Delta’s impact on the vaccinated: ‘Likely the most uncertain time we’ve faced’

• Link to: Northwestern Now Story

With federal, state and local guidelines on COVID-19 shifting by the day and urgency around delta breakthrough infections continuing to grow, vaccinated individuals are rethinking activities that have become part of their summer routine.

Can parents trust schools to keep their children safe from delta spread in the classroom? Is masking back up enough to keep vaccinated folks from spreading COVID-19 to peers in restaurants, at sports games or in the office?

Northwestern University experts provide guidance on how vaccinated individuals can protect themselves from delta, the impact of mixed messages and the role booster shots will play in coming months.

Experts include:

• James Druckman, political scientist examining how people make political, economic and social decisions, associate director, Institute for Policy Research at Northwestern
• Dr. Larry Kociolek, pediatric infectious diseases physician-scientist at Northwestern University Feinberg School of Medicine and the Ann & Robert H. Lurie Children’s Hospital of Chicago
• Dr. John Walkup, expert in child psychiatry, chief of child and adolescent psychiatry at Feinberg and chair of department at Lurie
• Dr. Rob Murphy, infectious disease and global health pandemic expert, executive director, Institute for Global Health at Feinberg
• Dr. Ben Singer, pulmonology and critical care physician-scientist, assistant professor, pulmonary and critical care at Feinberg

‘Inconsistent rules are bound to generate significant anxiety’

James Druckman: “I would say that this is likely the most uncertain time we have faced with COVID-19. The confluence of school starting, mixed messages on vaccine efficacy and inconsistent rules are bound to generate significant anxiety. Perhaps the most the interesting institutions to monitor are schools as they have become a new venue to air grievances about health and politics.”

Despite the relative risks, ‘no evidence that interventions for preventing COVID-19 less effective’ against delta in schools

Dr. John Walkup: “Students learn content better in a hands-on learning environment and the process of learning is also better. Learning from incidental contact with other kids and adults can’t be matched virtually, like talking after class with the teacher as you walk out the door or chatting with classmates in the hall. Incidental contact can occur virtually but often happens in much less controlled environments – like on social media.”

Dr. Larry Kociolek: “We know that in-person instruction is optimal for children’s education, development and mental health. We have learned that schools were able to safely remain open to in-person instruction last year, even during periods of extremely high community transmission of COVID-19. While delta adds another layer of complexity, there is no evidence that our interventions for preventing COVID-19 transmission in school will be any less effective. However, any time unvaccinated individuals congregate, especially indoors, there is risk of COVID-19 transmission. Fortunately, for the vast majority of children, COVID-19 infection is relatively mild and uncomplicated.

“Parents can help keep schools safe by keeping themselves and their families healthy. All individuals eligible for vaccine should get vaccinated. Parents should keep their kids home from school if sick and seek testing of their child prior to returning to school. Parents should advocate for their schools following school safety guidance recommended by the CDC.

“The CDC and local health departments have developed guidance for keeping schools safe. These include masking; distancing; optimizing ventilation and school cleaning; keeping sick kids out of school; contact tracing and quarantine when exposures occur; and potentially screening testing of students and staff. Schools should follow this evidence-based guidance.”

Schools present a model for other in-person interactions

Dr. Ben Singer on dining out: “Because people take their masks off to eat and because restaurant dining rooms are often crowded with limited airflow, restaurants are higher risk spaces for spreading COVID-19. Vaccinated people can reduce their risk of dining out by sitting outside and seeking out restaurants that require proof of vaccination for entry.”

Dr. Rob Murphy on working in an office with other vaccinated people: “If you do have to meet, make sure everyone is vaccinated, wearing masks and is socially distanced, just like the old days. It’s safest to do Zoom meetings at the moment.”

Singer on air travel: “Air travel presents risks because of the number of people travelers encounter in the airport and on the plane. Wearing a mask, particularly one with a good particulate rating like N95 or KN95, can help reduce risk for those who need to fly.” 

Murphy on public pools: “While the delta variant is more contagious than the original strain, the virus doesn’t survive in the water. It’s airborne, person to person. So stay socially distanced in the water.”

Singer on in-person sporting events: “All else being equal, outside activities are lower risk than indoor activities. Nevertheless, tightly packed spaces like sports venues still pose an increased risk of spreading viruses. Wearing a mask in closely spaced outdoor venues can help reduce the risk of viral transmission.”

Six months after your second shot, it may be time for a booster

Dr. Rob Murphy: “The latest guidance on boosters is now that for non-immunocompromised or elderly people, you should be getting a booster six months after your second shot. The current guidance out there is to try to get the version of the shot you had before. If you can’t, just take whatever mRNA vaccine you can get. And that goes even for those who received the Johnson & Johnson vaccine.

“The immune response is much broader than just antibody levels, but the antibodies are at least a marker of the immune response and are easy to measure. The Pfizer CEO said eight months after your second shot is when antibody levels are low enough to be clinically relevant and of concern. The CDC and NIH pushed back, but he does have the data to prove this: 30,000 people in a clinical trial. And they’re seeing all these elderly people who got the vaccine in the hospital now. Also, the Israelis, which are the sentinel group, saw the same thing. They’re a couple months ahead of us, had great vaccination rates, and they’re seeing more hospitalizations of vaccinated people now. It’s still much lower in vaccinated than non-vaccinated groups, but it’s happening. And they’re seeing clinical improvement with the booster already.”