COVID-19 Update: Active Cases, Hospitalizations Continue to Drop

A health care worker administers COVID-19 vaccine at a vaccination event in March

“So I’m going to say some things that are pretty obvious, but sometimes they need saying, because there are people out there who seem not to have gotten the message,” says Dr. William Schaffner. “The first thing is, COVID is real. It is a really bad virus, and the latest variant of this virus, the Delta strain, is just extraordinarily contagious. And the contagiousness of this Delta variant is what has brought all of this to the fore again.”

The infectious disease specialist and Vanderbilt University School of Medicine professor is speaking to the Scene near the end of July, a month that has seen the resurgence of a pandemic we might’ve been tempted to declare over. New cases of COVID-19 have risen to levels last seen in the spring, and hospitalizations have more than tripled. Some rural counties are now reporting that more than 20 percent of people who get tested for the virus are infected.

At a recent media briefing, Tennessee Department of Health Commissioner Dr. Lisa Piercey said the so-called Delta variant of the virus is now the dominant strain in the state. Although small numbers of vaccinated people have become infected and can spread the virus, it’s spreading rapidly among unvaccinated Tennesseans — a demographic Schaffner likens to an “interstate highway of transmission” — which is most Tennesseans. As of this writing, less than 40 percent of the state’s residents are fully vaccinated. Piercey noted that 98 percent of the people who have died in the ongoing wave were unvaccinated. There are indications that even low vaccine rates and a shift toward more infections occurring in younger people will mean fewer people die as a result of the ongoing wave, but the wave itself is currently showing no signs of slowing.   

“It will continue to spread,” Schaffner says. “Unvaccinated people will continue to have to go to the hospital, and some of them, I’m afraid, will succumb to this virus.”

The best path forward, public health officials agree, is vaccination. That approach has been hampered in large part by some right-wing elements in the state who, if not anti-vaccine, are at least resistant to pro-vaccine messages. The state’s health department is only just emerging from a controversy that saw national attention trained on Tennessee. After state Republicans seized on vaccination materials targeted at teenagers, the head of the department’s vaccine program, Dr. Michelle Fiscus, was ousted and the agency signaled a retreat from vaccine outreach to teens altogether. Now, although Fiscus’ firing still reeks of politics, the clouds appear to be lifting as it relates to the department’s approach to vaccines. Piercey said at her recent briefing that after a “brief pause” the department would resume its efforts, focusing on targeting its communication to parents. She also reiterated that vaccines are the best way to protect oneself against COVID-19, including the Delta variant.

The struggle for public health officials then is to break through the vaccine hesitancy — whether it is fueled by good-faith concerns or misinformation — that has kept the state’s uptake stubbornly low. 

“People who are unvaccinated have a whole series of reasons to be concerned, to be hesitant,” Schaffner says. “I respect all of those folks, I respect their reasons. But there’s an answer to each one of their questions. The only issue I haven’t been able to answer is, ‘I’m grumpy, and I’m not going to do it.’ ”

We are effectively witnessing a large-scale test of how the vaccine performs against the virus. And although there are some breakthrough cases, in which a vaccinated person gets infected, the results could hardly be clearer: Unvaccinated people are more likely to become infected, more likely to spread the virus to others, and more likely to be hospitalized or die from the illness. 

One notion Schaffner says he’s encountered often is the idea that people who have already been infected with the virus and recovered — of which there are more than 800,000 in Tennessee alone — might not need to be vaccinated. But the recommendation from the Centers for Disease Control and Prevention is that even people who have recovered from the virus should still get vaccinated. Schaffner explains why.

“As it happens, this has now been well-demonstrated — the vaccines provide more antibody in your bloodstream, more protection, than does the disease itself,” he says. “Why is that important? Here are the two reasons: Number one, more antibody is usually associated, with what we know about all other vaccines, with a longer duration of protection. And more important, given the current circumstance, higher levels of antibody seem to permit you to fend off the variants more successfully.”

Another common concern, Schaffner says, is about potential negative long-term effects of the vaccines. Schaffner says it’s a “perfectly reasonable” concern for a layperson to have, but one that’s ultimately not supported by our experience with vaccines.

“We’ve been doing this now, for many of these vaccines, for 30, 40, 50 years,” he says. “None of those vaccines have any long-term effects that show up, two years, four years, five years or eight years later. None of them. There’s no such thing as a long-term effect that shows up — you get vaccinated today and four years down the road you’re going to have some sort of adverse event. That doesn’t exist. You can’t find that in a medical textbook. And so there’s no reason for that to happen with a COVID vaccine either.”

COVID-19 and its variants are part of our world now, Schaffner says. But we can minimize the suffering and death associated with it. 

“We talk about trying to stop the pandemic, but that doesn’t mean the virus is going to be gone,” Schaffner says. “No, it’s part of our life now around the world, and we’re going to have to cope with it the way we cope with influenza. We can do a better job with influenza, and we surely can do a much better job than we’re currently doing with COVID. But we all have to participate in this. It’s important for ourselves and important for everyone around us.”

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