Even If You're Vaccinated, The Delta Variant Can
Still Impact You
The delta
variant is spreading in the U.S. mainly among people who are not vaccinated.
Fully
vaccinated people have a low risk of severe COVID-19, but surges in coronavirus
cases could still impact their health in other ways.
Experts say
that throughout the pandemic, coronavirus surges disrupted routine screenings
and outpatient care.
Nearly all
COVID-19 deaths in the United States are now among the unvaccinated, according
to an Associated Press analysis.
With the
rapid spread of the delta variant in the United States, coronavirus cases are
spiking in parts of the country, especially in areas with low COVID-19
vaccination rates.
This has
led to surges in COVID-19 hospitalizations and deaths, largely among people who
are not fully vaccinated.
In fact,
nearly all COVID-19 deaths in the United States are now among the unvaccinated,
according to an analysis by the Associated Press.
At a White
House briefing on June 22, Director Dr. Rochelle Walensky, director of the
Centers for Disease Control and Prevention (CDC), said most of these deaths
were “entirely preventable.”
Although
fully vaccinated people have a much lower risk of severe illness, their health
could still be impacted as COVID-19 surges send ripples throughout the healthcare
system, something we’ve seen throughout the pandemic.
In
addition, children under 12 years old are not yet eligible for vaccination,
which leaves them at risk — albeit a smaller risk than adults — of illness,
hospitalization, and other complications of coronavirus infection.
COVID-19
spikes disrupt other medical care
Increased
hospitalizations in some parts of the United States are driven by the
fast-spreading delta variant and low vaccination rates in those areas.
Overall,
53.8 percent of all people in the United States have received at least one dose
of a COVID-19 vaccine, according to the CDC.
But in some
states in the South and West, the one-dose rates are below 40 percent. The
situation is even more dire in certain counties in these areas.
Missouri
leads in hospitalizations, with intensive care beds filling up with mostly
unvaccinated COVID-19 patients. Many of them are “surprisingly young.”
Arizona,
also lagging behind in vaccinations, has seen a recent spike in coronavirus
infections and deaths.
Other
states with high numbers of hospitalized COVID-19 patients may follow
Missouri’s footsteps unless their vaccination efforts pick up.
Vaccination
remains the best protection against severe illness from COVID-19 and
hospitalization spikes that can affect non-COVID care.
Dr. Rishi
K. Wadhera, a cardiologist at Beth Israel Deaconess Medical Center in Boston,
says coronavirus surges disrupted routine screenings, outpatient care, and
prescription services throughout the pandemic.
“In
addition, elective procedures and surgeries were canceled during the height of
the pandemic,” he said.
Some of
these disruptions were due to limited resources.
Medical
staff was reassigned to take care of COVID-19 patients. Surgical suites were
converted to intensive care units. And shortages of personal protective
equipment (PPE), ventilators, and other equipment led to non-urgent procedures
being postponed.
In
addition, people shifted their behavior in response to the coronavirus.
“We know
that some patients with urgent or emergent conditions — like a heart attack —
avoided coming to the hospital because they feared contracting the virus,” said
Wadhera, “which may have contributed to higher death rates.”
Some cancer
treatments and screenings were also postponed during the pandemic, putting
people’s lives at risk.
“Cancer
didn’t stop just because COVID started,” said Dr. Vivian Bea, an assistant
professor of surgery at Weill Cornell Medicine in Brooklyn, New York.
“Unfortunately, there was disruption in the care of breast cancer patients
[during the pandemic].”
This
included shifting the order of cancer treatments.
When cancer
surgeries were postponed during the pandemic, some patients were given
chemotherapy or endocrine therapy instead, which before the pandemic may not
have been the first-line treatment.
In
addition, Bea says many women were not able to get their annual breast cancer
screening, or mammogram, because breast imaging departments were shut down
during the surges.
Delayed
screenings increase the risk that a cancer will be detected at a later stage,
when it is more difficult to treat.
Other
factors also contributed to the decline in screening during the pandemic, says
Bea, such as women no longer having health insurance coverage because they lost
their job or focused on taking care of their family and just getting through
the pandemic.
Disruptions
deepened existing health disparities
Wadhera
says disruptions of non-COVID care likely had a larger impact on Black and
Hispanic populations due to their higher burden of chronic medical conditions.
In a recent
study published in the journal Circulation, Wadhera and his colleagues found
that this and other factors contributed to a greater jump in cardiovascular
deaths in Black and Hispanic populations during the early months of the
pandemic.
Among Black
and Hispanic populations, heart disease deaths increased about 20 percent in
March through August 2020, compared to the same period in the previous year.
For stroke-related deaths, it was around a 13 percent increase.
In
contrast, heart disease deaths among whites increased only 2 percent, and stroke-related
deaths only 4 percent.
“Black and
Hispanic communities have not only borne the burden of COVID-19 due to
long-standing structural and systemic inequities,” said Wadhera, “but these
communities have also shouldered the indirect effects of the pandemic.”
“This has
contributed to an increase in deaths [among these groups] due to other —
non-COVID-19 — conditions,” he added.
Some health
systems tried to minimize care disruptions during the pandemic by using
telemedicine to connect with patients.
However,
not everyone has the right technology or stable internet access to be able to
do telemedicine, or they may not be internet or phone savvy enough to connect
with their doctor that way.
“For some
patients, [telemedicine] actually worked,” said Bea. “But for others, there was
a digital divide, which meant decreased [medical] access for them during the
COVID surge.”
With the
decrease in coronavirus cases since the peaks of the pandemic, delivery of
healthcare services has essentially returned to normal, says Wadhera.
However,
some health experts expect low vaccination rates and the delta variant — or
other faster-spreading variants — to continue to fuel surges in parts of the
country.
“It is
possible that, in spite of our vaccination efforts, we’re going to go through
another wave, driven by this new variant,” said Dr. Federico Laham, medical
director for Orlando Health Arnold Palmer Hospital for Children Infectious
Diseases in Florida.
This could
once again impact non-COVID care.
“It’s
possible that healthcare disruptions will occur again if we see a resurgence of
COVID-19 cases, particularly as novel variants emerge,” said Wadhera. “Regions
of the U.S. with low vaccination rates will be most vulnerable.”
Are
children and teens at risk from the delta variant?
Currently,
COVID-19 vaccines are approved only in the United States for people 12 years
and older.
Like
vaccinated adults, children and teens fully vaccinated are well-protected
against the coronavirus, including the delta variant.
However,
their medical care could be disrupted if there are spikes in hospitalizations
in their area. This is more likely to happen in parts of the country with lower
vaccination rates and higher levels of the delta variant.
Unvaccinated
childrenTrusted Source — those under 12 years old and older children and teens
who haven’t been vaccinated yet — can still get sick from COVID-19.
While
children and teens have a lower risk than adults of severe illness from
COVID-19, they can still get sick or need to be hospitalized.
They are
also at risk of a serious complication called multisystem inflammatory syndrome
in children (MIS-C)Trusted Source.
Some
children and teens also experience long COVIDTrusted Source — lingering symptoms
such as fatigue, muscle and joint pain, or sleep problems — even after a mild
infection.
While the
delta variant appears to spread more easily among unvaccinated children and
teens, it doesn’t appear to cause more serious diseases in them than earlier
strains of the virus.
Laham says
the United Kingdom — where the delta variant now accounts for almost all of the
new coronavirus casesTrusted Source — has not seen an increase in children
admitted to the hospital or with severe disease.
“That’s
very encouraging,” he said. “So it’s pretty safe to say that [the U.S.] should
not brace for an increasing number of sick kids,” he said.
However,
spikes in coronavirus cases among children could still disrupt schools, camps,
sports and other activities, which would impact their mental health.
The more
children and adults who are fully vaccinated, the easier it will be for the
country to fully reopen, including healthcare systems.
“I still
strongly recommend that you immunize your child as soon as you can,” said
Laham, “because you need two doses of the mRNA approved vaccine to confer the
level of protection that you want.”
Some
parents may be concerned about the possible side effects of the COVID-19
vaccines in their children.
Most of the
side effects are mild, such as soreness at the site of injection or short-term
fever or fatigue.
This week,
though, the CDC found a “likely association” between the Pfizer-BioNTech and
Moderna-NIAID COVID-19 vaccines and a higher risk of heart inflammation in
adolescents and young adults.
Laham notes
that those side effects are extremely rare and have been mild in almost all of
the cases.
“The
benefits of vaccination still completely outweigh the risk of one of these very
rare side effects,” he said.
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