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“Delta changes the game. It is about 200 percent more contagious than the original COVID, and is as contagious as chicken pox,” continued Jetelina. “One person will infect eight others. The viral load is 1,000 times more, which means people are shedding a ton more of the virus. You are contagious for 18 days when contracting the variant.”
She said that vaccines previously reduced contracting the virus by 90 percent, but with this variant it only reduces transmissions by 20 percent. People need to wear masks to reduce the spread. “The number one mask is the N95 mask (which is now readily available). Being double-masked, (i.e. cloth over surgical mask) reduces exposure by 83 percent. The least effective is the cloth mask, which reduces exposure by 40 percent.”
Booster shots have been recommended to start in September, she continued, saying that the first two doses were too close together, and that is why boosters are needed now. “Doses are most effective if they are six months apart.”
Immunocompromised individuals are authorized to get boosters first. “Hopefully this peak will be in fall.” She urged everyone to stay informed by following her on https://yourlocalepidemiologist.substack.com/.
Kaatz described COVID and the effects in the lungs: Microthrombosis and COVID infection causes pulmonary edema, which makes it harder for oxygen to get through the aveoli or air sacs. The capillaries around the aveoli allow oxygen to get into the blood stream. This virus inflames and injures those blood vessels, thus patients die because they can’t get enough oxygen.
He noted that a new trial, which is being published and available online August 27, compares high- and low-dose therapeutic anticoagulation.
Valentino moderated questions from the audience. The first was addressed to Jetelina concerning COVID and students returning to school.
“Data on masking makes a difference in schools,” she answered. “A study came out this week that showed masks made an eight-fold difference in spreading the virus. When combined with air filters, this goes to 30-fold.”
Kaatz added that if those who are immunosuppressed are at risk. The more chronic diseases present, the more susceptible to infection and the greater the risk.
Next, Jetelina told the viewers that even after getting a third (booster) vaccine, everyone still needs to be vigilant and wear a mask. The Delta variant is showing to be more severe among adults.
“The first wave of COVID attacked many older adults, but they were the first to be vaccinated; now the age has clearly shifted,” Kaatz said. “October is scaring me. All the unvaccinated patients are going to end up in the hospital, and I don’t want to go back to doing rounds in a parking lot.”
Concerning children going back to school, Jetelina said it is important that kids are in school and have structure and socialization. “But masks, social distancing, and ventilation need to be in place. Kids transmit the disease at the same or higher level as adults. We need to work together to end this pandemic.”
Valentino said unfortunately there is no research specific to COVID-19 for people with bleeding disorders and disease prevalence. The management issue, however, is the problem. There is no reason to get one vaccine over another if you have a bleeding disorder.
For more information, please visit NHF’s FAQs on COVID-19: https://www.hemophilia.org/news/covid-19-vaccines-and-bleeding-disorders-frequently-asked-questions-faqs ■