San Antonio Express-News (Sunday)
Virus variant is on the move in Texas
People without second shot at risk; tens of thousands in Bexar overdue
A highly contagious coronavirus variant that appears to be adept at evading the immune system is spreading in Texas and most other states and poses a new risk to people who are only partially vaccinated.
The Delta variant, which was discovered in India, is estimated to be 40 to 60 percent more transmissible than an earlier variant found in Britain that was already several magnitudes more contagious than previous mutations.
Where the variant has taken hold, it has rapidly become dominant, said Dr. Ruth Berggren, a medical humanities and global health expert at UT Health San Antonio.
It also appears to be more adept at evading the immune system, including in people who have not received two doses of a COVID vaccine.
A recent study out of Britain found that people who were fully vaccinated had 88 percent protection against the Delta variant, but that figure plummeted to 33 percent with just one dose. Previous research had determined that a single dose of the Pfizer or Moderna vaccines provided around 80 percent protection against previous versions of the virus.
“What this really boils down to is people should get vaccinated as soon as they possibly can, and people should not neglect their second dose of the vaccine,” said Berggren, who previously advised Bexar County officials on coronavirus policies.
In Bexar County, nearly 52 percent of residents age 12 and older and almost 55 percent of those 16 and up are fully vaccinated. About 66 percent of residents have received at least one dose, including more than 108,000 people who are overdue for their second dose, said Dr. Junda Woo, medical director of the Metropolitan Health District.
“Those are people who would still be vulnerable, even though
they’ve been vaccinated,” she said.
Woo said people have given a number of reasons for not getting their second dose, including scheduling issues and qualms about side effects. Some have expressed the belief that if they have already been infected with the virus, they need only one dose for full immunity, an approach that Woo called an “experiment.”
Those who remain at risk include children under age 12, Berggren said, who are not yet eligible for vaccination. Adult inoculation helps protect that group as well as the immune-compromised, she said.
But Woo is more concerned about young adults, who have lower vaccination rates and are more likely to transmit the virus.
As the coronavirus has receded, Dr. Jason Bowling has watched residents remove their masks and return to many of their pre-pandemic routines.
But the infectious disease physician is regularly reminded that COVID-19 still poses a threat. He sees it up close during his rotations at University Hospital, where coronavirus patients, largely unvaccinated ones, are being treated for severe illness.
For Bowling, they are a reminder that, even at low levels, the virus is still circulating and large swaths of the public remain vulnerable to its current and future iterations.
“What was predicted was true, in that this virus will continue to mutate and evolve over time,” said Bowling, an assistant professor of infectious disease at UT Health San Antonio. “We’re still not where we need to be as far as people getting protected with vaccine.”
Metro Health data shows an average of about 100 people a day are still becoming infected. Since the pandemic began, the virus has infected more than 225,000 people in Bexar County and killed more than 3,500.
“What was predicted was true, in that this virus will continue to mutate and evolve over time.”
Dr. Jason Bowling, assistant professor of infectious disease at UT Health San Antonio
Some of Bowling’s COVID patients have expressed a desire to get their shots after they recover. But that is not how he wants to convert the hesitant. He likened it to the decision to wear a seat belt after a crash has already happened.
“I don’t want people to be scared, but I still want people to retain a healthy respect for this virus,” he said.
Even as the coronavirus continues to mutate, the Pfizer and Moderna vaccines have remained remarkably effective, Woo said. That protection will help blunt future outbreaks, she said, but there will still be pockets where the virus can cause severe illness.
At this point in the pandemic, Woo said, those are unnecessary outcomes.
“This is a vaccine-preventable disease, so even one more hospitalization and death is more than we really should have,” she said.
The Delta variant’s emergence coincides not only with widespread reopenings across the U.S. but also plateauing vaccination rates. Woo and Berggren said local efforts to administer shots have become increasingly difficult.
“All the easy low-hanging fruit have been picked off,” Woo said. “This is very much like the ground game that politicians do, talking to people one at a time.”
She added that it’s also harder for people in San Antonio to be cognizant of the virus when community transmission has been low for months.
After more than a year of collective grief and tragedy, Bowling said, it is understandable that people are ready to move on — it’s a natural response to trauma. But he
and Woo agreed: The virus will still be with us for some time.
“We’re not done,” Woo said.