Confused about COVID? Let's sort it out.

Over a year of disinformation creates climate where even clear messages get cloudy. The president turns to trusted pediatricians and others to boost vaccination rates among the resistant.

In this week’s edition, a summary of top COVID-19 news for the USA and a brief rundown on what each of us needs to know and do about COVID-19 now.

The news:

With new COVID-19 cases up about 10% in the past week and the fast-spreading delta variant now estimated to be causing up to half of new cases in some regions, President Biden Tuesday called on local doctors to help increase the number of young people getting vaccinated against COVID-19. Administration officials and First Lady Dr. Jill Biden will continue traveling the country promoting COVID-19 vaccination. The First Lady will participate in an event at a high school in Savannah, Georgia on Thursday. The vaccination rate there is under 40%, while COVID-19 transmission rates are increasing in the region.

The president said that the nation will reach his 70% target by the end of the week, and 160 million Americans will be fully vaccinated within a few days — half the nation’s population. However, the rate of vaccination among people under 40 remains low, especially in places where transmission and new case rates are high — and rising.

The White House also is boosting support for mobile vaccination clinics such as at worksites, sporting events and religious gatherings, in addition to other outreach to people who are not going on their own to get the free COVID-19 shots.

A few other items of note:

  • Portable HEPA filters can reduce viral transmission in conference rooms, a CDC study finds. This could make these devices reasonable alternatives to overhauling ventilation systems.

  • The language used in the patient information provided with the COVID-19 vaccines granted emergency use authorization in the USA is over-the-heads of almost everyone, a study finds. The researchers found that a reader had to be at least at the 10th grade reading level to understand most of the information, which had passive voice, complex words, long sentences or paragraphs and small print.

  • The delta variant is blamed for recent surges across Asia.

Clearing up confusion

As we have seen throughout the pandemic, self-proclaimed experts pop up almost everywhere. Some social media posts include what appear to be links to scientific papers or articles in credible news media outlets. Please dig deeper before acting based on anything. The science of COVID-19 is complicated, and there remains much that is unknown. Some of what we thought a few months ago has turned out to be wrong, and data from months ago has been eclipsed by mounds of new information.

Here are my answers to some questions I’ve been hearing over the past week or two. As always, I write these as an experienced medical journalist, not a physician or scientist. Please check with your own healthcare professionals for personal guidance.

If I got the J&J vaccine, should I be concerned?

The results of the Phase 3 clinical trial that showed 66-72% efficacy of the J&J vaccine has been a source of great confusion. What matters most is that the J&J vaccine was shown to be 85% effective at preventing severe illness after just one shot. The Pfizer and Moderna vaccines had only slightly better phase 3 results, and their clinical trials were conducted before more virulent variants were observed.

Should I get a booster shot to protect against the delta variant?

Almost all of the evidence so far indicates that all three vaccines being used in the USA plus the AstraZeneca vaccine in use elsewhere are highly effective against the delta variant. One new study estimates that a person fully vaccinated with any of these vaccines is 75% protected against delta, only slightly less than the 78% protection observed against the original COVID-19 virus. The study specifically looked at the Pfizer and AstraZeneca vaccines, but White House Chief Medical Adviser Dr. Anthony Fauci says that similar results would be expected from the Moderna and J&J vaccines, since the vaccine technologies are similar. The study also underscores the importance of getting both doses of the two-dose vaccines - the odds of getting COVID-19 are at least three times higher among those who only get one of the two doses.

What about getting a booster shot with a different vaccine?

A respected Canadian virologist said she was getting one of the mRNA vaccines as a booster after getting the J&J shot awhile back. Other experts say there simply is not enough evidence to support this, nor is there reason to think the J&J shots are ineffective. The Los Angeles Times put all of this into perspective in this article. There’s more in the Washington Post, too.

Different health authorities have said different things about wearing masks indoors. What should I do?

The confusion here stems from the challenge of making sweeping recommendations that apply around the world. The WHO went the cautious route, suggesting that masks indoors remain a good idea. Los Angeles County’s health director made this recommendation, too, based on the rapid increase in delta variant cases in the area. But state and federal authorities disagree, repeating their assurance that fully vaccinated individuals need not wear masks indoors.

For most people, confidence that any of the COVID-19 vaccines protects us sufficiently is reasonable. However, based on my interpretation of the guidance and data, I would wear a mask if I go into an indoor public place in an area where delta variant cases have been observed. I would also wear a mask if attending a crowded outdoor event in such an area. Elsewhere, no mask needed.

Should I change my travel plans because of the delta variant?

If you are fully vaccinated, you are reasonably safe going almost anywhere. However, if you go to an area where there is significant community transmission and low vaccination, you certainly have somewhat higher risk of COVID-19 exposure. The vaccines are outstanding and nearly 100% protective against severe illness or death. However, you increase the odds that you could become one of the 5% or so of people who get mild COVID-19 even after vaccination. In other words, avoid areas with high transmission and low vaccination, and if you do go to such places, maybe wear a mask.

Do you have questions — or answers?

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