Delta and Beyond: What Variants Mean for the Fully Vaccinated

It's unclear how many people need to be vaccinated to avoid this outcome — estimates range between 70 and 90 percent of the population. Currently, about 50 percent of the entire U.S. population is fully vaccinated.

Variants could bring back some restrictions

It's unlikely the U.S. will see a new wave of lockdowns like we experienced in 2020, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said — even as the delta variant rips though communities across the country. But some familiar restrictions could return if cases continue to surge.

Several cities, counties and businesses are once again requiring masks indoors, following new research that suggests vaccinated people who are exposed to the delta variant can become infected and unknowingly pass the virus on to others, including unvaccinated children and people who are immunocompromised. Even in the absence of mandates, health officials are recommending that people who are fully vaccinated mask up in areas where community transmission is deemed high or substantial. (You can check your area's status on the CDC's website.)

And with delta surging, you may want to consider a mask upgrade, says Luis Schang, a virologist and professor of chemical virology at Cornell University. He recommends a surgical mask, which he says is both effective at blocking virus transmission and more comfortable than the gold-standard N95. “They strike a good balance in between the ease of use and protection,” Schang says.

Wearing a surgical mask under a cloth mask can help improve the protection offered, the CDC says. Knotting the ear loops of your surgical mask also ensures a snugger fit.

It's possible other mitigation efforts, such as physical distancing requirements and crowd limits, could creep back into daily life in areas hit hard by the summer spike. The same goes for travel restrictions, especially overseas. And if they do, Schang encourages patience and tolerance.

"It's up to us to win [the fight against COVID-19]. And we definitely have the tools,” Schang says. “Let's try to be proactive to use the least disruptive measures like getting vaccinated and wearing face masks in order to try to avoid more disruptive measures.”

Fall could get ‘very ugly’

Reports of overwhelmed hospitals are starting to make headlines again in areas where vaccination rates are low and prevention efforts are lax. And all of it is happening right as the country heads into cold and flu season, which by itself can stress the health care system.

Last year's flu season was essentially nonexistent, and experts say all of the efforts put in place to slow the spread of COVID-19 (face masks, distancing, school and office closures, reduced travel, etc.) are the reason why we saw so few influenza cases. But many of those efforts have been scaled back, and routine illnesses are starting to pick up.

Cases of RSV (respiratory syncytial virus), a common respiratory virus that can be especially dangerous for babies and older adults, are on the rise, CDC data show. Others are “roaring back to normal or even above normal” as well, Lawler says. And when you add COVID-19 to the mix, making sure the health system doesn't get clobbered is “going to be a bigger challenge this fall than it was last year,” Lawler predicts.

Add to it the fact that schools are returning for in-person learning this year. Health officials are recommending that everyone in schools, regardless of vaccination status, wear a mask to help prevent the spread of COVID-19 and to protect younger children who aren't yet eligible for the vaccines. However, not all schools are requiring them.

"So it's going to be, unfortunately, a very ugly fall across much of the country,” says Lawler, who adds that communities with higher vaccination rates will likely “do much better” than those where rates remain low.

"We're probably going to see a combined epidemic wave of COVID, plus influenza, plus parainfluenza, plus RSV — all of the other fall and winter respiratory viruses that we usually see, but actually had very low rates of last year,” he adds.

Variants could outsmart vaccines

While much of the focus remains on delta, researchers are keeping a close eye on other circulating variants, including lambda, which originated in Peru and is responsible for about 1,000 cases in the U.S.

So far, experts are “not yet really worried” about lambda being more contagious than delta, which is about twice as contagious as the other variants, Francis Collins, director of the National Institutes of Health, told ABC's George Stephanopoulos on Aug. 8, “but [it] needs to be looked at.”

Scientists and health officials are also studying how the emerging variants stack up against the current crop of vaccines. “So far, so good,” Collins said. “We don't have anxieties yet about delta or lambda or any of the others that are sort of lurking out there. But we all worry about the day when a variant arises that is so different from the original Wuhan virus, that basically the vaccines stop working as well.”

The best way to avoid that scenario? “Get as many people vaccinated as quickly as we possibly can” before the virus has a chance to mutate into a more menacing version, Fauci said in a recent news briefing.

"It's no question that the vaccines are our answer to get out of this mess if we can get enough people to take them,” Lawler says.

Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.