Tag Archives: SARS-CoV-2 Delta variant

Health

CDC Rules Anime NYC Convention Not a Covid Superspreader Event

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Costumed people attend Anime NYC at the Jacob K. Javits Convention Center in New York City on November 20, 2021.
Photo: Kena Betancur/AFP (Getty Images)

The Center for Disease Control released a study yesterday that the 2021 Anime NYC convention was not a superspreader event, despite the attendance of one of the first known people in the U.S. to have been infected with the Omicron variant of the coronavirus. But this wasn’t just luck—the event had several measures in place to minimize infection, which means it can be used as a model for other fan conventions in the future.

The reason Anime NYC was suspected to be a superspreader (even assumed to be, one might say) is because Omicron is significantly more infectious than previous iterations of covid-19, and more than 53,000 anime fans came to the con, held in New York City at the Javits Center. The CDC says the event’s “good air filtration, widespread vaccination, and indoor masking” helped minimize spread of the virus. Additionally, Anime NYC required attendees to have at least one vaccination dose, while the convention center used HEPA filters in its ventilation.

According to the New York Times, “The share of attendee tests that came back positive was similar to the share of coronavirus tests that were positive across New York City around the same time, the CDC said. What’s more, the few positive samples that were genetically sequenced were largely of the Delta variant, not Omicron. And conventiongoers who became infected were more likely than those who tested negative to have gone to bars, nightclubs, or karaoke clubs.”

However, don’t go packing your bags for San Diego Comic-Con just yet. There are still a lot of additional factors that likely kept infection rates down. For instance, the CDC reported that had Omicron been more prevalent around the city at the time, things likely wouldn’t have gone so well. And, of course, Omicron is far more prevalent now across the country.

Still, this means Anime NYC could stand as a model for other conventions to follow in the future in order for relatively large groups of fans to come together and celebrate comics, anime, gaming, and more in relative safety. There’s obviously no timeline in sight where 160,000 people are all going to crowd into the San Diego Convention Center anytime soon, but man, it would be nice to hang out with some fellow nerds in person again eventually.

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Health

Highly Virulent Variant of HIV, VB, Discovered in Netherlands

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An image of the HIV virus taken with transmission electron microscopy.
Image: BSIP/Universal Images Group (Getty Images)

Researchers in a new paper this week say that a highly virulent variant of HIV has been silently circulating in the Netherlands, likely for decades. Thankfully, the variant still responds to conventional treatments and its spread appears to have declined in recent years. But the discovery may offer a timely lesson about the nature of germs like HIV and how they can evolve over time to become more dangerous.

The researchers, based in the UK and elsewhere, had been working on the BEEHIVE project, a study meant to figure out why some strains of HIV can cause more harm to a person’s immune system than others when left untreated—the end result of which leads to AIDS. To do this, they studied samples from people infected with HIV throughout Europe and Uganda, including those collected by earlier studies, hoping to find common mutations that could make the virus more damaging.

During this search, they found a group of 17 people, mostly from the Netherlands, who all carried the same variant of HIV-1, the most common type of HIV. This version of the virus—eventually christened as the “VB variant”—appeared to be exceptionally high in virulence. In practice, this meant that people with VB had far higher viral loads than usual and their levels of CD4 cells, the immune cells that HIV primarily infects and kills, dropped off very rapidly as well.

To confirm their suspicions, the team dug into another database of HIV patients living in the Netherlands. Sure enough, they found the variant in more people there as well. All told, they’ve identified VB in 109 people so far. And these individuals seemed to be no different from other residents in the country living with HIV in their age, sex, or other characteristics, further indicating that the virus itself is responsible for the increased virulence seen in their cases. The team’s findings were published Thursday in Science.

“Before this study, the genetics of the HIV virus were known to be relevant for virulence, implying that the evolution of a new variant could change its impact on health. Discovery of the VB variant demonstrated this, providing a rare example of the risk posed by viral virulence evolution,” said lead author Chris Wymant, a researcher at the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, in a statement from the university.

VB certainly does pose an added danger for those unlucky enough to contract it. Because CD4 cells decline so rapidly with this infection, Wyant and his team estimate that it would take as little as nine months for someone to develop AIDS (typically, it can take years). People’s higher viral loads would also likely make them more infectious to others. But fortunately, VB doesn’t seem to behave any differently from other HIV strains once people get on antiretroviral therapy, meaning the treatments can still suppress the infection and make people less or even completely unable to pass the virus to others.

By studying its genetics, the team also found evidence that VB may have first emerged in the 1990s. And though it might have spread more rapidly in the early 2000s, its spread has likely slowed in the last decade. In other words, while VB is an important discovery, it doesn’t appear to be a major public health threat at this time.

VB might also offer some broader lessons about viral evolution, which are all the more relevant in our pandemic times. It’s often claimed by those seeking to downplay the pandemic, for instance, that harmful viruses inherently and inevitably become milder over time, since it would allow them to infect more people who don’t die from it. In truth, the process of viral evolution is more complicated than that.

The transmission potential of a germ can be negatively affected by its fatality, such as with Ebola. But viruses like SARS-CoV-2 are so transmissible early into an infection that it may not be pressured to change much at all, and even a deadlier version of it can still easily thrive, since it can take weeks for people to die as a result of infection. Indeed, we probably saw this happen with the emergence of the Delta variant of covid-19, which appears to have caused more severe illness than past strains. With HIV, its ability to cause illness and eventually kill people seems to be tied to the same attributes that allow it to be transmitted more easily. So a variant that’s deadlier may still gain a foothold if it’s also more transmissible, at least up to a certain point, as VB and possibly other strains seem to have done. Other factors outside of the germ itself, like our preexisting immunity to it, also play a role in determining how mild it can be as an illness.

That’s not to say that widespread strains of a virus can’t become milder either—something we’ve perhaps now seen with the Omicron variant of covid-19. It just means that predicting the trajectory of virulence for any germ isn’t so easy, including for the coronavirus. In an op-ed discussing the new findings, Joel Wertheim, an evolutionary biologist from the University of California, San Diego, makes a similar point.

“Although it is certainly possible that SARS-CoV-2 will evolve toward a more benign infection, like other ‘common cold’ coronaviruses, this outcome is far from preordained,” Wertheim warns.

As for VB, the researchers say its emergence isn’t a sign that our current strategy against HIV isn’t working. Some researchers have argued that treating certain infections can actually promote the evolution of highly virulent variants, possibly including HIV. But the researchers argue back that VB seems to have arisen in spite of these treatments, not because of it. And since even people with VB given early treatment are less infectious, it only shows that effectively containing the virus is still the best way to keep variants like VB from spreading further.

“Our discovery of a highly virulent and transmissible viral variant therefore emphasizes the importance of access to frequent testing for at-risk individuals,” they wrote, “and of adherence to recommendations for immediate treatment initiation for every person living with HIV.”

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CDC guidelines for antivirals give the unvaccinated the lion’s share

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Almost one year ago, the universal rollout of COVID-19 vaccines began in the United States. 

While some initial hesitancy was expected, it was widely assumed the public would embrace a safe, effective, free vaccine once readily available. That a significant percentage of the eligible population would reject such vaccines — too often at the cost of death to themselves or family members — seemed unfathomable. And yet that is precisely what has occurred. 

Paradoxically, of the hundreds of unvaccinated patients treated in my hospital over the course of this pandemic, I have yet to see one refuse therapies such as monoclonal antibodies, all of which carry many more side effects than the vaccines they have declined.  

Though mandates have boosted the vaccine numbers among certain groups, incentives, outreach and appeals continue to meet stiff resistance. There is little reason to believe that will change. Having survived the winter 2021 COVID surge, health care systems experienced a relative lull for an extended period. In my own hospital, the number of COVID patients declined from a high of over 700 during the first wave to single-digit numbers in the spring and summer of 2021. The delta wave that arrived this fall, followed rapidly by omicron, has swelled the number of cases dramatically with rising admissions by the day. 

Waning immunities from the initial vaccines — requiring booster shots — has compounded the problem. It must also be noted that current vaccines and boosters were engineered against a virus that no longer exists. While further boosters will inevitably be required (most diseases require chronic therapies), the current vaccine/booster regimen offers the best protection now available. But we are still vulnerable. 

Breakthrough cases routinely occur among the vaccinated and boosted. Twenty-five percent of our current COVID hospitalizations have been in vaccinated patients, with a small percent having been boosted as well. These numbers will surely grow in the coming months as vaccine immunities continue to wane. While their prognosis will be better than their unvaccinated counterparts, vaccinated patients will still be hospitalized, suffer and potentially die, particularly if they are afflicted with comorbidities.    

As COVID cases surge, there is a corresponding increase in the demand for treatments. 

Current therapies such as Sotrovimab, a monoclonal antibody with activity against omicron, and the oral agents, Paxlovid, and Molnupiavir, exist in very short supply. Already the demand has far outstripped our capacities raising the specter of rationing and a host of medical, social and ethical issues.  

The use and administration of these therapies – funded by the federal government without cost to the end-user – are governed by the Centers for Disease Control and Prevention and state prioritizations. Although immunosuppressed patients are appropriately atop the list, most unvaccinated patients will be granted the next highest level of priority.  

For example, a 35-year-old unvaccinated former smoker with asthma gains priority over a 66-year-old vaccinated cancer patient. Similarly, an unvaccinated 25-year-old smoker with depression takes precedence over a 64-year-old vaccinated patient with chronic pulmonary disease. Indeed, the highest priority on the CDC list does not include a single profile of vaccinated patients other than the immunosuppressed, regardless of other comorbidities. Based on current supplies, unvaccinated patients will receive most of these lifesaving medications.  

Beyond its inherent unfairness, the decision to prioritize unvaccinated patients for scarce therapies is based on assumptions regarding risk factors, and the data regarding which risk factors contribute to a poor prognosis is weak at best. It is this very paucity of evidence that explains the lack of clear prioritizations in the initial vaccine rollout. 

Health systems and society are benefiting greatly from a renewed focus on health equities. Underpinning it all is the question of fairness. The decision to refuse vaccination is a matter of personal choice, but with choice comes consequence. To date, the adverse consequences of such rejections have shifted from the individual to the community.  

The financial cost of caring for sick and hospitalized unvaccinated patients is being borne largely by the taxpayer. The additional cost of the unvaccinated spreading the virus, even to those who are vaccinated and boosted, tears at our social fabric. Personal freedom to refuse a vaccine takes away freedom from nearby susceptible individuals. It deprives them of safe social contact with others. Without personal consequences, refusing vaccination becomes an easier decision. Denying the unvaccinated priority to remedial treatments and therapies needs to be reevaluated.   

Summoning consensus over divisive issues, especially in times of crisis, will always pose a great challenge to a free society. Self-determination and choice are fundamental to our way of life, but so too are the principles of personal responsibility and fairness.    

Bruce Farber, MD, is chief of Public Health and Epidemiology at Northwell Health, and the chief of Infectious Diseases at North Shore University Hospital and LIJ Medical Center. Farber is a fellow of the Infectious Disease Society of America.



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Health

Covid-19 Linked to Four Times Higher Risk of Stillbirth During Delta Era, CDC Finds

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Empty newborn beds in the maternity ward of a hospital.
Photo: Sean Gallup (Getty Images)

New research affirms the added risk that pregnant people and their families face from covid-19. Data recently released by the Centers for Disease Control and Prevention shows that pregnant people infected with covid-19 are more likely to have a stillbirth; this link appears to have become stronger after the emergence of the Delta variant.

Studies have suggested for some time that covid-19 is more dangerous for pregnant people. They’re more likely to experience serious illness, death, and delivery complications. This new research, published by the CDC last week, provides a closer look at the risk of stillbirth posed by the coronavirus, particularly the Delta variant.

The study looked at over a million hospital deliveries performed between March 2020 and September 2021. Stillbirths—the loss of a baby before or during delivery—were generally low during the time period. But individuals infected with covid-19 at the time of delivery were still significantly more likely to have a stillbirth. Overall, about 1.26% of infected pregnant people had a delivery that ended in stillbirth, compared to 0.64% of those not infected.

The Delta variant of the coronavirus is much more transmissible than the original strains of the coronavirus that first spread around the globe last year. But there’s mixed evidence on Delta’s ability to cause more serious illness. According to the CDC, there is data showing that people in general may be more likely to become hospitalized as a result of Delta, but that hospitalized people then have similar outcomes as they did with pre-Delta strains. Unfortunately, this doesn’t seem to be the case for pregnant people.

During July 2021 to September 2021, when the Delta variant had become firmly established as the predominant form of the virus, the rate of stillbirth substantially rose among covid-infected people, from 0.98% of deliveries before Delta to 2.70%. Compared to non-infected people, this meant a roughly fourfold increased risk of stillbirth.

The findings seem to confirm anecdotal reports of more stillbirths and other complications during the latest Delta-led peak of the pandemic, and they don’t bode well for the near future, either. Covid-19 cases are undeniably on the rise again, though they remain concentrated among the unvaccinated.

Compared to the general public, however, pregnant people are still less likely to get vaccinated for covid-19, in part due to misconceptions about the vaccines’ safety. In truth, studies have shown no increased risk of negative health outcomes from the vaccination of pregnant people, and experts, including the current study’s authors, continue to urge that they get vaccinated as soon as possible.

“Implementing evidence-based covid-19 prevention strategies, including vaccination before or during pregnancy, is critical to reduce the impact of covid-19 on stillbirths,” the authors wrote.

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Health

U.S. COVID death toll hits 700,000

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The United States reached its latest heartbreaking pandemic milestone Friday, eclipsing 700,000 deaths from COVID-19 just as the surge from the Delta variant is starting to slow down and give overwhelmed hospitals some relief.

It took 3 ½ months for the U.S. to go from 600,000 to 700,000 deaths, driven by the variant’s rampant spread through unvaccinated Americans. The death toll is larger than the population of Boston.

This milestone is especially frustrating to public health leaders and medical professionals on the front lines because vaccines have been available to all eligible Americans for nearly six months and the shots overwhelmingly protect against hospitalizations and death. An estimated 70 million eligible Americans remain unvaccinated, providing kindling for the variant.

“You lose patients from COVID and it should not happen,” said Debi Delapaz, a nurse manager at UF Health Jacksonville who recalled how the hospital was at one point losing eight patients a day to COVID-19 during the summer surge. “This is something that should not happen.”

Despite the rising death toll, there are signs of improvement.

Nationwide, the number of people now in the hospital with COVID-19 has fallen to somewhere around 75,000 from over 93,000 in early September. New cases are on the downswing at about 112,000 per day on average, a drop of about one-third over the past 2 ½ weeks.

Deaths, too, appear to be declining, averaging about 1,900 a day versus more than 2,000 about a week ago.

The easing of the summer surge has been attributed to more mask wearing and more people getting vaccinated. The decrease in case numbers could also be due to the virus having burned through susceptible people and running out of fuel in some places.


California sets vaccine mandate for students

03:55

In another development, Merck said Friday its experimental pill for people sick with COVID-19 reduced hospitalizations and deaths by half. If it wins authorization from regulators, it will be the first pill for treating COVID-19 — and an important, easy-to-use new weapon in the arsenal against the pandemic.

All treatments now authorized in the U.S. against the coronavirus require an IV or injection.

Dr. Anthony Fauci, the government’s top infectious disease specialist, warned on Friday that some may see the encouraging trends as a reason to remain unvaccinated.

“It’s good news we’re starting to see the curves” coming down, he said. “That is not an excuse to walk away from the issue of needing to get vaccinated.”

Unknowns include how flu season may strain already depleted hospital staffs and whether those who have refused to get vaccinated will change their minds.

“If you’re not vaccinated or have protection from natural infection, this virus will find you,” warned Mike Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

Like many other health professionals, Natalie Dean, a professor of biostatistics at Emory University, is taking a cautious view about the winter.


Study: COVID pill cuts deaths in half

04:07

It is unclear if the coronavirus will take on the seasonal pattern of the flu, with predictable peaks in the winter as people gather indoors for the holidays. Simply because of the nation’s size and diversity, there will be places that have outbreaks and surges, she said.

What’s more, the uncertainties of human behavior complicate the picture. People react to risk by taking precautions, which slows viral transmission. Then, feeling safer, people mingle more freely, sparking a new wave of contagion.

“Infectious disease models are different from weather models,” Dean said. “A hurricane doesn’t change its course because of what the model said.”

One influential model, from the University of Washington, projects new cases will bump up again this fall, but vaccine protection and infection-induced immunity will prevent the virus from taking as many lives as it did last winter.

Still, the model predicts about 90,000 more Americans will die by January 1 for an overall death toll of 788,000 by that date. The model calculates that about half of those deaths could be averted if almost everyone wore masks in public.

“Mask wearing is already heading in the wrong direction,” said Ali Mokdad, a professor of health metrics sciences at the university. “We need to make sure we are ready for winter because our hospitals are exhausted.”

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Health

U.S. COVID death toll hits 700,000

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The United States reached its latest heartbreaking pandemic milestone Friday, eclipsing 700,000 deaths from COVID-19 just as the surge from the Delta variant is starting to slow down and give overwhelmed hospitals some relief.

It took 3 ½ months for the U.S. to go from 600,000 to 700,000 deaths, driven by the variant’s rampant spread through unvaccinated Americans. The death toll is larger than the population of Boston.

This milestone is especially frustrating to public health leaders and medical professionals on the front lines because vaccines have been available to all eligible Americans for nearly six months and the shots overwhelmingly protect against hospitalizations and death. An estimated 70 million eligible Americans remain unvaccinated, providing kindling for the variant.

“You lose patients from COVID and it should not happen,” said Debi Delapaz, a nurse manager at UF Health Jacksonville who recalled how the hospital was at one point losing eight patients a day to COVID-19 during the summer surge. “This is something that should not happen.”

Despite the rising death toll, there are signs of improvement.

Nationwide, the number of people now in the hospital with COVID-19 has fallen to somewhere around 75,000 from over 93,000 in early September. New cases are on the downswing at about 112,000 per day on average, a drop of about one-third over the past 2 ½ weeks.

Deaths, too, appear to be declining, averaging about 1,900 a day versus more than 2,000 about a week ago.

The easing of the summer surge has been attributed to more mask wearing and more people getting vaccinated. The decrease in case numbers could also be due to the virus having burned through susceptible people and running out of fuel in some places.


California sets vaccine mandate for students

03:55

In another development, Merck said Friday its experimental pill for people sick with COVID-19 reduced hospitalizations and deaths by half. If it wins authorization from regulators, it will be the first pill for treating COVID-19 — and an important, easy-to-use new weapon in the arsenal against the pandemic.

All treatments now authorized in the U.S. against the coronavirus require an IV or injection.

Dr. Anthony Fauci, the government’s top infectious disease specialist, warned on Friday that some may see the encouraging trends as a reason to remain unvaccinated.

“It’s good news we’re starting to see the curves” coming down, he said. “That is not an excuse to walk away from the issue of needing to get vaccinated.”

Unknowns include how flu season may strain already depleted hospital staffs and whether those who have refused to get vaccinated will change their minds.

“If you’re not vaccinated or have protection from natural infection, this virus will find you,” warned Mike Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

Like many other health professionals, Natalie Dean, a professor of biostatistics at Emory University, is taking a cautious view about the winter.


Study: COVID pill cuts deaths in half

04:07

It is unclear if the coronavirus will take on the seasonal pattern of the flu, with predictable peaks in the winter as people gather indoors for the holidays. Simply because of the nation’s size and diversity, there will be places that have outbreaks and surges, she said.

What’s more, the uncertainties of human behavior complicate the picture. People react to risk by taking precautions, which slows viral transmission. Then, feeling safer, people mingle more freely, sparking a new wave of contagion.

“Infectious disease models are different from weather models,” Dean said. “A hurricane doesn’t change its course because of what the model said.”

One influential model, from the University of Washington, projects new cases will bump up again this fall, but vaccine protection and infection-induced immunity will prevent the virus from taking as many lives as it did last winter.

Still, the model predicts about 90,000 more Americans will die by January 1 for an overall death toll of 788,000 by that date. The model calculates that about half of those deaths could be averted if almost everyone wore masks in public.

“Mask wearing is already heading in the wrong direction,” said Ali Mokdad, a professor of health metrics sciences at the university. “We need to make sure we are ready for winter because our hospitals are exhausted.”

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Health

People with delta variant twice as likely to be hospitalized: study

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People who contract the delta variant of the coronavirus are twice as likely to be hospitalized as those who contract the original strain, according to a study published in The Lancet on Friday.

Researchers in the United Kingdom evaluated patients with COVID-19 in England between March 29 and May 23. Of those patients, 8,682 were infected with the delta variant and 34,656 were infected with the original strain.

Most of the patients in the study, 74 percent, were unvaccinated.

Of the patients with the delta variant, 2.3 percent were admitted to the hospital, compared to 2.2 percent of those with the original strain within 14 days of testing positive

But accounting for certain factors that contribute to the risk of hospitalization such as age, sex, recent travel and vaccination status, the delta variant was associated with a 2.26-fold increased risk of hospitalization over the original variant. The delta variant was also responsible for a 1.45-fold increased risk of requiring emergency care.

Anne Presanis, one of the study’s authors, said in a statement that getting vaccinated is crucial for reducing the risk of symptomatic infection with delta.

“Our analysis highlights that in the absence of vaccination, any delta outbreaks will impose a greater burden on healthcare than an alpha epidemic,” Presanis said, according to Bloomberg. “Getting fully vaccinated is crucial for reducing an individual’s risk of symptomatic infection with delta.”

The delta variant has become the dominant strain of COVID-19 in many countries, including the U.S.

A separate study in Scotland published in June also found that the delta variant is linked to an increased likelihood of hospitalization.



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Fauci: Amount of virus in breakthrough delta cases ‘almost identical’ to unvaccinated

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Anthony FauciAnthony FauciSunday shows preview: Delta concerns prompt CDC mask update; bipartisan infrastructure bill to face challenges in Senate Israeli president receives COVID-19 booster shot AstraZeneca CEO: ‘Not clear yet’ if boosters are needed MORE, President BidenJoe BidenThe Supreme Court and blind partisanship ended the illusion of independent agencies Missed debt ceiling deadline kicks off high-stakes fight Senate infrastructure talks spill over into rare Sunday session MORE‘s chief medical adviser, on Sunday discussed new Centers for Disease Control and Prevention (CDC) data that showed the levels of coronavirus in breakthrough cases of the delta variant among those who are fully vaccinated are “almost identical” to the levels seen among unvaccinated individuals.

Appearing on CBS’s “Face the Nation,” Fauci stressed that the majority of breakthrough cases involving the delta variant saw “minimal symptoms or no symptoms at all.”

Guest host John Dickerson asked Fauci what the CDC’s reasoning was for recommending masks be worn by both vaccinated and unvaccinated people indoors.

“What we learned that’s new, John, in answer to your question, is that when you look at the level of virus in the nasopharynx of people who are vaccinated who get breakthrough infections, it’s really quite high and equivalent to the level of virus in the nasopharynx of unvaccinated people who get infected,” Fauci said.

The nasopharynx is part of the nasal cavity located above the back of the throat. Fauci stated that it was “troubling” to find that the level of virus from the delta variant in both vaccinated and unvaccinated people is “really quite similar, almost identical.”

According to Fauci, these findings differ from what was observed in cases involving the previously dominant alpha variant.

“So we know now that vaccinated people who get breakthrough infections can spread the virus to other people,” Fauci said. “The fundamental basis for the CDC modifying their guidelines and saying now, ‘If you’re an area of a high or substantial trend of level of virus, namely a red or an orange zone, when you’re in an indoor public setting, you need to wear a mask.’ That’s the fundamental reason for that change.”



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US

CDC says “pivotal discovery” about delta variant prompted new mask guidance and urges universal masking in some places

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The Centers for Disease Control and Prevention is urging local health authorities to consider heightened prevention strategies like “universal masking” for public indoor settings, particularly when it comes to large indoor gatherings with travelers. It cited new data from a delta variant outbreak in Massachusetts that led to hundreds of coronavirus infections — many among fully vaccinated travelers.

The CDC, in the agency’s Morbidity and Mortality Weekly Report, also published more details about the “pivotal discovery” that prompted federal health officials to ramp up their masking guidance earlier this week. Tests used to diagnose cases linked to the Massachusetts outbreak had similar “cycle threshold” values among both unvaccinated and fully vaccinated “breakthrough” cases, suggesting both groups could be carrying similar loads of the virus.

“High viral loads suggest an increased risk of transmission and raised concern that, unlike with other variants, vaccinated people infected with Delta can transmit the virus,” CDC Director Rochelle Walensky said in a statement.


Doctor discusses CDC’s latest mask guidance

10:46

“This finding is concerning and was a pivotal discovery leading to the CDC’s updated mask recommendation,” said Walensky.

The scientists who authored the report, published Friday, said their finding amounted to a “crude correlation” to transmissibility, and cautioned that “microbiological studies are required to confirm these findings.”

Beyond merely measuring the amount of virus someone is carrying, scientists would need to confirm the risk by culturing live virus from a specimen, a spokesperson for the Massachusetts Department of Public Health told CBS News.

However, the investigation’s findings add to a growing body of evidence that has spurred federal health officials to ramp up their guidance to curb surging cases of the delta variant around the country.

In Provincetown, CDC researchers — as well as local, state and university scientists and investigators — had turned up 469 cases of COVID-19 among Massachusetts residents who traveled to the Cape Cod destination starting on the Fourth of July weekend.

A total of 346 of those cases, or around three in four patients, were in fully vaccinated people. A majority of those had symptoms and nearly all had the delta variant. However, no deaths were reported and only five were hospitalized, suggesting the vaccine’s goal of reducing the severity of the disease remained successful.

An internal document within the agency recently urged health officials to step up their warnings around the virus, acknowledging that “the war has changed” in light of the new highly-contagious delta variant.

Nationwide, with the delta variant now estimated to make up nearly all of the circulating virus in the United States, the average pace of new cases has climbed to rates not seen since mid-April. Walensky warned members of Congress on Thursday, according to a release from a House subcommittee, that hospitalizations had surged to levels beyond the peak of summer last year.

The new data also comes as the public health agency had come under renewed criticism for not having released the data underlying its shifting guidance earlier this week, apart from vague references to the figures in press conferences and online posts.

“This outbreak investigation is one of many CDC has been involved in across the country and data from those investigation will be rapidly shared with the public when available,” Walensky said.

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In internal document about COVID-19 vaccines and delta variant, CDC says “the war has changed”

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The Centers for Disease Control and Prevention says “the war has changed” against COVID-19 and that the agency should acknowledge that in communications, according to an internal presentation by the agency.

Data in the document, which was first obtained by The Washington Post, underscores the danger posed by the highly-contagious delta variant of the virus that was first spotted in India.

In the presentation, dated July 29, the agency does not estimate that vaccinated Americans are at a significantly greater risk of so-called “breakthrough” infections. In fact, it cites recent unpublished data from several of the CDC’s ongoing cohort studies that have scrutinized large groups of Americans suggesting vaccine effectiveness remains high months after their second shot, suggesting the Pfizer and Moderna vaccines remain 65-75% effective even against asymptomatic infection.

Public health officials have repeatedly emphasized that the vaccines provide strong protection against serious illness, hospitalization and death, even if a vaccinated person does contract the virus.

The CDC’s presentation also points to new “preliminary data” from its COVID-NET system that suggests vaccinated people remain a minority of COVID-19 hospitalizations in the United States. In May, fully vaccinated people accounted for 9% of all hospitalizations according to the document, which the presentation says reflects “increases in vaccine coverage” that are higher “in older adults.”

The CDC had previously disclosed that less than 3% of hospitalizations had occurred in fully vaccinated people.

However, the CDC also now estimates in its presentation that the Delta variant could be as transmissible as Chickenpox and far more than other diseases like Ebola or SARS-CoV-2’s original ancestral strain.

A CDC spokesperson declined to comment on the leaked document.

The agency cites data — expected to be released on Friday — from a July 4th outbreak of cases among residents and visitors to Provincetown, Massachusetts, showing the amount virus in samples collected from vaccinated and unvaccinated cases were virtually identical. That echoes previous reports from India, which the agency cites in the presentation, suggesting vaccine breakthrough cases with the delta variant could be far more transmissible than with previous mutant strains, spreading even as much as in some unvaccinated cases.

The research on the July 4th outbreak prompted federal health officials to urge even fully vaccinated Americans to wear masks indoors in areas of “substantial” or “high” spread of the virus, urge all people in schools to wear masks this fall, and revise its earlier guidance exempting many fully vaccinated people from COVID-19 testing recommendations.

Local health authorities have since tracked the outbreak from the popular Cape Cod retreat to hundreds of confirmed cases, many among fully vaccinated residents.

CDC Director Rochelle Walensky and Dr. Anthony Fauci, the president’s chief medical adviser, also briefed members of Congress on Thursday about the new data, according to a release from the House Select Subcommittee on the Coronavirus. Fauci warned the group that the Delta variant is “considerably more transmissible” with a viral load “about a thousand times higher” than the original strain.

The CDC had also faced growing criticism for not releasing the data driving the change behind its recent guidance, aside from citing “unpublished data.” 

Briefing reporters earlier this week about the shift in the agency’s guidance, Walensky acknowledged that their science on the risk fully vaccinated people had of spreading the virus to others — in the rare cases they had a “breakthrough” infection — had shifted.

“Public health experts, scientific experts, medical experts, when we have shown them these data have universally said that this required action. I thought and I felt that when I saw the data myself,” Walensky said.



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