Given rising concern about the Delta variant, we met Wednesday morning to discuss the current state of COVID-19 infection here in Connecticut and take note of challenges that may lie ahead this fall when school resumes and flu season arrives. The goal, of course, is advance planning so that we are as ready as we can possibly be.
Below, Dr. Rick Martinello shares insights on the Delta variant nationally and locally, and Dr. Tom Murray provides an overview of how children in our state have been affected—and you’ll also read updates on a few other matters of interest.
I also want to take this opportunity to emphasize the importance of continued mask-wearing in health care facilities. The University’s mask-optional policy does not apply to health care settings. Thank you for your continued vigilance.
Delta Variant: What We Know Now
Dr. Rick Martinello offered an overview of what we should know about the Delta variant, including its prevalence here in Connecticut and information on how well the current vaccines protect people. You can see the PowerPoint here—and below are some highlights:
- The Delta variant currently accounts for about 30% of COVID-19 cases across the U.S. and its pace is accelerating, particularly in areas where vaccination rates are low.
- Connecticut rates of Delta infection are low, possibly due to our relatively high vaccination rate, which currently stands at 72% for persons over 18 and 61% of the entire state population, according to The New York Times.
- Delta appears to be both more contagious and potentially more severe: Pre-print data from Public Health England suggests about 60% higher transmissibility compared with the already more easily spread Alpha variant, while data from Public Health Scotland shows about an 85% higher risk of severe disease that requires hospitalization, again relative to the Alpha variant.
Regarding vaccine efficacy, there is some variance comparing one to the others and comparing efficacy against Delta vs. other variants, but all results show vaccine effectiveness to be well above the 50% level at which vaccines are considered to be highly protective.
COVID-19 and Kids: What We’ve Seen Here at Yale
Dr. Tom Murray shared insights on how the pediatric population is and has been affected by COVID, along with thoughts on how the situation will look once school starts up again in the fall. See Dr. Murray's PowerPoint presentation.
COVID infection rates among kids are down and, overall, they have been far less impacted than adults. Throughout the health system, 213 children and adolescents have been hospitalized for COVID or for multisystem inflammatory syndrome in children (MIS-C), with zero mortality.
MIS-C, if it arises, tends to be seen 3-5 weeks after infection. Clinical criteria for MIS-C is a fever that lasts 24 hours or longer and having had a positive COVID test. “Because there have been reports of high mortality, we err on the side of making the diagnosis and treating the condition,” says Dr. Murray, noting that treatment involves use of IV antibiotics and steroids.
Systemwide, Yale has seen 10 cases of post-vaccination myocarditis. “We were one of the earliest medical centers to see this and make the association,” says Dr. Murray, adding that all 10 patients treated here have fully recovered, with no apparent complications. The typical presentation is sudden chest pain that arises within four days, usually after the second dose. Incidence is .009% which, Dr. Murray notes, “contrasts very favorably with the risks associated with getting COVID.”
Kids can get long COVID. Though the numbers are small, “there is a population that has long-haul symptoms, primarily exercise intolerance,” says Dr. Murray. Though fine most of the time, kids with long COVID are easily fatigued when being physically active. Though treatments such as inhalers don’t tend to help, he reports that most are better after six months or so.
Data show that school reopening is safe. Even if vaccination rates are less than optimal, schools can safely reopen if staff, teachers, and students wear masks and, when cases are identified, quarantine. Referencing several recent studies, Dr. Murray said that proper masking and quarantine measures eliminate the need for social distancing and that the only activity associated with higher risk of infection is sporting events where players are unmasked.
Vaccination hesitancy continues to be a problem. “The biggest challenge we face is the misconceptions parents have about the risks associated with getting their kids vaccinated,” Dr. Murray concluded, pointing specifically not only to the incidence of post-vaccination myocarditis but to an enduring and baseless myth that the vaccine can negatively affect a woman’s fertility in years to come.
“Obviously we need to remain prepared for change, as no one can predict what will happen,” Dr. Murray concluded.
CME Module on Techniques to Address Vaccine Hesitancy
Drs. Saad Omer, Brita Roy, and Kavin Patel have developed a CME module that provides an overview of evidence-based techniques to promote vaccine uptake.
Our goal is widespread dissemination in the service of protecting our communities. The program (and this two-minute preview) is available to you through the Continuing Medical Education section of the YSM website. We invite you to share it with others you know, regardless of where they live and work.
See a recent guest essay by Dr. Omer in The New York Times on the subject of vaccine hesitancy.
Self-Scheduling Campaign Underway
Yale Medicine has launched a multi-platform communications campaign to promote patient self-scheduling. As part of this campaign, a targeted email was sent recently to established patients of participating providers, encouraging them to utilize MyChart to schedule their next return visit. The ongoing communications strategy also includes information on the YM website, digital (social media) advertising targeted to YM patients, and print collateral in the clinic environment. We are excited to provide this convenience to our patients, and grateful for your partnership in helping us to arrive at this goal.
Paul Taheri, MD, MBA
Deputy Dean for Clinical Affairs, YSM
CEO, Yale Medicine