August 2, 2021

COVID-19 Update: Current Situation

Good morning. We hope you and your families have been managing at least a little fun as the world seeks to get back to some version of normal.

As many of you know, on Friday officials reported the first three cases of the Delta variant in El Paso. In addition, seven fully vaccinated people have died of COVID-19 in our city so far. While these developments are concerning, it is important to remember this corresponds to a mortality rate of 0.0015% among vaccinated El Pasoans and that all seven reportedly had underlying health risk factors. This means COVID-19 is significantly less dangerous than influenza among the vaccinated. From a practical standpoint, this news shows us we should continue to be cautious and wear masks when indoors with strangers or others outside your “pod”. This is not due to concerns that the Delta variant will harm us. Rather, it is because there are still so many unvaccinated among us and that Delta is unlikely to be the last new and more dangerous strain.

And, this is the bigger problem. The Delta variant is likely only the tip of the iceberg. This variant, as with nearly all others, almost certainly originated among the unvaccinated. It is simply a case of mathematics. The more copies made of a virus, the more random variation occurs—mistakes as the virus is copied. Eventually, given enough time, a new configuration occurs that has an advantage. In this case, Delta is more than 100% more contagious than the original strain and those infected can carry 1,000 times more virus. This new advantage is so effective that Delta now accounts for 83% of active US COVID-19 cases.

But it is not Delta that we should be worried about. Among the vaccinated, Delta is more likely to cause symptomatic infection (about 88% protection vs 95% for mRNA vaccines). However, both mRNA vaccines continue to reduce the risk of hospitalization by around 95% and death by more than 99.9%. This corresponds to the fact that nearly all (95%) of those hospitalized for COVID-19 over the past 30 days are unvaccinated.

Our true concern lies with what is coming next, with the masses who know more than science and with the poor who lack access to vaccines. The Delta variant has mutations that change the shape of its spike proteins and help it evade detection by our immune systems. How long before this advantage is even more effectively exploited with billions of unvaccinated hosts each making millions of viral copies?

There is still a chance that it will not happen. Cases have begun to decline in India where Delta originated despite low vaccination rates. The reasons for this appear to be complex and are still not entirely clear. What is clear is that vaccines are our only true power over COVID-19. The truth of this is evident in the dramatic decline in hospitalizations and deaths among the vaccinated worldwide. Over the next few months we will all take part in a massive gamble. Like it or not, our fates are tied together as a society and as a world.

At this time, we advise wearing a mask indoors in public or with strangers—even if you are vaccinated.

COVID-19 Update: Vaccination

Around the globe vaccinations continue at a brisk pace. Meanwhile, efforts at home have nearly stalled with a staggering number of eligible individuals electing not to be vaccinated.

For children under age 12, current estimates are the mRNA vaccines will not be available until midwinter 2021. This delay stems from rare occurrences of myocarditis (heart inflammation) in young boys. Overall, the chances of catching COVID-19 and the virus causing myocarditis still appears to be much higher for children than any risk associated with vaccination. The American Academy of Pediatrics continues to fully endorse vaccinating children.

This week worldwide COVID-19 vaccinations reached 4.1 billion doses. US vaccinations stand at 346 million. About 164 million or 50.1% of Americans are fully vaccinated. However, only 1% of people in low income countries have received at least one dose.

While wealthy countries are rapidly improving, the poor may not be vaccinated until 2023. However, dangerous variants are likely to emerge from under vaccinated regions and richer countries must work towards global immunity, out of self interest if nothing else.

El Paso continues to make progress toward our threshold for herd immunity but, as with the rest of the country, the pace has slowed dramatically. As of today 560,360 have received at least one dose and 479,504 have received both. (Our population 12 and older is 686,863). This means 57% of our population is fully vaccinated. Approximately 207,000 eligible people have not been fully vaccinated (age 12 and older).

If you have the chance to be vaccinated, please take it. In Texas all people age 12 and older are eligible for vaccination. Remember, so far these vaccines appear to prevent nearly 100% of hospitalizations and deaths due to COVID-19. To reiterate, these vaccines are both extremely safe and extremely effective.

Please get vaccinated as soon as possible, if not for yourself, for the good of others.

Wishing you good health,

CG Escandon, MD

Douglas Payne, MD

COVID-19 Information

For the week of 8/2/2021

Assumptions:

Staffed Hospital Beds: 1754

Available Hospital Beds: 572 (1/3 of total)

Staffed ICU Beds: 234

Available ICU Beds: 77 (1/3 of total)