“We’re at the leading edge of what’s likely to be a very large pandemic surge, and that is due to the dominance of the delta variant,” said Dr. Richard Williams, Virginia Department of Health district director for the Three Rivers District.

“Cases have been increasing over the past couple of weeks fairly dramatically and it looks like they’ll continue to do so for some time.”

The delta variant is a different beast than previous coronavirus variants, and it has Williams very concerned.  

The viral load in delta COVID is thought to be 1000 times higher meaning infected people put out 1,000 times more virus particles into the environment making the virus easier to catch, explained Williams.

One of the worrying issues with delta COVID is there are a lot of unknowns, and it appears to behave differently than previous variants.

The CDC ranks transmission in localities in four categories: low, moderate, substantial and high. Currently, the entire Northern Neck is at a level for concern. Transmission in Northumberland and Westmoreland is substantial, and in Lancaster and Richmond County it’s high.

As more people consider returning to work and the new school year approaches Williams provided insight on the situation.

Is the delta variant common in the Northern Neck?

Delta is dominant across Virginia now. The vast majority of cases, including in the Northern Neck and the Three Rivers District are now caused by the delta variant.

We’ve had a large uptick in cases over the past several weeks. I mean very large.

If you get COVID-19 the safest assumption is you’re probably dealing with the COVID delta variant.

Are vaccinated people getting infected?

Although the hospitalizations and serious disease occur mostly among unvaccinated people, one of the bad things about delta COVID is it can infect people who have been vaccinated, and it looks like they can give it to others, he said.

How many vaccinated people are getting infected with breakthrough transmissions?

VDH is collecting that data.

It’s also really important to get a sense of people who are vaccinated, get the disease, and transmit it to others. It was thought with previous variants that that was very unlikely because the viral counts were so low. But with this variant, the counts are higher. So it’s very likely that vaccinated people can transmit the virus to others.

That’s why the CDC made the recommendation that in areas of substantial and high transmission everybody should be wearing masks. Unvaccinated people should be wearing masks--period.

Is the delta variant a risk for children?

Kids can definitely catch it, and they are getting sick.

Is the delta variant a greater risk for children?

Because of the large number of cases, it’s hard to tell if pediatric cases are going to go up with the rest of the population. It’s not clear yet if a higher percentage of kids will get infected and get hospitalized and have really bad health outcomes.

That experience and evidence base is evolving now in places like Louisiana. They are having a lot of kids in hospitals, so we have to watch that carefully.

In cases where children are getting infected, are they mostly in households with vaccinated or unvaccinated family members?

The percentage of cases involving vaccinated people transmitting to kids is data that is evolving. I think it’s premature to try to put a number on that. We’re going to get to that number.

Should students be wearing masks?

The CDC recommended that everybody in the pre-K through 12th grade environment do universal masking, especially with delta. That’s something I certainly agree with, said Williams.

What else should schools and child servicing businesses do?

We learned last year with all the mitigations in places—masking , social distancing, hygiene,etc—that we could stay in school safely. There were only a few cases here and there.

With the delta variant we don’t have much experience and we’ve had a lot of trouble with delta variant causing outbreak among kids at camps, bible camps, etc. And plenty of kids went to the hospital at the national level.

Because delta COVID is so transmissible health officials very firmly recommend that all mitigation be used. And still, its going to be very difficult to keep everyone safe in schools.

What is the vaccination rate for 12 to 18-year-old age group?

Our youth vaccinations have gotten off to a slow start. Sometimes vaccination rates are tied to how much danger people perceive. So, at the end of last school year, case rates were down and the situation looked well. We were at low transmission rates.

We offered vaccination events, but we only had about 15% of kids take it. To date, about 29% of youth 12 to 19 in the health district have had at least one COVID shot. But we’re in a different place now, and I think that’s going to pick up.

Some schools are expressing interest in holding vaccination events.

Is in-person learning worth the risk?

It’s important to try to keep kids in school. It’s a recommendation from the CDC, and I certainly agree wholeheartedly with that.

What’s the logic behind easing state guidance to allow a masked student who comes into contact with another infected masked student to stay in school but requiring a masked teacher who comes in close contact with a masked infected student to quarantine?

The thought has been that since children have less ACE-2 receptors, which is what the coronavirus binds, children likely carry lower viral loads and are less likely to transmit the virus.

“So kid-to-kid, fully masked, there’s two risks there to consider. The risk of the virus and the risk to the child of not being in the school and falling behind in education, socialization, and everything else. There a lot of risks of being out of school. When you do the risk-balance equation, the risks of being out of school are higher.  

Adults are a different story” because you can substitute a teacher. So, in that case the virus risk dominates.

But with the delta variant I’m not sure how that may change, said Williams.

With so much focus on how many people have gotten a single shot, is the message from health authorities still that people need get both doses?

Absolutely.

And people need to understand that they need to get vaccinated as soon as possible because protection is not immediate.

If you get your vaccination today, your immune system will ramp over the next three to four weeks to the maximum potential for that one dose. The timeframe depends on whether you got Pfizer or Moderna.

Then, you get your second dose and you’re really not fully protected from that dose for another two weeks. So, if you get vaccinated today and get both doses, you’re looking six weeks to get to the levels where you’re really well protected.

Bottom line…

Whether you’re vaccinated or not, it looks like you can get Delta and you need to take action to protect yourself.

But vaccination is still extremely valuable and imperative. If you’re unvaccinated, you’re at a very much greater risk for serious disease and a bad health outcome.

The delta wave is coming and it’s going to peak in the not-too-distant future, said Williams.

Virginia Department of Health district director for the Three Rivers District, Dr. Richard Williams, weighs in on COVID concerns for the Northern Neck