MAYO CLINIC GRAND ROUNDS: THE DELTA VARIANT
Gregory Poland MD, Director of Mayo Vaccine Research Group, breaks it down with candor. Spoiler alert: It's bad. Really bad.
LECTURE DATE: 19 AUGUST 2021
YOUTUBE LINK:
PDF file of my transcribed notes:
https://drive.google.com/file/d/157rEFRirCKRE1OESykHkj-eWbUZMrs3c/view?usp=sharing
(In my notes I have select screenshots from Dr. Poland's lecture and additional commentary from me is in blue type.)
“We are now in a desperate, but unseen and barely noticed race of variant versus vaccine; of ignorance versus knowledge; of disease versus health...and we are losing...to know is science, to believe one knows absent data is simply ignorance.”
-Dr. Gregory Poland, MD, Director of the Mayo Clinic Vaccine Research Group
Thursday, August 19, was another outstanding grand rounds lecture by Mayo Clinic researcher, physician and one of the world's foremost authorities on vaccines and infectious disease, Gregory Poland MD. He is the Director of the Mayo Clinic's Vaccine Research Group and one of the most respected scientists in his field during this pandemic.
I have a 21 page PDF of my own transcribed notes that I encourage everyone to download and share with medical and scientific colleagues as well as those who are deeply interested in the science of the vaccines and the Delta variant as we move into a very deadly phase of the pandemic where the unvaccinated, either by choice or by age are too young for vaccination, are at increased risk. I had mentioned the same thing after sharing my transcribed notes from Dr. Poland's prior Grand Rounds lecture in early June.
Sadly, things have deteriorated badly in this pandemic since that June lecture. Dr. Poland's candor during yesterday's lecture was a stark and blunt warning about the direction we are headed as a nation.
Rather than repeat what can be found my notes, here is a list of take home messages from his talk worth sharing:
1/ We have given up as a nation and as a world in this pandemic. Human behavior remains his biggest concern in this pandemic. We are now at one out of every 512 Americans has died of COVID. Exponential spread of the Delta variant is continuing unabated due to behavioral factors. Our behavior is costing us the battle in this pandemic. It will get worse.
2/ "WE WILL NOT GET TO HERD IMMUNITY."
3/ "WE WILL NOT PREVENT EMERGENCE OF FURTHER VARIANTS."
4/ No previous vaccine has been studied to the same degree and scrutinized to the same degree prior to release as the COVID vaccines. The risks and benefits of vaccination are clear and they heavily favor the benefits based on millions and millions of doses administered worldwide.
5/ Overall, if you are unvaccinated, you have a 3X greater chance of getting infected than someone who is vaccinated. If you are unvaccinated, you have an 8X greater chance of having symptoms than someone who is vaccinated. If you are unvaccinated, you hae a 25X greater chance of being hospitalized for COVID than someone who is vaccinated.
6/ With the Delta variant, if you had COVID before and are unvaccinated, you have a 2.34X greater chance of getting reinfected and the symptoms may be worse.
7/ Kids infected with the Delta variant get sick quickly. Data from Canada shows kids infected with Delta have a 2.75X risk of hospitalization compared to if they had been infected with the virus from last year.
8/ At the time of diagnosis, those vaccinated and those unvaccinated HAVE THE SAME VIRAL LOADS. This why we must mask up even if vaccinated. But in those vaccinated, the viral loads drop faster as the immune system kicks in. The Delta variant causes viral loads 1000 to 1200X higher than last year's virus.
9/ “We are doing a huge experiment with our youth. We are taking the most contagious viral variant, not letting them use masks and crowding them together to see what happens.”
“Not one single expert thinks this is a good idea.”
While there are benefits to in-person learning, it can ONLY take place with two simple measures- vaccinate all the teachers and staff and mandate masks.
10/ Very good data from the UK shows a 9X increase in infection and transmission in school age children with the Delta variant compared to last year's virus.
11/ Most medications in widespread use today have had far fewer study participants as part of their approval process than the COVID vaccines. Full approval is coming soon, but it will not change vaccine-hesitant behaviors.
12/ The mutation rate of the virus is inversely proportional to the vaccination rate. The more we vaccinate, the less likely we will have new variants. But because people will not vaccinate, we get variants and the variants are why we need vaccination mandates.
13/ The pandemic will not end given the way the American public is behaving. We are on the verge of the emergence of a variant that will set us back at square one all over again.
14/ We do not yet know what level of antibodies are protective. We call this "correlates of protection". We were starting to get early data on this, but then the emergence of the variants set us back in determining correlates of protection.
15/ The incubation period of most infectious diseases is long enough to spool up and activate our long term immunity. The original SARS-CoV-2 virus and to an extent the Alpha variant had a long enough incubation period (7-10 days from exposure to development of symptoms) to allow for long term immunity to be activated. The Delta variant has a much shorter incubation period (only 3 days, 4 days max from exposure to development of symptoms) with very high viral loads that may be overwhelming the activation of long term immunity.
16/ We have had prior warnings of coronaviruses with SARS in 2003 and MERS in 2012. There will be future coronaviruses that will constitute a threat to all of us.
Many thanks to my good friend Sameer Keole MD for moderating this lecture along with the extensive Q&A session with Dr. Poland as well his ongoing work to educate everyone in this pandemic. He is one of many amazing folks that are now a part of my life that are the silver lining of this pandemic.
We will get through this as a community and not as individuals.