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A new internal government document claims the Delta variant appears to cause more severe illness than earlier coronavirus variants and spreads as easily as chickenpox.
In laying out the evidence that this variant looks like the most dangerous one yet, the document urges health officials to "acknowledge the war has changed," the Washington Post reported.
Shared with officials from the U.S. Centers for Disease Control and Prevention, the document reveals that the agency knows it must revamp its public messaging to emphasize vaccination as the best defense against a variant so contagious that it acts almost like a different novel virus, spreading faster than Ebola or the common cold, the Post reported.
It cites a combination of recently obtained, unpublished data from outbreak investigations and outside studies showing that vaccinated individuals infected with the Delta variant may be able to transmit the virus as easily as those who are unvaccinated. Vaccinated people infected with Delta have viral loads similar to those who are unvaccinated and infected with the variant, the Post reported.
"I finished reading it significantly more concerned than when I began," Robert Wachter, chairman of the department of medicine at the University of California, San Francisco, told the Post.
CDC scientists were so alarmed that the agency changed masking guidance for vaccinated people earlier this week, even before making the new data public, the newspaper said.
The data cited in the document prompted revamped recommendations that call for the fully vaccinated to wear masks indoors in public settings in certain circumstances, a federal health official told the Post, adding that the full data will be published on Friday.
Some of the data suggests there is a higher risk among older people for hospitalization and death, regardless of vaccination status. Other evidence estimates there are 35,000 symptomatic infections per week among 162 million vaccinated Americans, the Post reported.
"Although it's rare, we believe that at an individual level, vaccinated people may spread the virus, which is why we updated our recommendation," the federal health official, who spoke on the condition of anonymity, told the Post. "Waiting even days to publish the data could result in needless suffering and, as public health professionals, we cannot accept that."
The document also includes CDC data showing that the vaccines are not as effective in immunocompromised patients and nursing home residents, raising the possibility that the vulnerable will need a booster dose.
Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta, said he was struck by data showing that vaccinated people who became infected with Delta shed just as much virus as those who were not vaccinated.
"I think this is very important in changing things," Orenstein said.
A person working with the CDC on the Delta variant, who spoke on the condition of anonymity, said genetic data that came from a July 4 outbreak in Provincetown, Mass., showed vaccinated people were transmitting the virus to other vaccinated people. The person said the data was "deeply disconcerting" and a "canary in the coal mine" for scientists.
"I think the central issue is that vaccinated people are probably involved to a substantial extent in the transmission of Delta," Jeffrey Shaman, a Columbia University epidemiologist, told the Post. "In some sense, vaccination is now about personal protection — protecting oneself against severe disease. Herd immunity is not relevant as we are seeing plenty of evidence of repeat and breakthrough infections."
The document confirms that it is time to change how people think about the pandemic, experts said.
"We really need to shift toward a goal of preventing serious disease and disability and medical consequences, and not worry about every virus detected in somebody's nose," Kathleen Neuzil, a vaccine expert at the University of Maryland School of Medicine, told the Post. "It's hard to do, but I think we have to become comfortable with coronavirus not going away."
Biden announces 'vaccine or testing' mandate for federal employees
President Joe Biden announced Thursday that all civilian federal employees will have to be vaccinated or submit to regular testing, masking and travel restrictions.
"This is an American tragedy," Biden said in a speech from the White House. "People are dying, and will die, who don't have to die."
The move mirrors an announcement on Wednesday from New York Gov. Andrew Cuomo, who said that tens of thousands of state employees would be required to show proof of vaccination or submit to weekly testing, The New York Times reported. Cuomo also said that "patient-facing" health care workers at state hospitals must be vaccinated to stay employed. Two days earlier, New York City announced that all 300,000 municipal employees must be vaccinated or submit to weekly testing.
Biden's plan will only force employees to get a shot or lose their job if they work with patients at hospitals run by the Veterans Affairs department. But public health officials hope the prospect of extra burdens for the unvaccinated will help convince more people to get immunized, the Times reported.
Hours after Biden's announcement, the Pentagon said that it would require military personnel to attest to their vaccination status or face frequent testing and other restrictions, the Times reported.
In his speech, Biden had called upon the Department of Defense to move rapidly toward requiring coronavirus vaccines for all members of the military, a step that would affect almost 1.5 million troops. Many of those troops have resisted vaccination.
But Biden stopped short of saying he would issue a waiver to compel service members to get vaccines not yet fully approved by the U.S. Food and Drug Administration.
The lack of full approval hasn't stopped mayors, chief executives, hospital administrators and college presidents around the country from requiring vaccinations. In California, Gov. Gavin Newsom said Monday that the state's 246,000 employees would have to be vaccinated by Aug. 2 or would be tested at least once a week.
With the high contagious Delta variant threatening a surge of cases in the fall, Biden must walk a tightrope when setting national vaccine policies.
"You want to be careful," Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, told the Times. "You don't want to put wind in the sails of the anti-vax movement."
But Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told the Times that Biden should mandate vaccines to the degree that he can, among federal employees and the military.
"Sure, it will cause a backlash -- so what?" Offit said. "It isn't a personal choice. It's a choice for others. It's not an American's right to potentially catch and spread a fatal infection."
In the last six months, nearly half of the country -- 163.3 million people -- has been vaccinated, including 80 percent of those 65 and older, data from the U.S Centers for Disease Control and Prevention shows. But tens of millions of people remain unprotected against what CDC Director Dr. Rochelle Walensky has described as one of the most contagious respiratory diseases known to scientists.
Experts say a refusal to get vaccinated puts others at risk — especially those who cannot get shots for medical reasons, or whose immune systems are too weak to respond to the vaccine.
"The ongoing transmission of this virus is in fact largely due to the unvaccinated," Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the Times.
SOURCES: Washington Post; The New York Times
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