Delta variant thought to be cause of jump in Ohio cases

By CALLAN PUGH 

City editor 

COLUMBUS — The Delta variant of COVID-19 is continuing to concern health officials as cases continue to jump in Ohio according to Ohio Department of Health Chief Medical Officer Dr. Bruce Vanderhoff. Vanderhoff has been appointed and will take over as director of the Ohio Department of Health starting Monday. He spoke Thursday in a streamed press conference about coronavirus in Ohio. 

“We’re continuing to see a troubling increase in COVID-19 cases statewide, with more than 2,300 new cases reported yesterday (Wednesday) alone, as well as a sharp increase in our case rate per 100,000 residents — which is rapidly climbing toward 200 after having been as low as just 17.6 cases per 100,000 residents as of July 7,” Vanderhoff said. 

He noted that data on case rates over time, which had been archived as part of the Ohio Public Health Advisory System will be added back to coronavirus.ohio.gov website to allow for easier tracking of the numbers. 

“We’re also seeing an increase in hospitalizations, ICU admissions and in ventilator use — and as you can imagine these are in use by not just COVID-19 patients but by many other diagnoses as well,” Vanderhoff said. “While we have substantial hospital and ventilator capacity remaining here in Ohio, we nevertheless have heightened concern as reports emerge from states that hospitals there are beginning to turn away elective procedures and face real pressure on their physical resources. We don’t want to see our hospitals here in Ohio facing such a scenario and continue to remind Ohioans that the best way to protect yourself from serious illness with COVID-19 is choosing to receive a vaccine.” 

Vanderhoff said the increases are largely related to the delta variant, which is now the dominant variant in Ohio. This is monitored through genomic sequencing conducted on PCR tests that have enough sample remaining after being run and a high enough viral load to make it fit for sequencing. 

“It’s a complex process and … it can take three to four weeks to get results, so there is some data lag,” Vanderhoff said. “However, for the most recent available period of July 18 through the 31, the delta variant … [has] made up nearly all of the samples sequenced. That means we can safely assume that any case we’re currently seeing in Ohio is almost certainly the result of the Delta variant.” 

Vanderhoff reiterated that the Delta variant is much more contagious than previous variants of COVID-19. 

“COVID-19 is now more contagious than the common cold or the flu,” he said. “The Delta variant also appears to be more dangerous than other variants. We now have data from Canada and Scotland showing that those infected with the Delta variant have a higher likelihood of needing hospitalization and from Singapore that there may even be more risk of pneumonia, ICU admission or death. Finally, it appears that the Delta variant may produce a significantly higher viral load than was seen with previous strains, meaning it makes patients sicker, quicker.”

Vaccines continue to provide “outstanding protection” that makes it highly unlikely a vaccinated person will end up hospitalized or dying from COVID-19, Vanderhoff said. He said vaccination rates still haven’t returned to peak levels but are showing an upward trend.

“In recent days, we’ve seen more than 10,000 Ohioans choosing to start the vaccination process daily and another 5,000 more completing their vaccine series,” Vanderhoff said. “This is all movement in the right direction. Statewide, we have more than 50% of Ohioans of all ages and more than 60% of adults who have started the vaccination process. This is so important. … They can help prevent dangerous variants from taking hold. We continue to encourage all eligible Ohioans to choose to be vaccinated.”

Vanderhoff addressed some reasons Ohioans may hesitate to get vaccinated including side effects, vaccine safety, waiting for FDA approval of the vaccines and others who are just waiting to see what happens.

Side effects: Vaccine verses the virus

Regarding side effects, Vanderhoff reiterated that all medicines come with some risks of side effects, but that some getting the COVID-19 vaccine have no side effects at all, and for the most part, side effects are mild, short in duration and like other vaccines. Common side effects include pain, redness and swelling at the injection site, pain or fatigue throughout the body, muscle aches, chills, fever or nausea.

“Rare individuals may encounter an allergic reaction, which comes on quickly and is very treatable,” Vanderhoff said. “There also have been rare reports of myocarditis with the MRNA vaccines — but again most of these patients respond well to treatment and rest.”

Myocarditis also is a much more common side effect of contracting COVID-19.

The Johnson and Johnson vaccine also has had rare reports of a clotting disorder known as TTS, Vanderhoff said, “but for the vast majority getting a COVID vaccine isn’t a lot different than getting any of our other vaccines and side effects tend to be both mild and short.”

“Now, compare that with the long-term effects of COVID-19,” Vanderhoff said. “The most severe and irreversible complication is death. Right now, more than 99% of all COVID-19 deaths in Ohio have been among those who aren’t fully vaccinated. Likewise, it can make people of all ages very sick — landing them in the hospital or ICU. More than 98% of our hospitalizations for COVID have been among those who have not been fully vaccinated.”

Vanderhoff also explained that COVID-19 can continue to cause issues long after the initial infection such as inflammation of blood vessels and organs, meaning for some COVID patients long-term damage to the lungs, kidneys, heart, brain and other organs and can cause blood clots and blood vessel problems.

Long haulers — patients who report lasting symptoms for months after the initial infection also have been seen. Symptoms can include difficulty breathing, tiredness and fatigue, brain fog and difficulty concentrating, a lasting cough, chest and stomach pain and more.

“Some people report that it takes quite some time for their loss of taste and smell even to return,” Vanderhoff said.

Vaccine safety

“Bottom line is that today, COVID-19 is essentially a vaccine-preventable illness with vaccines that are both very effective and very safe,” Vanderhoff said. “We know that people have questions about the safety of the COVID vaccines, especially because they are so new.”

Vanderhoff said while vaccines were brought to the public “remarkably fast” it wasn’t “corners that were cut, but red tape.”

“Clinical trials of these COVID-19 vaccines started in March of 2020, just as the World Health Organization was declaring COVID-19 a global pandemic,” he said. “All the normal safety steps were taken just like they have been in the past for vaccines we’ve come to rely on — like those preventing measles, mumps and whooping cough. But this time without long delays between stages due to bureaucracy or due to the need to mitigate business risks.

“And now for months, following FDA authorization, these vaccines have been closely monitored by the world’s most comprehensive vaccine safety program. As a result, with more than 352 million doses administered in the United States, we have a staggering volume of clinical and safety data showing that serious reactions after receiving the vaccines are incredibly rare.” 

Vanderhoff said the reason it is known that some serious reactions have occurred and how to treat them is because of the safety programs.

To those using a wait and see approach, Vanderhoff reiterated that COVID-19 is not the common cold, but a “nasty virus with potential for serious consequences.”

“I continue to hear heart-wrenching stories about those who are hospitalized or have died who could have been vaccinated but weren’t,” he shared. “Hearing stories from somebody’s deathbed wishing they’d been vaccinated is of course heartbreaking, but it’s also particularly difficult for their loved one and the frontline health care providers who are doing their best to save that person’s life. Vaccines save lives and getting the COVID-19 vaccine could be what keeps you out of the hospital.”

Vanderhoff also reiterated that a two-dose vaccine takes about five weeks to provide full protection.

“With fall and cooler weather right around the corner, now is the time to be vaccinated,” he said. 

View from the field

Chief of Infectious Disease for Wright State University, Dr. Steven Burdette, also joined Vanderhoff on the call. He said in November and December, the hospital was seeing mostly elderly patients, often from nursing homes. Now the demographics have changed drastically.

“Number one, it is, almost exclusively, our sick patients are unvaccinated,” Burdette said. “We do see an occasional vaccinated patient. In general [vaccinated patients] are on low amounts of oxygen, they might be here for other issues and happen to test positive, but our vaccinated patients in general are minimally to no symptomatic and are doing very well and stable from a COVID standpoint.

“Our COVID intensive care unit is full of patients who are unvaccinated. We do not have nursing home patients to any great degree. Now we have younger patients. … We’re seeing younger people and many of them don’t have a reason — this is not young people with cancer, this is not young people with HIV — this is young people who were working in a factory two to three weeks ago before they got COVID. The one risk factor that we consistently see is obesity. Many of our younger patients who are critically ill are overweight.”

Burdette, who has been an infectious disease doctor for almost 17 years, said COVID continues to be unlike any other disease he’s seen.

“Patients with significant COVID will be doing OK, doing OK, and then within 3-4 hours they will be on max amount of oxygen, and you’ll have to put them on a ventilator,” Burdette said. “It is a very rapid decompensation that you can’t necessarily predict who it’s going to happen to. A year ago, it was happening in our nursing home patients and now it’s happening to the young people.”

Burdette said there have been fewer instances of kidney failure with the current process as occurred last year, however lung issues still are prevalent.

“Last year we would have entire units on dialysis because the virus would affect the kidneys,” Burdette said. “But now because this is impacting, younger healthier patients who have younger and healthier kidneys, their kidneys at least are able to absorb the damage and inflammation from the COVID, but their lungs are not.

“The thing is, if you are young and healthy — if you get bad COVID and it affects your lungs, and you go on a ventilator — your chances of coming off the ventilator unfortunately are not good. And that’s despite us doing everything that we can. With bacteria — with staph infection, MRSA — I have antibiotics that are going to treat that infection and get you better. With COVID, I don’t have anything that’s magic that’s going to guarantee you get better. A lot of it just depends on how your body is going to respond.”

Burdette said its incorrect to think the delta variant makes getting the vaccine pointless.

“There’s been a lot of discussion about the efficacy of the vaccine with delta and depending on what you look at and read you would think, ‘well why would I get the vaccine because it’s not going to do anything?’ — that is the farthest thing from the truth,” Burdette explained. “New England Journal of Medicine published an article — I believe it was based out of Israel — where the Pfizer vaccine particularly came in at 88% efficacy specifically against delta. Now, one vaccine is not enough. One dose of the Pfizer vaccine came in at like 30%, so you’ve got to finish the series. So those Ohioans that have only gotten one dose — you’ve got to go get the second dose.

“But I want the people to realize that — in the world of vaccines, in the world of infectious diseases — an 88% efficacy is awesome. … The old shingles vaccine was barely 50% effective. So for the vaccine to come in at 88% — we got spoiled early on the first six months of this year because the COVID vaccine was arguably 99.9% effective in preventing COVID. So, it’s not quite as good as it was then. But I’ll take something that’s 88% protection when the alternative is going on a ventilator from which you may never come off. … My personal experience and now the literature specifically looking at delta shows the vaccine is still effective and highly effective.”

Wyandot County Public Health is offering weekly open vaccine clinics with the Moderna vaccine from 9 a.m. to 4 p.m. Fridays. Ohioans also may check eligibility and schedule vaccine appointments by visiting gettheshot.coronavirus.ohio.gov. For additional vaccine information, visit the COVID-19 vaccination program tab on coronavirus.ohio.gov.