Tracking Delta breakthroughs -- Part 3 (Mitigation via distancing)

Last update: Monday 9/6/21

This is the third in a series of notes on this blog that briefly summarize what every health conscious U.S. resident should know about the Delta variant.  Part 1 discussed Delta's most disruptive properties. Part 2 discussed masks. This third part discusses distancing, the most effective way that individuals can help to mitigate the spread of Delta to those who have not been vaccinated yet and to those who need a booster shot to achieve full immunity. 

The CDC's May 2021 guidance declared that vaccinated persons did not have to wear masks or maintain social distancing in most public places. In late July, the CDC reversed its guidance upon learning about the hundreds of breakthrough cases in Provincetown, Massachusetts, and that breakthrough cases carried the same very high loads of Delta virus in their throats and noses as unvaccinated persons who became infected. Unfortunately, its July reversal only declared that vaccinated persons should wear masks in public places where infections were surging ... with no mention of distancing, the most powerful group of mitigation procedures

• "Interim Public Health Recommendations for Fully Vaccinated People", C.D.C,. 7/28/21

Types of distancing

One can distinguish at least four different types:

• Social distancing ==> Many people in our community are infected, and many don't show any symptoms, so they might not know they are infected; indeed, I may be infected and not know it. So I will keep away from you, and you will keep away from me ... at least 6 feet in U.S., about 3 feet in most other countries
  
  
• Quarantine ==> I'm infected or I got close to someone who was infected, so I will go home to keep far away from everyone else until I am no longer contagious
  
  Sometimes the individual makes this decision to quarantine; sometimes his or her employer makes this decision for a number of employees who have become infected or were close to other infected employees. During 2020 and the first half of 2021, this kind of distancing was not practiced in the U.S. as extensively as in some other countries, e.g., the United Kingdom.  However there are indications that it will be done far more frequently in the final phases of the pandemic.
  
  -- "In Los Angeles, price for admission at nation’s second-largest school district is a negative covid test — every single week",  Erica Werner, Washington Post, 8/29/21 ... Note: Students, teachers, and staff who test positive for the virus will be directed to quarantine at home. "Even the fully vaccinated are required to get tested. Those who test positive stay home for at least 10 days. And those who decline to get tested can’t come at all"
  
  
• Shelter-at-home ==> Too many people in our community are infected, so I am going to work/stay at home to keep away from all of you.
  
  During the pandemic, some employees were able to persuade their employers to let them work at home; more often the employers directed many/all of their "non-essential workers" to work at home. Sending employees home was especially favored by employers involved in tech and finance; however it quickly became the norm for educational institutions at all levels -- K through 12, colleges, and universities.
  
  Many large employers do not share the CDC's disdain for distancing. Indeed, the recent surge in Delta infections has caused them to have second thoughts about bringing their employees back to the office any time soon.
  
  -- "Apple delays its return to office as the Delta variant surges", Jack Nicas and Mike Isaac, NY Times, 7/20/21
  
  -- "Ford delays return-to-work program until January due to Covid delta surge", Michael Wayland, NBC News, 8/25/21
  
  -- "Surging Delta Cases Reverse the World’s March Back to the Office", Bloomberg, 8/20/21
  
  -- "Despite Biden’s vaccine order for feds, delta surge causes some back-to-office plans to be scrapped", Lisa Rein and Eli Rosenberg , Washington Post, 8/6/21
  
  -- "Why You Might Not Be Returning to the Office Until Next Year", Kellen Browning, Lauren Hirsch and Coral Murphy Marcos, NY Times, 9/6/21
  
  
• Lockdown ==> A large percentage of us are infected, so we will "all" shelter-at-home (except for "essential workers") until "no one" is contagious.It seems highly unlikely that we will witness another national lockdown; but hard pressed governors in blue states might mandate partial lockdowns as last resorts.

Question: To which of these types of distancing should health conscious U.S. residents give their fullest commitment?

Answer: All of them. Delta is so contagious that an unknown, but substantial percentage of fully vaccinated persons can become infected, i.e., become breakthrough cases. Worse still, these breakthroughs can easily infect other people, thereby cancelling the possibility of herd immunity. 

Anticipating an ever increasing number of breakthrough cases, the Biden administration recently announced its intention to acquire and distribute a large enough supply of vaccines to provide everyone with an additional shot to boost their immunity, starting in September, 2021. Stronger immunity would yield fewer breakthroughs. Of course, this initiative assumes that the required permissions will be obtained from the FDA and from the CDC. 

• "U.S. to Advise Boosters for Most Americans 8 Months After Vaccination", Sharon LaFraniere, NY Times, 8/17/21

It has become clear that there is little chance that everyone will ever become vaccinated. Common sense suggests that it is even less likely that everyone will sign up for the booster shots. As consequence, mitigation measures must be employed for the foreseeable future, with greatest emphasis on distancing, the most powerful mitigations.

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Related notes on this blog:

• "Downgrading the CDC's guidance", Last update: 7/25/21
  
  
• "Is the CDC misguiding us again, this time with regards to Delta breakthrough infections???", Last update: 8/13/21
  
  
• "Tracking Delta breakthroughs -- Part 1 (Three disruptive properties", Last update: 8/21/21
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• "Tracking Delta breakthroughs -- Part 2 (Mitigation via masks)", Last update:  8/22/21
  
  
• "Tracking Delta breakthroughs -- Part 4 (Mitigation via testing and contact tracing)", Last update:  9/5/21