This NY Times article is a decent assessment of the Delta variant:
Good morning. Covid cases are rising in Britain — and U.S. trends may soon follow.
The Delta danger
Britain has had one of the world’s most successful Covid-19 responses in recent months.
Unlike the European Union, the British government understood that quickly obtaining vaccine doses mattered more than negotiating the lowest price. Unlike the United States, Britain was willing to impose nationwide restrictions again late last year to reduce caseloads. British officials also chose to maximize first vaccine shots and delay second shots, recognizing that the strategy could more quickly reduce Covid cases.
Thanks to these moves, Covid has retreated more quickly in Britain than in almost any other country. Fewer than 10 Britons per day have been dying in recent weeks, down from 1,200 a day in late January. On a per-capita basis, Britain’s death rate last month was less than one-tenth the U.S. rate.
Despite this success, Britain is now coping with a rise in Covid cases. The main cause appears to be the highly infectious virus variant known as Delta, which was first detected in India. Britain’s recent moves to reopen society also probably play a role.
The increase is a reminder that progress against the pandemic — even extreme progress — does not equal ultimate victory. Britain’s experience also suggests that cases may soon rise in the U.S. “What we’re seeing in U.K. is very likely to show up in other Western countries soon,” The Financial Times’s John Burn-Murdoch wrote.
How bad is it?
Relative to where Britain was in January, the recent increase in Covid cases is tiny:
But there is still cause for concern. As small as it may look on that chart, new Covid cases have more than doubled over the past month, to more than 4,000 a day from about 2,000 a day.
Pandemics feed on themselves, in both directions. When new caseloads are falling, it increases the chances that they will continue to fall, because fewer newly infected people are able to spread the virus to others. When caseloads are rising, the opposite occurs.
With about 40 percent of Britons still having not received a vaccine shot, the recent increase has the potential to get significantly worse. The country is at a “pivotal moment,” as Dr. Chaand Nagpaul of the British Medical Association told the BBC.
Will deaths rise?
Fortunately, the current surge is almost certain to cause less death than previous outbreaks, because most people vulnerable to serious illness have already been vaccinated. About 90 percent of Britons 65 and older have received both shots. And the vaccines continue to look effective against the Delta variant, researchers say.
For now, deaths have barely risen, and it’s possible that they will not rise much; the Covid death rate for people under 40 has been very low. But it is too soon to know. Covid death trends typically trail case trends by a few weeks. If the Delta variant ends up being significantly more severe, it could cause an increase in deaths.
“There are reasons to be hopeful — we’re not seeing a big trend in hospital admissions — but it’s early days,” James Naismith, who runs the Rosalind Franklin Institute, a research center, told The Times. “If we don’t see anything by June 14, we can exhale.”
British officials are debating whether to stick to their earlier plan to remove all activity restrictions on June 21 or push back that date.
First shots vs. second
One unknown about the vaccines is the ideal delay between the two shots (for those vaccines that require two, as most do). The U.S. staggers the shots by only a few weeks, while Britain has made people wait up to 12 weeks for the second one. Overall, Britain’s strategy appears to have worked better.
But the Delta variant is adding a wrinkle. Data suggests that it is more contagious than the original virus and more likely to infect people who have had only one shot.
I have noticed some confusion on social media and in news accounts about what this means. It does not necessarily mean that Britain’s strategy has been a mistake. Obviously, two shots are better than one for every version of the virus. Yet that’s not the choice countries face.
The choice they face is which to prioritize: first shots or second shots. Any dose given as a second shot is unavailable to be given as a first shot, and vice versa. The evidence continues to suggest that first shots make a bigger difference than second shots, including for the Delta variant, Jennifer Nuzzo, a Johns Hopkins epidemiologist, told me.
But the Delta variant does call for some changes in Britain, many scientists say. The country is accelerating second shots for vulnerable people. And people who have received only one shot should not behave as if they are vaccinated, said Devi Sridhar of the University of Edinburgh.
Three U.K. lessons
I see three main lessons from Britain’s recent rise in cases:
One, vaccines are still the most effective way, by far, to defeat this terrible pandemic. Nothing matters more than the speed at which shots go into arms — in Britain, in the U.S. and especially in poorer countries, where vaccination rates are still low.
Two, behavior restrictions can still play a role in the interim. If hospitalizations or deaths in Britain rise over the next two weeks, there will be a strong argument for pushing back the full reopening of activities. And that has obvious implications for the U.S., too. Restricting indoor activities for unvaccinated people is particularly important.
Three, caseloads are no longer as important a measure as they used to be. Before the vaccines were available, more cases inevitably meant more hospitalizations and deaths. Now, the connection is more uncertain. As a recent Times story put it, paraphrasing British scientists, “upticks in new infections are tolerable so long as the vast majority do not lead to serious illness or death.”
Over the next couple of weeks, I promise to to keep you updated on Britain and the Delta variant.