelming majority of hospitalizations and deaths (more than 97%) are among those who are not vaccinated. The available COVID-19 vaccines are working exceptionally well at preventing severe outcomes.  

How is all of this impacting PIH's work in the U.S.? 

PIH’s U.S. Public Health Accompaniment Unit continues to work with our public health and community partners to end the COVID-19 pandemic through contact tracing, case investigation, equitable vaccination, and care resource coordination, prioritizing the well-being and safety of the most vulnerable and marginalized communities. We know that vaccine access has been lower for communities impacted by structural racism and inequitable policies, and with the continuing impact of the Delta variant, PIH remains committed to improving access to COVID-19 vaccines for those with the most significant barriers.  

What's the most important takeaway people should consider during this summer's COVID-19 surge? 

This pandemic is not over. Vaccination rates in the U.S. are currently insufficient to stop viral transmission, disability, and death, and new and more infectious variants will continue to develop. Prevention efforts in the form of masking, distancing, and contact tracing will save lives while we continue to support everyone age 12 and older to get vaccinated. 

If you haven’t yet received your vaccination, now is the time. If someone you know hasn’t yet been vaccinated, talk to them about the benefits for themselves, for their loved ones, and for those who remain at high risk or are not yet eligible to receive a vaccine. This is lifesaving work.  

The ideas presented in this article reflect the latest public health thinking and scientific evidence as of July 2021. You are advised that the COVID-19 landscape remains highly fluid, and it is your responsibility to ensure that decisions are made based on the most up-to-date information available. Partners In Health does not provide medical advice, diagnosis or treatment in the United States. Always seek the advice of a physician or other qualified health care provider with any questions regarding a medical condition. The information, including but not limited to, text, graphics, images, links and other material contained in this document, are intended for general informational purposes only and should not be construed as professional advice or a substitute for such advice.

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