En español | While cases of COVID-19 have fallen significantly since the beginning of the year, the coronavirus is still circulating in the U.S. And a new strain is gaining a foothold.
All viruses mutate and they mutate often, says Andrew Pekosz, professor of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health. But when a mutation causes a virus to change its behavior — maybe the virus becomes more contagious or more lethal than previous versions — it gets classified as a variant.
Delta — the World Health Organization (WHO) names coronavirus variants after Greek letters — is the latest variant of concern in the U.S. Here's what you need to know about it.
1. Delta is spreading quickly
One thing that sets the delta variant apart from other coronavirus strains is the speed at which it's spreading. In just a few months’ time, the delta variant went from being nonexistent in the U.S. to now making up the majority of new COVID-19 cases, according to data from the Centers for Disease Control and Prevention (CDC). In some areas of the country, it's responsible for nearly three-fourths of new infections.
It's a pattern that's played out in other countries, as well — most notably India, where delta was first identified, and the United Kingdom, where it is also the dominant variant. “As soon as [the delta variant] enters a country, it starts a real upward trajectory and eventually becomes the dominant virus, or at least the majority of virus circulating in that country,” Pekosz says. “So that’s telling us that there’s something about this virus that’s making it better to transmit in the population, because it’s given [other variants] a head start, and it‘s still able to catch up and overtake them in terms of the numbers of infected people.”
2. Delta may cause different symptoms
Some reports suggest that the delta strain could cause different symptoms than other variants. A U.K. study that tracks COVID-19 symptoms through an app, for example, reported a change in the top-ranked symptoms since delta starting dominating.
Cold-like symptoms, including headache, runny nose and a sore throat, now top the list in the ongoing study, while more traditional COVID-19 symptoms — loss of smell, shortness of breath, fever and persistent cough — have since moved down. And doctors in the U.S. are noting a similar trend, especially in areas that have some of the highest rates of delta cases, NBC News reports.
One possible explanation for the shake-up in symptoms: Younger people are less likely to get severe disease from a coronavirus infection than older adults, says Lisa Gralinski, an assistant professor of epidemiology at the University of North Carolina's Gillings School of Global Public Health. They are also less likely to be vaccinated. About 78 percent of Americans 65 and older are fully vaccinated, whereas about 8 percent of 18- to 24-year-olds and about 20 percent of 25- to 39-year-olds are fully vaccinated.
Then there’s the question of whether the new set of symptoms is “something that's more intrinsic to this variant that's on the rise,” Gralinski notes. “I don't think we have enough information to really know that yet.”
3. The variant could be to blame for severe disease in some communities
There isn't solid evidence to suggest that the delta variant is deadlier than other coronavirus strains, says Wafaa El-Sadr, M.D., professor of epidemiology and medicine at Columbia University. But CDC Director Rochelle Walensky suggested in a July 1 briefing that the variant may be to blame for a surge in hospitalizations in some communities with low COVID-19 vaccination rates.
New COVID-19 hospital admissions increased slightly in the U.S. between the week of June 16 and the week of June 23, CDC data shows. Spikes were especially noticeable in regions where the delta variant is circulating more widely.
4. COVID vaccines provide strong protection against delta
The delta variant “evades a little bit of the immune response that's generated after vaccination,” Gralinski says. Even so, it’s no match for the authorized vaccines, which experts say provide a high level of protection against delta and other variants circulating in the U.S.
Variants of concern in the U.S.
- Alpha (B.1.1.7)
- Beta (B.1.351)
- Gamma (P.1)
- Delta (B.1.617.2)
These variants seem to spread more easily than other coronavirus strains, according to the CDC. And ease of transmission may lead to more cases of COVID-19, which will put more strain on health care resources and lead to more hospitalizations and potentially more deaths, the CDC says.
Pointing to a handful of new studies, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a recent briefing that after both doses, the mRNA vaccine from Pfizer-BioNTech is about 80 percent effective at preventing infection from the delta variant, 88 percent effective at preventing symptomatic disease and 96 percent effective at preventing hospitalization caused by delta. New data out of Israel, however, shows lower rates of effectiveness — around 64 percent protection from infection and 93 percent protection from serious illness and hospitalization. (Moderna's vaccine also uses mRNA technology and has shown similar rates of overall effectiveness to the Pfizer-BioNTech in previous studies.)
The key to this protection, however, is full vaccination, Pekosz says. “If you've only gotten one of your mRNA shots, that’s where you can really see the delta variant being able to evade some of those immune responses,” he says. In fact, one dose of the two-dose mRNA vaccines was found to be only 33 percent effective at preventing symptomatic disease caused by the delta variant in a preprint study out of the U.K.
"So if you've got a good strong immune response generated by both doses of the mRNA vaccine, then you should be in a good place,” Pekosz says. “But if you're only partially immune — if you're in between doses or if you take in the first dose and you decide to skip the second dose — then you're in an area where the vaccine may protect you against older strains, but it may not be enough immunity to protect you against the delta variant.”
Johnson & Johnson released a statement on July 1 noting that its one-shot vaccine “generated strong, persistent activity against the rapidly spreading delta variant and other highly prevalent SARS-CoV-2 viral variants.” The studies containing this data are currently being submitted for publication. Hours before J&J's announcement, Fauci said it's reasonable to assume the effectiveness of J&J's vaccine is on par with AstraZeneca's vaccine, which uses the same viral vector technology. The AstraZeneca vaccine, which isn’t authorized for use in the U.S., has been shown to be 60 percent effective at preventing infection and 92 percent effective at preventing hospitalization caused by the delta variant.
Experts will be keeping a close eye on the strength and duration of these vaccines — especially in more vulnerable populations. Pekosz doesn't see the need for a national booster campaign yet but says it's not outside the realm of possibilities that “highly vulnerable populations might be asked to go in and take a booster that consists of the delta variant or maybe the next variant that comes by, just to make sure that they're maintaining that level of immunity.”
5. You may still want to keep your mask handy
Fully vaccinated individuals no longer need to wear a mask in most situations, according to CDC guidance issued in mid-May. But experts say you may want to keep one handy — especially with delta on the tear.
The reason? No vaccine is 100 percent effective at preventing infection or illness, and with a highly transmissible virus gaining traction in a number of communities throughout the country, a little extra caution makes sense, Pekosz says: “If you know you're in a situation where you'll be coming in contact with people who might be carrying the virus, it's always best to have another layer of protection, like a mask or some level of social distancing.”
Los Angeles County recently recommended that its residents, regardless of vaccination status, wear masks in indoor public settings “until we better understand how and to who the delta variant is spreading.” The area has seen a surge in new COVID-19 cases, likely attributable to delta.
Timothy Brewer, M.D., a professor of medicine and epidemiology at the University of California, Los Angeles (UCLA), says there's no good evidence to suggest that vaccinated individuals need to mask up when they're outside, but it's “probably reasonable to consider wearing a mask when you're indoors and around lots of other people, particularly if you can't physically distance.” He still wears a mask at the grocery store and says he would do the same if he were going to a large indoor event “like a concert or a movie theater.”
It's unclear whether other communities will follow L.A. County and issue new mask guidelines. In the meantime, experts say, pay attention to what's happening in your area. If vaccination rates are high where you are, there's less of a risk. “The more you're exposed to people who are unvaccinated, that possibility of getting infected increases,” El-Sadr says.
Keep this in mind, too, as you travel this summer — especially considering that more than one-third of U.S. counties have vaccination rates under 30 percent, according to CDC data.
"If the risk increases, why not do something to help mitigate that risk? Mask wearing is an easy” solution, Pekosz says.
6. Delta won't be the last variant to pop up
Not only does vaccination help prevent infection and illness from the delta variant and others out there (there are currently four “variants of concern” circulating in the U.S.), but vaccination also helps to keep new and potentially more dangerous variants from popping up.
That's because every time the virus jumps to a new person, its chances of a mutation increase. “But if we break the cycle of transmission and decrease the number of infections in a community, that is the best defense against the evolution and the development of these new variants,” El-Sadr says.
7. Be vigilant, not alarmed
While the delta variant’s rise to dominance is concerning, “there's no reason to be alarmed,” El-Sadr says — especially since the vaccines can protect people from infection and prevent serious illness. “That's important. I don't want people to be absolutely panic stricken about this,” she adds.
The advice of experts: Get vaccinated if you haven't already, and if you're holding out on your second shot in a two-dose series, go back and complete it. Also, if you're sick, stay home — even if you are vaccinated, UCLA's Brewer says. “And remember to wash your hands after you're been out and try to maintain your physical distancing.”
Finally, “use your judgment,” El-Sadr says. “If you're in a crowd that makes you feel uncomfortable, especially when you don't know whether people are vaccinated or not, it's prudent to put a mask on to protect yourself.” Doing so will also protect others around you, should you get infected and unknowingly pass it on, El-Sadr adds.
Editor’s Note: This article, originally published July 2, 2021 has been updated to reflect new information.
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.