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Delta Blues

Being a personal reflection on the impacts of the pernicious variant coronavirus.

Being a personal reflection on the impacts of the pernicious variant coronavirus.

The first hint that I might have the dreaded Covid disease came at 7:30 pm on Monday, September 20, when I felt flush in the face and my temperature rose to 98.4 degrees. While that might not seem very high to others, I had been measuring it almost daily since March 2020, and it had generally come in under 97. By 8:45 pm it had risen to 99; my oxygen saturation level, measured with a pulse oximeter, had fallen below 95 percent, while my pulse hit nearly 100. And my throat and nasal passages were getting clogged with mucus, causing me to cough repeatedly. Something was badly amiss.

Thus, at about 11 pm, I pulled out the QuickVue rapid Covid-19 test kit that I'd purchased about a month earlier at the pharmacy and began going through the steps. (Boy, how I hated sticking that swab up my nose!). Sure enough, it came back with both a blue line and a red line on the test strip — positive for the SARS-CoV-2 coronavirus. (By contrast, my partner Elisabeth fortunately tested negative about an hour later.)

But rapid antigen tests can have false positives, so I called my doctor early the next morning, and he set me up for a more definitive PCR test at 11 am in the Island Primary Care clinic (getting a swab stuck up my nose yet again — arghh!). It came in positive, too, as I learned in a Wednesday morning phone call.

How had it ever happened? And why me? I'd been especially careful to dodge the dastardly virus for more than a year, wearing my three-layer mask whenever I had gone indoors in a public space (such as Island Market on Orcas Island), often applying antiseptic wipes or lotions to my hands beforehand and afterwards. And as I'd been vaccinated (with Moderna) twice in March, I thought I had an extra layer of protection.

It turns out that I'd visited the mainland the previous Friday, mainly for a semi-annual checkup at Fairhaven Dermatology. But I'd also piled on a bunch of errands that had been accumulating — at Trader Joe's, Lowes, Dewey-Griffin Subaru, Office Depot and Petco, among others. But I'd always worn my mask indoors during these visits. 

Nevertheless, the stealthy virus somehow slipped through my defenses. Either it was the accumulated dosage from several such encounters, or I'd gotten too close to a super-spreading virus carrier (perhaps in a bathroom?) at one of them. I'll never know.

My case clearly underscores the extreme infectiousness of the Delta variant virus, at least to me. Although my nasal virus sample has not to my knowledge been sequenced yet, Delta had become the overwhelmingly dominant variant in the state by early August, as the graph below illustrates. And San Juan County Public Health Officer Frank James, MD, told me they had seen nothing else in their sequenced samples since July.

Coronavirus sequencing results versus time for Washington state (Credit: WA State Dept. of Health) Click to enlarge.

A close look at this graph demonstrates just how infectious Delta is. Compare the light-blue (Alpha) areas with orange ones (Delta). Alpha is only about 50 percent more contagious than the original, "wild-type" virus, and can coexist with other variant types — for example, the P.1, or Gamma, variant (which I wrote about in May when it was common in Whatcom County). But Delta is two to three times more contagious than the wild type, and completely blows all the others away! Now it's the only game in town. It's so much worse than the other variants that we might well call it a new disease, Covid-21.

Such is the relentless logic of exponential growth. Delta's infectiousness leads to substantially larger values of the exponent and thus easily swamps the competition. To quote President Bill Clinton, "It's just arithmetic!"

And we unwittingly abetted its initial surge by relaxing our caution in July, removing our masks indoors and out. According to a recent Washington Department of Health report, the effective viral reproduction number (the number of persons infected by an individual bearing the virus) soared to nearly 2.0 in mid-July, from well below 1.0 in June. Any number over 1.0 leads to exponential growth, which is why the state experienced steeply rising case counts in August.

But Orcas Islanders — and probably most of San Juan County — put our masks back on indoors in late July, well before any official county or state mandate ever went into effect. Indoor masking and physical distancing are the easiest ways to reduce this reproduction rate back down below 1.0, thereby extinguishing the exponential growth. That's probably why the county still has one of the lowest hospitalization rates in the state, despite the fact that about a third of our population is over 65 and therefore much more vulnerable to serious infections. And we still have absolutely NO DEATHS. By contrast, Whatcom County has recorded 48 Covid deaths since late July, over 30 percent of its total since March 2020.

Part of the reason for our low hospitalization rate, in addition to community members caring about one another, is our high level of vaccinations — among the best in the state. According to state DoH data, over 88 percent of the 65+ population has gotten at least one dose and over 74 percent of the entire county population has been fully vaccinated as of this writing. When combined with the natural immunity of those who have been infected, that makes it more difficult for Delta to find susceptible victims hereabouts.

Such is not the case for Whatcom County, where just over 61 percent of the total population has been fully vaccinated. Nor for Skagit County (where I also traveled that fateful Friday), which has just over 58 percent of its population fully vaccinated. Delta accordingly has a much easier time finding victims on the mainland, and community spread of the virus is therefore still rampant there.

And I'll bet dollars to dimes that my vaccinations kept me out of the hospital, which in my case could have meant a $15,000 helicopter ride in the dead of night to Island Hospital in Anacortes, given the sorry state of our ferry system. There were — and as far as I can tell from the Web, still are — no empty ICU beds at St. Joe's Hospital.

"I'll bet dollars to dimes that my vaccinations kept me out of the hospital."

Looking back on my encounter with the virus, that first Monday night should have been scary. At my advanced age (pushing 75) and with (controlled) high-blood pressure, I was an excellent candidate for serious complications and a hospital visit. A follow-up X-ray revealed "ground-glass opacities" in my lungs — a sure sign that the virus had snuck in there and was beginning to wreak havoc, given my high pulse rate (over 100 at midnight) and low oxygen level that evening. My educated guess is that the additional antibodies in my blood stream due to the vaccinations helped fight it off.

I experienced serious symptoms for just three days, until Wednesday evening, September 23. My temperature peaked at 100.6 degrees, but my oxygen level edged back up above 95 percent and my pulse dropped back to normal. All in all, it felt like a moderate cold, with a long, continuing tail of coughing — normal for me afterwards.

Still, I had to remain in isolation another nine days until Friday, October 1. Fortunately, I had my Florence Nightingale — Elisabeth, who did all the shopping, cooking and meal-serving for over a week. And then had to sleep in the guest room with her cats!

Given Delta's severe infectiousness, it looks like we'll have to push percentage vaccinations even higher than originally thought — probably over 90 percent — before we can relax our collective guard and return to "normal" living. Or the combination of vaccinations plus the natural immunity that occurs due to Covid infections has to reach such a level. We may be able to do that in San Juan County before winter, but it will be difficult to do so on the mainland, given the higher levels of vaccine resistance there.

Historical and projected Covid-19 hospitalizations in Washington State (Credit: WA State Dept. of Health) Click to enlarge.

As the DoH graph at right suggests, we may experience another, or sixth, wave of the disease as winter begins.  Hopefully, it won't be as bad as the fifth (or Delta) wave, which was obviously the worst yet in terms of hospital admissions, thanks largely to the unvaccinated. And the Delta wave may soon challenge the third wave last winter in terms of deaths. Our vaccine holdouts should recognize the human costs — and the costs to society — of their illogical, anti-scientific resistance.


But do they care?

 

References

Michael Riordan, "Coronavirus and Community" Orcas Currents (26 October 2020).

Michael Riordan, "Variant Virus Strains Hit the County," Northwest Citizen (28 May 2021).

Washington State Department of Health, "SAR2-CoV-2 Sequencing and Variants in Washington State," (20 October 2021), chart on p. 5.

Washington State Department of Health, "COVID-19 Transmission across Washington State," Situation Report No. 40 (20 October 2021), graph on p. 12.

Comments by Readers

Randy Petty

Oct 25, 2021

Fascinating Michael.  I appreciate you writing this.   We’re about the same age.  I just got my Pfizer booster and generally don’t go anywhere but Fred Meyer for curbside grocery pickup.
I’ve been postponing ( and suspect I’ll continue to postpone) my dermatology checkup.  I’m sure the staff at my dermatology clinic are tired of hearing from boomers who grew up in California before anybody started telling them to wear hats and sunscreen.  😊

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Michael Riordan

Oct 25, 2021

Thanks, Randy,

Just try to stay out of the bathrooms when you have to visit the stores. That’s where I’d guess I caught it — several such visits that day, which only us aged can truly understand!

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Steve Harris

Oct 25, 2021

Indeed facinating, thanks for sharing.  Someone who triple masks inside, practices very thorough hygiene, and is fully vaccinated, becomes infected after a brief visit to a public restroom (suspected place of infection) where a “super spreading virus carrier” must have infected you.  

However, you have spent much more time indoors, unmasked, and as a symptomatic virus spreading carrier with your partner; yet, she wasn’t infected.—NOTE: I too was a symptomatic virus spreading carrier, and neither my wife, nor children caught the virus from me. BTW, I’m vaccinated and they weren’t at the time. 

Getting vaccinated has been shown as a very effective way of preventing severe illness and death (in comparison to being unvaccinated). However, suggesting that simply getting vaccinated is our way out of this mess is overly simplistic. 

For example, our current protocols still presume that becoming vaccinated prevents you from spreading this virus to others.  In most protocols, proof of vaccination is accepted over proof of a negative covid test. Why? Over 25% of new infections in Whatcom County are those that have been fully vaccinated and we know that asympomatic persons can spread this virus (irrespective of vaccination status).  However, If I’m in close contact with a known infected person in the workplace, as a vaccinated person, I’m able to keep working as long as I don’t present with symptoms or test positive.  Yet, an unvaccinated employee (even if recently recovered from an infection) has to quarantine for 14 days, even if asymptomatic with a negative test.—I get that we’re trying to get back to some level of “normal” with the least amount of restrictions as we can. 

The data shows that getting vaccinated will give you a far greater chance of a mild infection then not getting vaccinated (especially for those with increased risks). However, from what I’m seeing from the data around the world, this virus is not going to go away, and will eventually become endemic.  No amount of vaccination is going to prevent this from occurring as it’s now spreading among the vaccinated. 

 

 

 

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Ray Kamada

Oct 25, 2021

Michael, I’m glad you had just a mild case. Meanwhile,

1) recent data suggests that transmission rates from vaccinated breakthrough cases are lower than from the unvaccinated, probably because the vaccinated clear the virus faster. So, if you also care about your family and friends, vaccination remains worthwhile. Ourworldindata shows that nearly half the global population has been jabbed at least once, by at least six different types of vaccines. Serious complications are exceedingly rare. These are de facto no longer experimental drugs. They’re not perfect, but they do what we expected them to do. And more and better are on the way.

2) The Bellingham Trader Joe’s restrooms are turnstiles. There’s no way virions can clear from such a small space during the scant seconds between users. Bodily eliminations/gases can be chock full of virions. Even if N95 masked, I avoid such confines like the plague pots they are. 

3) Delta is a different animal. Nasal cultures show ten to a thousand times more virions than earlier strains.

4) Along with better, cheaper treatments, universal vaccines, designed to bind to non-mutating parts of the SARS-COV2 spike protein, will likely be available within a year..

5) One contact tracer I happen to know says she’s seeing a lot more breakthrough cases, all Pfizer. So, having been dosed with Moderna, your case is quite unusual for now.

6) I agree, Michael, people being what they are, that a 5th wave will hit us soon after Thanksgiving. Even with vaccine mandates and people wanting and needing boosters, the NYT and WaPo daily trackers just aren’t showing jab rates high enough to prevent it. Sadly, any significant mitigation will likely be due as much to those with prior Delta cases, as to those who’ve been vaxxed and boosted. Prior exposure to earlier strains won’t help nearly as much. Delta is different.

7) Again, people being people, many vaccinated are getting more lax about masking. So, the flu rate this winter isn’t expected to be near zero like it was last winter. Ergo, beyond my three covid jabs, I got jabbed for flu. None of them had more than superficial effects.

8) The saddest thing for me was a friend’s email. Her husband has an aggressive cancer, yet had to wait 3 months for surgery because mostly unvaxxed covid patients had filled all available local hospital beds. She also needs a pacemaker but can’t get it either and worries she won’t be able to care for him as he convalesces, if she has to go in right away once a bed comes available. I didn’t have the heart to repeat what she already knows - that the unvaxxed have lessened his chances. 

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Michael Riordan

Oct 26, 2021

You’re right, Steve, it’s remarkable that Elisabeth didn’t come down with Covid, for she must have been exposed to me for at least a day before I began experiencing symptoms but was still infectious. One mitigating factor may have been her antibody level, which she had had measured at Quest Diagnostics (Fairhaven office) a few weeks earlier and came in with the maximum level they report (>20). She, too, had two Moderna vaccinations, in February and March.

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Angelo Tsoukalas

Oct 26, 2021

Good morning Michael, 

I’m glad you are doing better. Now in your above article, you said “I’d been vaccinated (with Moderna) twice in March, I thought I had an extra layer of protection.”

Yeah but these vaccines aren’t quite what they’re saying they are and are effective for so long and do they really protect from other variants? Remember these companies are for profit. 

“The scientists, led by Ali H. Ellebedy, PhD, of the Department of Pathology and Immunology at Washington University School of Medicine in St Louis”... “also found the Moderna and Pfizer vaccines provide robust protection for at least 12 weeks after a second dose and could provide low-level protection for at least a year.” https://www.webmd.com/vaccines/covid-19-vaccine/news/20210629/pfizer-moderna-vaccines-give-more-protection-thank-known

So it sounds like you’re ripe for that booster shot. But your nightingale seems to have a much higher immune system since she didn’t get infected. (Which brings us back, please don’t shoot, to the natural immunity argument.)

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Ryan M. Ferris

Oct 26, 2021

The official CDC breakthrough (deaths and hospitalization) count is here: https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html 

(Scroll for the table far below.) The ‘leaked’ DOD assisted “Project Salus” slides are here: https://yournews.com/2021/10/02/2231096/ai-powered-dod-data-analysis-program-named-project-salus-shatters-official/

Apparently, the CDC doesn’t keep track of ‘breakthrough cases’ anymore but CMS (Medicare) keeps track of ‘breakthrough cases’ for those 65 and over on Medicare. ‘Project Salus’ by DOD contractor HUMETRIX had a 5.6M cohort study from this Medicare data.

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Michael Riordan

Oct 26, 2021

From the scientific evidence I’ve seen recently, Angelo, the Moderna protection supposedly lasts substantially longer than Pfizer’s — perhaps because the dosage was more than three times as much. It’s hard to tell from these studies, however, because Delta was coming on hard in the midst of them and any difference in timing can easily lead to a difference in results unless it’s not factored out.

From my own particular case, I now have my doubts about Moderna.

But I’m just a sample of one! That’s called “anecdotal evidence.” 

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