Covid Delta variant indicates bigger problem for the United States

In May and June, as vaccine eligibility and access expanded in the United States, the fever pitch of Covid-19 worry in the United States started to ebb. Just like with motorcycle helmets or guns, it seemed like some people would take safety seriously, some wouldn’t care at all, and many others would fall somewhere in between. The country was reopening, and something akin to normalcy seemed to be within our grasp.

But then the delta variant, and its close cousin, delta plus, were identified. As this variant has begun to dominate both the news and the genomic sequencing of new Covid-19 infections, Americans’ anxiety has proportionally increased.

Some of this worry is deserved. Some of it is overblown. But the variant generally points to a bigger problem about the way Americans will live with coronavirus in the future.

Let’s start with the bad news: This variant is up to no good.

The World Health Organization has already declared this variant to be the “most transmissible” yet identified. Dr. Anthony Fauci has declared it to be the “greatest threat” to the U.S.’s attempts to stop Covid-19. It spreads at least 60 percent more easily than the previously feared Alpha variant, meaning that it gets many more people sick, more quickly. And due to its transmissibility, it pushes out the other “O.G.” coronavirus strains. The delta variant may also be getting people sicker, faster.

Also concerning: A single dose of the Pfizer, Moderna or Astra-Zeneca vaccines does not sufficiently protect against this variant. In countries with high levels of vaccine rollout, the novel variant seems to be attacking those who’ve received just one dose at rates only slightly lower than the unvaccinated. (Data on the efficacy of the Johnson & Johnson/Janssen vaccine, which requires only one dose, is still pending.)

This bad news is the reason we are observing a quick increase in cases in the United Kingdom, particularly among the unvaccinated. It’s no wonder the variant strikes fear in the hearts of scientists, public health professionals, and health care workers across the globe.

But the good news? The two-dose vaccines remain marvelously effective against this newest variant, as long as you’ve received both shots.

Granted, recent reports from Israel suggest that some people who’ve been fully vaccinated have been infected with the variant. But these cases are milder, and the data is still minimal. Although the delta variant is pushing out other variants of Covid-19 among kids — who, by and large, aren’t eligible for vaccines — it does not seem to be more virulent among the younger age groups. (Data on lethality for all age groups is still pending. We just don’t know yet if it causes higher mortality.)

Moreover, for younger kids or folks who are immunocompromised, masks still work, too. So if you’re actually following the CDC’s guidelines (meaning: you’ve gotten vaccinated if you can, and if you’re not vaccinated, you’re wearing a mask indoors), then you will most likely be OK. If you want to be extra-cautious, continue to wear a mask indoors, even if you’ve been vaccinated, especially if you live in an area with low rates of vaccine uptake.

In America, different groups have always had different health outcomes. For example, we know that race and ethnicity, socioeconomic status, and zip code are among the strongest predictors of life expectancy and a host of other medical problems. Structural factors matter more than genetics for many diseases.

Covid-19 has hardened and worsened such disparities. And the delta variant will make this divide even worse. The same structural divides and inequities that influence every other part of our health also influence who has received a vaccine, who will catch and even die from the delta variant, and who will be exposed to the variants-yet-to-come.

But stopping a discussion of the delta variant with a paean to the magic of vaccines misses the bigger picture. Even as we focus on the short-term dangers caused by variants, we need to be thinking about the longer-term health dangers that result from the United States’ social divisions.

We are already seeing a rise in Covid-19 cases in some red states, where vaccination rates are dramatically lower than in blue states. The simplistic explanation is that these folks are avoiding the vaccine because of politics: that people who voted for former President Donald Trump just won’t get the vaccine. But as we’ve shown in other areas of health policy, the vote is just a proxy. The underlying policies in these states are also to blame (just as they are to blame for other health disparities).

And even in red states, people who self-identify as Black or Hispanic are less likely to be vaccinated. Blaming differences in vaccination rates on “politics” absolves those who are vaccinated, from doing the hard work to gain trust, understand a community’s challenges, and make it easy to be healthy. And by the way, that work must include addressing health factors other than vaccines.

My biggest fear about the delta variant in the United States, then, is that the shadow cast by “deaths of despair” for the working class will now add another “d”: “deaths from delta.” I and others expect to see many of the same communities that have been decimated by opioids and suicide and gun violence — who happen to also be the neighborhoods not getting vaccinating — dying young, yet again.

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