Q&A: What we know so far about the Delta variant

Iowa is experiencing a surge in new COVID-19 cases, spurred by the highly contagious Delta variant that has rapidly swept through the nation and hit states with low vaccination rates especially hard in recent months.

After experiencing months of decline, Iowa now has seen a steady increase in the number of new COVID-19 cases as well as hospitalizations and deaths in recent weeks.

As of Wednesday, well over half of Iowa counties have high levels of community transmission of the novel coronavirus, according to data from the U.S. Centers for Disease Control and Prevention. Only four counties — Jackson, Mitchell, Taylor and Union — had a low level of transmission.

According to CDC data on Wednesday, Linn County had a high level of transmission and Johnson County had a moderate level of transmission.

"We’re in a serious predicament that could become overwhelming, but we want people to recognize we have some control in this,“ said Dr. Theresa Brennan, chief medical officer at the University of Iowa Hospitals and Clinics.

Here’s what we know so far:

Q: Why has Delta spread so quickly?

A: Delta, first identified in India, was labeled as a “variant of concern” by public health officials for its ability to transmit quickly. This past week, the Washington Post reported a CDC internal document stated the variant was as contagious as the chickenpox and can spread faster than the common cold and influenza.

The spread of the Delta variant also comes as vaccination rates both in Iowa and nationwide have plateaued.

The variant was first identified in Iowa in early May.

Q: Who is most at risk from Delta?

A: Those who are not fully vaccinated against the novel coronavirus remain the most at risk from an infection from the Delta variant, as well as any variant of the virus.

Nine in 10 COVID-19 cases, hospitalizations and deaths nationwide have occurred among Americans who are unvaccinated or not yet fully vaccinated, according to a Kaiser Family Foundation analysis of available state data.

COVID-19 vaccines have been proven to be highly effective in preventing serious illness, in turn successfully preventing hospitalizations and deaths as a result of the virus.

Therefore, the best way to protect yourself from the Delta variant is to get the free vaccine, area doctors say.

"If you are unvaccinated, you should take a step back and think about why that is,“ Brennan said. ”There are millions of people who have received the vaccine, and it has been proven to be safe and effective.“

Brennan also said individuals should encourage their family members and friends to get the vaccine, if they have not already done so.

"That conversation begins with compassion and empathy,“ she said. ”Encourage them to talk to their doctor, because they have your medical information and they know you.“

Without an increase in overall vaccination rates, experts say the risk remains that the virus will continue to mutate into more dangerous variants.

“The longer we don’t get under control, the more likely (the virus) will mutate again and make it harder on us,” said Dr. Tony Myers, chief medical officer at Mercy Medical Center in Cedar Rapids. “My concern is that it could get to a point to where vaccine isn’t effective.”

Q: If I’m vaccinated, should I be worried about Delta?

A: COVID-19 vaccines are highly effective in preventing hospitalizations and deaths, but no vaccine is 100 percent effective. A small percentage of fully vaccinated individuals can become infected.

Doctors still don’t have a full understanding of the potential for breakthrough infections among fully vaccinated individuals with the Delta variant. The CDC stopped monitoring those breakthrough cases in May.

But experts surmise breakthrough cases, hospitalizations and deaths are extremely rare events among fully vaccinated Americans, the Kaiser Family Foundation found in its analysis of data from several states.

In fact, the rate of breakthrough cases among the fully vaccinated is “well below 1 percent in all reporting states, ranging from 0.01 percent in Connecticut to 0.29 percent in Alaska,” according to the Kaiser analysis.

In addition, COVID-19 hospitalizations among fully vaccinated people ranged from “effectively zero” to 0.06 percent, Kaiser found. The rates of death among fully vaccinated people were “effectively zero (0.00 percent) in all but two states,” which were 0.01 percent.

Iowa was not a state included in the Kaiser analysis. However, health care providers in Eastern Iowa have reported similar trends.

Hospitalizations have been increasing at Corridor hospitals over the past two weeks or so, and officials say the vast majority of COVID-19 patients admitted are not vaccinated.

Q: When should I wear a mask?

A: The CDC has long recommended that anyone who is not vaccinated should wear masks in public indoor settings.

This past week, the federal health agency issued new guidance that advised anyone — even those who are fully vaccinated — to mask up in counties with “substantial” or “high” levels of community transmission of COVID-19. As of Wednesday, that included all but 22 counties in Iowa, according to the CDC data.

Local health care officials encourage any Iowan living in, working in or visiting counties with the elevated levels of spread to wear masks in crowded, indoor public spaces if the vaccine status of those around them are unknown.

“We know this virus is highly transmittable,” Brennan said. “If we can prevent one more person from getting infected, that prevents more people getting infected down the road.”

Besides the vaccine, masks are the best tool for preventing spread of COVID-19.

“Masks do work if you wear them correctly,” said Dr. Dustin Arnold, chief medical officer at UnityPoint Health-Cedar Rapids.

Most experts say you don’t need to wear a mask outdoors if you’re not in a crowded space and can maintain social distance. You also don’t need to wear a mask in indoor spaces if you know others around you are fully vaccinated.

Q: If I’m vaccinated and have symptoms of COVID-19, should I get tested?

A: Yes, anyone who has symptoms should get tested for COVID-19, Brennan said, adding that vaccinated individuals who are infected with the virus may still be contagious.

“Even if you think it’s just allergies or a cold, you need to stay home and you need be tested,” she said.

In particular, Arnold recommends individuals experiencing symptoms to get a test if they’ve recently been around others who are most at-risk from an infection, such as those who are immunocompromised or are unvaccinated.

Alternatively, vaccinated individuals should isolate themselves if they are experiencing COVID-19 symptoms, Myers said.

Any unvaccinated individual experiencing symptoms of COVID-19 should be tested, officials say.

To have a free test kit sent to your home, or to find a pickup site, visit testiowa.com. However, if you currently are experiencing symptoms, you should see a health care professional right away.

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