2021-08-09 04:00:03 Europe’s Delta COVID Surges Show It Can Be Controlled

Europe’s Delta COVID Surges Show It Can Be Controlled

“The United Kingdom and the Netherlands should be a source of hope,” one expert told BuzzFeed News. “We don’t have to be pessimistic about the Delta variant.”

In recent weeks, the Delta coronavirus variant has dashed the hopes of many Americans who were looking forward to a “hot vax summer” and the end of the pandemic.

As health experts predicted in June, the highly contagious Delta variant has struck especially hard in states with low vaccination rates, clogging hospitals and morgues and bringing the pandemic back to its darkest days. And, unlike previous variants, new evidence suggests that some vaccinated people who become infected with Delta can still spread the virus to others, despite being overwhelmingly protected against severe disease. As a result, the CDC has advised vaccinated people in areas with higher viral transmission to resume wearing masks in indoor public spaces.

There are still many unanswered questions about the extent to which “breakthrough” cases are spreading in Delta. However, there is a growing fear that Delta will be an unstoppable force.

However, the message from experts monitoring Delta waves in Europe is more encouraging, implying that the usual rulebook remains in effect: Vaccination and strategies such as masking indoors in public and avoiding crowds can help to reduce the number of cases.

Meanwhile, some observers have looked at what happened with Delta in the United Kingdom and India, where the variant was first discovered, and speculated that the United States’ Delta woes may be short-lived, regardless of what we do to limit its spread. In both countries, a sharp increase in cases was followed by a sharp decline, implying that the rapidly spreading Delta variant typically burns itself out fairly quickly.

This viewpoint has two major flaws. To begin with, if we simply let Delta run its course, the cost in lives and overburdened hospitals will be high.

“There would be a catastrophic number of hospitalizations on the way to that point,” said Lauren Ancel Meyers, a computational epidemiologist at the University of Texas at Austin and director of the UT COVID-19 Modeling Consortium, to BuzzFeed News. “You would completely overburden your healthcare system.”

Second, the diversity of Delta curves seen across Europe makes it difficult to conclude that there is a typical fast-burning Delta wave. Changes in people’s behavior, rather than the inherent characteristics of the Delta variant, appear to be a big part of what has turned things around in those countries that have seen a rapid rise and fall.

When you delve deeper into the causes of the various Delta waves seen across Europe, a more hopeful message emerges: as frightening as the Delta variant is, it appears to be controllable. Vaccination is our most powerful weapon, but the modest social distancing measures that have worked against other, less transmissible forms of the coronavirus can still be extremely effective.

Delta waves in selected countries

Experts argue that comparing India’s disastrous Delta wave to those in the United States, the United Kingdom, and other European countries is pointless. Not only was India’s vast population largely unvaccinated when the Delta variant ravaged the country in April and May, but surveillance and testing were so lacking that it’s unclear whether the recorded curve of new cases accurately reflects how many people became infected.

However, the curves of the Delta waves seen so far in European countries and the United States are very different. Only the United Kingdom and the Netherlands show a rapid rise and fall in the chart above, while the others have experienced a slower rise. The Delta curve is barely visible in Germany.

While the UK was exposed to the Delta variant before the others, owing largely to people traveling to and from India, the timing with which Delta established its dominance cannot account for the differences shown for the other nations.

The exact reasons for the differences in Delta waves between European nations are difficult to decipher. However, transmission will be determined by the number of people who have some immunity — either through vaccination or prior coronavirus infection — as well as behavioral patterns that encourage spread.

France has the lowest vaccination rate of the countries shown, with only 49 percent of its population fully vaccinated (the US is just a bit ahead of that, at 50 percent ). Meanwhile, the United Kingdom has the highest vaccination rate, with 57.3 percent of the population fully vaccinated. The other European countries shown are all tightly packed between 53.2 percent and 54.2 percent. As a result, the extent of vaccination does not appear to explain the large differences in the Delta curves of the nations.

One sign that behavioral differences have played a role is that Germany has maintained stricter social distancing controls than most of its European neighbors, requiring people who don’t live together to keep 1.5 meters (about 5 feet) apart and to wear medical-grade masks on public transportation and in stores.

Looking at the two nations that have seen a rapid rise and fall in cases caused by the Delta variant, on the other hand, provides strong indications that large crowds played an outsized role in each of those waves.

How a soccer tournament boosted the UK Delta wave

The Euro 2020 soccer tournament appears to have accelerated the UK’s rise, as fans packed into pubs and homes to watch the games. In both England and Scotland, the number of new cases increased noticeably a week or two after the respective teams’ first games, only to reverse a few weeks later after each team dropped out.

Scotland’s team was eliminated early on. However, in England, which advanced to the final, the watch parties lasted until July 11.

The timing of the subsequent peaks is exactly what epidemiologists would expect if crowds gathered to watch the games were a major driving force behind the Delta waves. “It takes two weeks for an unequivocal signal to appear in the data,” Paul Hunter, an epidemiologist at the University of East Anglia in the United Kingdom, told BuzzFeed News.

Unlike previous surges in the UK, cases were overwhelmingly male, reflecting the demographics of those who watched the games. A new study from Public Health Scotland supports the notion that the UK’s pronounced Delta peak was largely caused by a breakdown in social distancing during tournament watch parties. According to the researchers, “at its peak, more than half of the cases reported in Scotland either attended a EURO 2020 event or were close contacts of someone who had attended.”

The majority of those infected were young and did not become seriously ill. This, combined with the UK’s rapid progress with vaccination in recent months, meant that the peak in hospitalization was less than a fifth of what it was in January, at the peak of its wave with the Alpha variant. While COVID deaths have increased slightly, only about 90 people per day are dying from the disease in the UK today, compared to more than 1,200 at the peak of the Alpha wave.

The rapid turnaround in UK cases has surprised some experts, who expected infections to skyrocket following “Freedom Day” on July 19, when Prime Minister Boris Johnson lifted the last remaining coronavirus restrictions in England, allowing pubs and restaurants to operate normally and eliminating all mask requirements.

While disease modeler Neil Ferguson of Imperial College London predicted that new cases could reach 200,000 per day, the seven-day rolling average of new cases peaked at fewer than 50,000 per day around Freedom Day before falling. The drop in the number of cases appears to have leveled off in recent days, and it is unclear where the UK’s Delta wave will go from here.

The Netherlands is the other European country with a clear rapid rise and fall in cases. Cases began to rise about 10 days after the Dutch government lifted almost all remaining coronavirus restrictions on June 26. “It was really a peak of cases among young people,” said Tom Wenseleers, a biostatistician and evolutionary biologist at Belgium’s Catholic University of Leuven. As in the UK, this did not result in a significant increase in hospitalizations or deaths.

Nonetheless, the country abruptly reversed course on July 9, closing nightclubs and restricting bars and restaurants to assigned seats 1.5 meters apart. “The majority of infections have occurred in nightlife settings and large-group parties,” the Dutch government said in a statement announcing the new restrictions.

Within two weeks of the new restrictions, the Dutch Delta wave peaked. If the rapid turnaround was caused primarily by the closure of nightclubs, it sends another encouraging message that the Delta variant can be contained through more subtle behavioral changes rather than a total lockdown.

“The United Kingdom and the Netherlands should be a source of hope,” Bill Hanage, an epidemiologist at Harvard T.H. Chan School of Public Health, told BuzzFeed News. “We don’t have to be pessimistic about the Delta variant.”

Hanage is not alone in believing that, in the face of the Delta variant, simple precautions such as wearing masks in public indoor spaces and avoiding large gatherings can make a significant difference.

“We see these kinds of turnarounds when behaviors change, with or without official policy changes, in a way that protects you from infection,” Meyers said.

Delta waves and COVID vaccination in US states

So far, states with lower vaccination rates have had more severe Delta waves.

In the long run, increasing vaccination in areas where few people have received shots remains the best hope for defeating the Delta variant in the United States. However, while vaccination rates are increasing most rapidly in states experiencing the most severe Delta surges, there is still a long way to go — and people who get their first shot today will not have strong protection for several weeks.

When asked what the US needs to do to combat its Delta waves at a White House press briefing on Thursday, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, backed the idea that controls that have helped reverse previous surges will work again.

“You do it right now in the immediate sense by mitigating,” Fauci explained. “Mitigation is the kinds of things you’ve heard from the CDC recommendations, such as masking and avoiding crowded situations where the virus has a greater ability to spread.”

“Vaccination is the ultimate goal of all of this,” Fauci added. However, he believes that if the United States can reduce spread in the short term while increasing vaccination rates in the long term, “we will turn the Delta surge around.” That is something I can assure you will happen.”

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Europe's Delta COVID Surges Show It Can Be Controlled