Dealing With Delta


By Dr. J. Stacy Klutts

Here’s what we know about the Delta variant.

I have found a front row seat to all of the latest data since we used that information to make our national policy decisions, so here are a few important points that help explain why you should get vaccinated and wear a mask. I’ll try to do this so it makes sense to you.

1. The Delta variant has a particular collection of mutations in the spike protein that make it extremely effective in attaching to human cells and gaining entry. If the original COVID strains were covered in syrup this variant is covered in ultra fast drying gorilla super glue (industrial strength)!!

2. There are two recent publications that the viral loads in the back of the throat of infected patients are 1000 times higher with the Delta than with previous variants!

3. This much higher load plus the ultra stickiness of the Delta strains for adhering to human cells makes it more infectious than previous strains. The earlier version could infect 2 people at a time whereas the Delta can infect up to 8 people at a time (chicken pox and measles are all we’ve had before that spread that efficiently from human to human).

4. The viral loads in the throats of vaccinated persons who become infected with Delta rises at the same rate as an unvaccinated person but only for the first few days after five days or so the viral loads in the vaccinated person start to drop quickly whereas those unvaccinated persist.

5. This pandemic, round 2, is primarily being observed in younger patients than in round 1. Our children’s hospitals are already filling up or full. Because of the Delta viral dynamics, it is much more capable of causing severe disease in a larger swath of the population. This sets up very poorly for the beginning of the school year, which has already started in Florida. It is terrifying. I sure hope we have vaccines for the five to 11 year olds soon.

6. We know a lot about vaccines for upper respiratory viruses as we have been giving the population one every year (influenza). When you get a vaccine as a “shot” the “antigen” in the vaccine leads to formation of an antibody response. What’s important is that it primarily leads to a specific Immunoglobin G (IgG) response. That’s the antibody type that circulates around in really high numbers in the blood, is located some in tissues, and is more easily detectable by a blood test. What that shot does not do is produce an Immunoglobulin A (IgA) antibody response to the virus at the surface of the throat mucosa. That’s the antibody type that could prevent the virus from ever binding in the first place.

***In a vaccinated person, the virus can still attach like it’s about to break into the house, but it doesn’t realize that there is an armed homeowner on the other side of the door. When that virus is detected, the IgG beats it up and clears it before the person gets very ill or ill at all. ****

7. The COVID-19 vaccines are designed to prevent death/disease through that IgG response. We now understand that the virus fades from the back of the throat pretty quickly in a vaccinated person. We also know that an infected vaccinated person can transmit this very infectious virus to others for at least a couple of days, so being asked to wear a mask is primarily to protect others. Those of you in the south, particularly in Florida, know that the tsunami is already on your shores!!!


Dr. J. Stacy Klutts is a clinical associate professor of pathology and clinical microbiology at the University of Iowa and is the chief of the Pathology and Laboratory service for the Central Iowa VA Health Care System. This is adapted from a St. Pete Times article.


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