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Coronavirus delta variant ‘may hit us pretty hard’ this fall. Here’s what you need to know

As Americans mourn 600,000 lives lost to COVID-19, two states once hit hard by the pandemic — California and New York — ended nearly all health restrictions on gatherings Tuesday in a sign of the return to normalcy. But states where vaccinations are lagging are not out of the woods yet, especially with the delta variant. University of California's Dr. Robert Wachter joins Judy Woodruff to discuss.

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  • Judy Woodruff:

    Six hundred thousand, that is the estimated number of Americans who have now died from COVID.

    The latest data from Johns Hopkins University come at a bittersweet moment. Two states once hit hard by the pandemic, California and New York, ended nearly all health restrictions on businesses and gatherings today. More than 65 percent of all individuals over the age of 18 have gotten at least one dose, but those percentages are significantly lower in some places.

    Well under half of adults in Mississippi, Alabama, Louisiana, Georgia, and Wyoming have had at least one shot.

    We look at the latest, even as concerns grow about some of the variants.

    Dr. Robert Wachter is the chair of the Department of Medicine at the University of California, San Francisco. And he joins us now.

    Dr. Wachter, thank you very much for being with us.

    As we mourn our losses — and they are significant — we are, as we just pointed out, seeing some moments of progress, are we not?

  • Dr. Robert Wachter:

    We are.

    I would say, you got it right. It's a bittersweet day; 600,000 people have passed away in the United States. That's more people than live in the city of Baltimore or the city of Milwaukee. So it's staggering, and it's also staggering to think that many could have been saved if we had responded better.

    But the vaccination is going generally quite well. And the case rates, the hospitalization rates and the death rates have come down massively. So we find ourselves in a good place. And it is appropriate for us to be opening up and getting back toward normal, although there are a few clouds still on the horizon.

  • Judy Woodruff:

    And as we talk about the progress we have made, it is importance, as we said at the outset, to mark the losses. I mean, 600,000 is more, by far, than any other country in the world.

  • Dr. Robert Wachter:

    Yes.

    And the numbers are so big that it's hard to get your mind around them, and you really have to do some work to say each one is a human being who had a family and friends and a life.And it's really something we have to — we have to take some time, take a step back and really think hard about what happened.

    Some of it was inevitable, given this pandemic. Some of it, I think, didn't have to happen. As we take stock, we should also take stock on our response and think about how we might do better next time.

  • Judy Woodruff:

    And as we're thinking about what was done right and what wasn't, Dr. Wachter, we know the CDC today is raising warnings about one of the new variants out there, the so-called Delta variant.

    What do we know about it? How widespread is it right now in this country?

  • Dr. Robert Wachter:

    Yes, it is somewhat concerning.

    So, the — we have seen lots of different variants. Through 2020, I spent a lot of my time telling people there are tons of variants, they're all — they're not doing anything important.

    But that changed with the Alpha variant, the one that was first reported from the U.K. And now it's changed again with the Delta variant, the one that was first reported in India.

    There are three things about variants to pay attention to. One is, are they more infectious? The second is, are they more serious? If you get it, are you more likely to get very sick and go to the hospital and die. The third is, are they resistant to vaccines or to immunity?

    And the Delta variant is — appears to be more infectious than the Alpha variant, which was more infectious than the original. So it's substantially better at its job in infecting people. It appears to be more serious. The data on that is a little bit less clear. But I think that the consensus is, it probably is more serious.

    And it has some ability to evade the vaccine. The great news is, when you're fully vaccinated, the vaccines work spectacularly well, as they do against the original. But you can tell that it has some superpowers because the first dose of your vaccine, which was 80 percent effective for Pfizer and Moderna with the original virus, now appears to be only 30 or 35 percent effective.

    So you need to be fully vaccinated in order to stave off this variant. It's now responsible for somewhere between 6 and 10 percent of the infections in the United States. And if we're anything like the U.K. — and there's no reason to believe we won't be — within a month or two, it will become the dominant virus.

    So, if you're not vaccinated, you're not any better at fighting off a virus than you were a year ago, but the virus has gotten substantially better at its job than it was a year ago. So it's yet another reason that people really need to get vaccinated when they have the chance.

  • Judy Woodruff:

    A warning signal, the flashing red light couldn't be any clearer, it sounds like. If you don't have a vaccination, then you should worry about this.

  • Dr. Robert Wachter:

    I think that's right.

    And we are beginning to see this pattern play out in hospitals and in states, where there are younger people coming in the hospital. And, in many cases, they are unvaccinated. And, of course, they thought they were fine. But they are not.

    And that's without very much of this Delta variant around. So, when this Delta variant does hit us, we're going to see more people who are unvaccinated get infected. They are probably going to have worse outcomes.

    And one of the real differences, this first vs. second dose thing may not seem like a big deal. But, if you think about it, if we were dealing with the original virus, all right, I hear it's coming, I hear there are more cases in my state or my community, I'm going to get vaccinated now, I have been waiting.

    And a couple of weeks after that first shot, you were moderately well-protected. You didn't reach full protection until after the second shot. With this variant, at least so far, it looks like you're not going to be fully protected for about five or six weeks, until you're fully vaccinated.

    That first shot doesn't do the same job that it used to do. So, waiting until you hear that there's an uptake in cases is now a very bad strategy that's likely to not go well.

  • Judy Woodruff:

    And, Dr. Wachter, is it accurate to say that most of the people who are now hospitalized with COVID are individuals who had not had their full vaccinations yet?

  • Dr. Robert Wachter:

    We don't have great data on that. That's what we're hearing anecdotally. And that's certainly what we're seeing.

    We're not seeing that many hospitalizations here in California, certainly not in San Francisco, because virtually everybody's vaccinated. We have done very, very well.

    But when I talk to colleagues around the country, and they say, who am I seeing in the hospital in the intensive care unit, it increasingly is folks that did not get vaccinated or have only gotten their first shot.

    So, that is a warning sign that, if you're not vaccinated, you may be lulled because you see the case rates going down and you say, look, I don't have to worry about anything. But, in fact, you do. The case rates are going down because the vaccinated people are not getting infected. You are no better protected than you were in January 2020.

    And, actually, you're less protected, because the virus is better at its job than it was in January 2020. So, those of us who take care of patients, just — we plead for people to get vaccinated. Please stop waiting. This is the time, particularly if the Delta variant is going to hit us. It will hit us in the fall. And it's — it may hit us pretty hard.

  • Judy Woodruff:

    The message is clear, and it's a sobering message.

    Dr. Robert Wachter with the University of California, San Francisco, thank you.

  • Dr. Robert Wachter:

    Thank you.

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