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Analysis | The Health 202: Some vaccinated people are still carrying big loads of the delta variant - The Washington Post

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with Alexandra Ellerbeck

The Centers for Disease Control and Prevention says it has studies backing up its decision to reinstate mask recommendations for the vaccinated, although it hasn't released the data yet.

But the evidence, if and when it becomes public, is unlikely to persuade exasperated Republicans who definitely aren’t buying the guidelines this time around.

The CDC has some sobering data on how the delta variant is behaving.

CDC Director Rochelle Walensky said earlier this week that she has research indicating vaccinated people infected with delta are carrying high viral loads — a new phenomenon, compared with how the original version of the virus behaved. 

With the original alpha variant, not only were breakthrough infections exceedingly rare, but vaccinated people also weren’t found with big viral loads, meaning they almost never transmitted the virus to unvaccinated people. That's what led the CDC to recommend in May that vaccinated people no longer had to mask up in most situations.

Delta seems to be messing with that comforting reality.

If Walensky is correctly presenting the new research — that delta can spread even among the vaccinated — that’s not great news. An outside expert briefed on the data confirmed to me that those were the findings. As for the CDC, a spokeswoman acknowledged there are studies forthcoming but didn’t clarify when they might be released.

The concern here isn’t so much that vaccinated people might get covid-19. Nearly all serious cases of the illness are among the unvaccinated. When vaccinated people still get sick, it tends to be mild.

Experts told me problem is with the viral load the vaccinated could be carrying. There are still millions of unvaccinated Americans who could contract the virus from a vaccinated person and get more seriously ill.

Although, to be fair, many of the most vulnerable are vaccinated already.

Experts acknowledge the death rate isn’t going to rise the way it did last winter, even as infections mount. In Great Britain, the delta-fueled rise in cases is now taking a nose dive. And unvaccinated people have refused vaccines of their own volition — fueling arguments from conservatives that the government shouldn’t be penalizing the majority in the interest of the minority.

“It’s the unvaccinated people driving the government to make decisions,” Chris Condeluci, a former GOP congressional staffer and health policy wonk, told me. “We now have a subset of the population driving policy.”

The guidelines are engendering furious pushback, and they'll probably go ignored by many.

“To President Biden’s supporters, the president is simply shifting his message, as he should, in response to an aggressively evolving virus,” The Post’s Annie Linskey writes.

“But the new masking guidelines also highlight questions that public health officials have been asking for weeks — whether the administration was too quick to relax guidelines in May and too fast to celebrate getting back to normal, especially with Biden inviting 1,000 guests to the White House for Independence Day.”

Writer Matt Yglesias:

“Trying to tell people to mask again is a little bit like trying to put toothpaste back in the tube,” said Carlos Del Rio, a professor of medicine at Emory University.

Even former Obama adviser David Axelrod told Annie that Americans will be “grumpy” about having to wear masks again.

Republicans on Capitol Hill are more than grumpy.

Leading House Republicans openly criticized the new CDC guidance, calling it politically motivated. 

House Minority Whip Steve Scalise (R-La.):

A handful of members – including GOP firebrands Marjorie Taylor Greene (Ga.), Chip Roy (Texas), Lauren Boebert (Colo.) and Matt Gaetz (Fla.) – refused to wear them.

CNN reporter Annie Grayer:

House Speaker Nancy Pelosi (D-Calif.) got involved too, calling her GOP counterpart, House Minority Leader Kevin McCarthy (R-Calif.), a “moron” for his Twitter comments criticizing the mask recommendations.

Pelosi tried to amend her statement later in the day, telling reporters, “I said earlier in my comments, ‘Science, science, science’ … to say that wearing a mask is not based on science, I think, is not wise, and that was my comment.”

Ahh, oof and ouch

AHH: Covid cases in Britain are plummeting after delta-driven spike.

Coronavirus cases in Britain were supposed to soar, but the number of new infections in the country on Wednesday, when the country reported 27,734 cases, is about half of where the caseload was a week ago. Scientists are puzzled, The Post’s Karla Adam and William Booth report.

“The trajectory of the virus in Britain is something the world is watching closely and anxiously, as a test of how the delta variant behaves in a society with relatively high vaccination rates. And now people are asking if this could be the first real-world evidence that the pandemic in Britain is sputtering out — after three national lockdowns and almost 130,000 deaths,” our colleagues write.

Many of the nation’s top infectious-disease experts had predicted that cases would keep rising. They aren’t sure what has caused the downturn. Maybe, some posit, it was the sunshine from a week-long heat wave or the fact that kids are not in school during summer break. It could be the effect of a large-scale test-and-trace effort, or maybe infections are still happening without being reported.

Some scientists are hopeful that it’s a sign that Britain could be reaching population immunity. More than 70 percent of adults in the country are fully vaccinated, and 88 percent have had a first dose. Many of those unvaccinated may have already had an infection and natural immunity.

Neil Ferguson, an epidemiologist at Imperial College London, says he’s hopeful that Britain has turned the corner. “We’re not completely out of the woods,” he said. “But the equation has fundamentally changed. The effect of vaccines has been huge in reducing the risk of hospitalizations and death. And I’m positive that by late September or October . . . we will be looking back at most of the pandemic.”

OOF: Pfizer is outlining the case for booster shots.

Pfizer and BioNTech found that their vaccine was 96 percent effective against symptomatic covid-19 in the first two months but that that figure declined by several percentage points every two months after, falling to 83.7 percent after four to six months. The study has not yet been peer-reviewed.

Pfizer stands to gain billions if boosters are recommended for most Americans. But while the company cites waning immunity as evidence for the need of boosters, federal health officials and scientists are not convinced mass boosters are necessary.

For one thing, the vaccines remain extremely effective at preventing the worst outcome. The study found that the vaccine’s efficacy in preventing severe disease held steady at about 97 percent.

OUCH: California Gov. Gavin Newsom (D) pulled his kids from a summer camp where other kids weren’t using masks.

“The Newsoms were concerned to see unvaccinated children unmasked indoors at a camp their children began attending yesterday and after seeing this, removed the kids from the camp,” Newsom spokesperson Erin Mellon said in a statement published in Politico. “The family reviewed communication from the camp and realized that an email was missed saying the camp would not enforce masking guidance. Their kids will no longer be attending this camp.”

California requires all people to wear masks indoors in youth settings, including summer camps.

“The announcement from Newsom's office came a day after Reopen California Schools, a group opposing pandemic restrictions that have kept kids at home to learn remotely, tweeted that it identified publicly posted photos of the governor's 10-year-old son with other maskless children indoors at a summer basketball camp,” Politico’s Colby Bermel reports.

More in coronavirus news

  • Another coronavirus variant is showing up in South Florida. The B.1.621 variant has not yet received a Greek-letter designation and trails behind the delta variant, but scientists are watching it closely, The Post's Lateshia Beachum reports.

Elsewhere in health care

Biden rolled back a Trump-era policy limiting fines on nursing homes.

“The policy favoring lower penalties, adopted in 2017 by the Trump administration, directed regulators at the Centers for Medicare and Medicaid Services to shift from fining a nursing home for each day it was out of compliance with federal standards. The relaxed policy reduced many penalties to a single fine, effectively lowering amounts from hundreds of thousands of dollars to a maximum of $22,000,” the New York Times’s Reed Abelson reports.

The regulation was part of a broad deregulatory push by President Donald Trump. Biden revoked it with little fanfare earlier this month, stating that regulators should have the flexibility to impose either per-day or per-instance penalties.

The policy change comes as the delta variant raises new concerns about safety in nursing homes. While 81 percent of residents are vaccinated and deaths in the facilities have plummeted, only 58 percent of nursing home workers are vaccinated.

A House panel will consider cures for neurodegenerative diseases in a hearing this morning.

One of the witnesses will be 35-year-old Kala Booth, who is the second generation of her family to be diagnosed with Huntington's disease, a rare condition that causes degeneration of the brain and for which there's no cure. Booth will ask Congress to pass a measure that would eliminate wait periods for Huntington's patients to enroll in Medicare and Social Security disability insurance.

“Even though Huntington’s disease is on the Social Security Administration’s compassionate care list, HD families often spend years battling against an uninformed system that does not recognize or understand Huntington’s disease,” Booth will say, according to prepared remarks shared in advance with The Health 202. “Individuals often are denied coverage multiple times and forced to hire attorneys to help them navigate the system to secure coverage.”

The hearing will be live at 11 a.m. here.

Many workers will see their sign-up window for free COBRA coverage close this week.

Under coronavirus relief legislation signed by Biden in March, the federal government pays in full the health insurance premiums for employees who have been laid off and are covered under a federal law known as COBRA. The federal funding lasts from April through September, but some workers are unaware of the option and their time to take advantage of it is ticking, Kaiser Health News's Michelle Andrews reports.

For people who lost their jobs before April 1 and were notified about a COBRA subsidy by their employer at the end of May, the window to sign up for the subsidized coverage will close July 31.

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