Internal CDC documentation warns that delta infections can be more serious


Coronavirus delta mutants cause more severe illness than previous mutants and appear to spread as easily as chickenpox.

This document is a slide presentation of the US Centers for Disease Control and Prevention, shared within the CDC, and obtained by The Washington Post. This has led to a surge in cases across the United States, and new studies suggest that vaccinated people may spread the virus, so people are encouraged to accept vaccinations and precautions, including wearing masks. It captures the struggle of the top public health agencies in the country to persuade.

This document calls for urgent attention, Ebola and colds.

Unpublished data recently obtained from outbreak studies and external studies showing that vaccinated people infected with Delta can be infected with the virus as easily as unvaccinated people. The combination of is quoted. Vaccinated people infected with Delta are unvaccinated and have a measurable viral load similar to those infected with the mutant.

“I’m much more worried than when I started,” wrote Robert Wachter, president of the University of California, San Francisco School of Medicine, in an email.

CDC scientists were so wary of new research that they changed their guidance to vaccinated people earlier this week, even before releasing new data.

According to federal health authorities, the data and studies cited in this document have been revised to require all people, with or without vaccination, to wear masks indoors in public in certain circumstances. Played an important role in the recommendations. The official told the post that the data will be fully released on Friday. Rochelle Walensky, director of the CDC, personally briefed parliamentarians on Thursday, using much of the material in the document.

One slide states that older people are at higher risk of hospitalization and death than younger people, regardless of vaccination status. Another estimate is that there are 35,000 symptomatic infections per week among 162 million vaccinated Americans.

This document describes vaccinated people, including concerns from the local health sector about whether the coronavirus vaccine will continue to be effective and “publicly convinced vaccines no longer work / increase required doses”. It outlines the “communication challenges” caused by the cases of.

The presentation focuses on the difficult challenges facing the CDC. Mild breakthrough infections may not be so uncommon, and emphasizes the proven effectiveness of vaccines to prevent severe illness and death, while acknowledging that vaccinated individuals are infected with the virus. You have to keep going. Agencies need to fully publish their success goal posts.

The CDC declined to comment.

“In rare cases, we believe that vaccinated people may spread the virus, so we’ve updated our recommendations,” said federal health officials on condition of anonymity because they don’t have the authority to speak. Said. publicly. “Waiting for days to publish data can cause unnecessary pain and we cannot accept it as a public health expert.”

The presentation took place two days after Warensky announced a reversal of guidance on masking for vaccinated people. On May 13, I was told that if I had been vaccinated, I would no longer have to wear a mask indoors or outdoors. The new guidance reflects the strategic withdrawal in the face of the Delta variant. According to the CDC, even vaccinated people need to wear masks indoors in areas where the virus is fairly widespread and in areas where there are people who are particularly vulnerable to infections and illnesses.

While this document presents a new science, it also suggests the need for new strategies for communication. Be aware that public confidence in vaccines can be undermined if people experience or hear breakthrough cases, especially after public health officials have described vaccines as rare.

Matthew Seeger, a risk communications expert at Wayne State University in Detroit, said the lack of communication about breakthrough infections proved to be a problem. The perception that the vaccine is not perfect may seem like a betrayal, as public health officials have emphasized the superior efficacy of the vaccine.

“We did a great job of telling the public that these are miraculous vaccines,” Seeger said. “We’re probably a bit in the trap of over-reassurance, one of the challenges of a critical communication environment.”

The CDC’s revised mask guidance has not reached what the internal documentation requires. “Given the higher infection rates and current vaccination rates, universal masking is essential to reduce delta mutant infections,” he said.

This document reveals that vaccination provides substantial protection against the virus. However, the CDC also states that “there is a need to improve communication about individual risks.” [the] The risk depends on many factors, such as age and whether someone has a disorder in the immune system.

This document contains CDC data from studies showing that the vaccine is not very effective for immunocompromised patients and residents of nursing homes, and that some individuals at risk may receive additional vaccines. You may need it.

The presentation contains a note that the findings and conclusions are those of the author and do not necessarily represent the official position of the CDC.

The internal documentation contains some of the scientific information that influenced the CDC to change the mask guidance. Kathleen Hall Jamison, director of the University of Pennsylvania’s Annenberg Public Policy Center, said the agency faced criticism from outside experts this week when it changed mask guidance without disclosing data. ..

“When you’re a public health authority, you don’t want to say,’Trust us, we can’t teach you how,'” Jamison said. “Scientific norms suggest that when you speak on the basis of science, you show science …. And the second mistake looks frank about the extent to which breakthroughs lead to hospitalization. There is no such thing. “

According to the CDC briefing, breakthrough cases are expected and will probably increase as a percentage of all cases, as so many people are currently vaccinated. This reflects data from studies in other countries, including highly vaccinated Singapore. In Singapore, 75% of new infections are reported to be associated with breakthrough cases.

The CDC document cites public skepticism about vaccines as one of the challenges. “Vaccines that the public is convinced of no longer work,” is one of the first slides in the presentation.

Walter Orenstein, associate director of the Emory Vaccine Center, was impressed with the data showing that vaccinated people infected with Delta released as much virus as unvaccinated people. Stated. This slide shows that vaccinated and unvaccinated people shed about the same amount of virus in Barnstable County, Massachusetts.

“I think this is very important in changing things,” Orenstein said.

Data from July 4 in Provincetown, Massachusetts show that genetic analysis of the outbreak shows that other people have been vaccinated, according to a person working with the CDC in a delta variant study that spoke on condition of anonymity. It means that people who were vaccinated against the virus were infected with the virus. He said the data was “extremely embarrassing” and “coal mine canary” for scientists looking at the data.

As the CDC states, when war changes, so does the calculation of success and failure. The extreme infectivity of Delta makes herd immunity a more challenging target, infectious disease experts said.

“I think the central issue is that vaccinated people are probably involved to a large extent in the transmission of the delta,” said Columbia University epidemiologist Jeffrey Shaman, who reviewed the CDC slides. After that, I wrote it by e-mail. “In a sense, vaccination is now about protecting individuals, that is, protecting themselves from serious illness. Herd immunity is irrelevant because there is plenty of evidence of repeated and breakthrough infections.”

This document emphasizes what scientists and experts have said for months. It’s time to change how people think about pandemics.

Kathleen Neuzil, a vaccination expert at the University of Maryland School of Medicine, said increasing the number of people vaccinated remains a priority, but in the near future, the relationship with viruses that will almost certainly be associated with humankind. May need to be changed.

“We need to shift towards the goal of preventing really serious illnesses, disorders and medical consequences, and we don’t have to worry about every virus detected in someone’s nose,” Neuzil said. .. “It’s difficult, but I think we have to get used to keeping the coronavirus from disappearing.”