Marisa Wojcik:

Welcome to “Noon Wednesday,” Im Marisa Wojcik, multimedia journalist with Here & Now on PBS Wisconsin. Today is August 4. The Delta variant is quickly gripping Wisconsin, especially among the unvaccinated, and hospitalizations and infections are up. So much information is rapidly coming out so to help us understand the latest facts is Dr. Nasia Safdar at UW Medicine and Public Health, and so thank you so much for being here.

Nasia Safdar:

Thank you.

Marisa Wojcik:

I want to start with understanding the difference between new case numbers that we’re seeing in data versus the reality of how many people are catching this really contagious virus. Is Delta more prevalent than we know?

Nasia Safdar:

I think that is almost certainly the case. People can carry the virus in their nose and have no symptoms. The only way to detect that is if they get tested. We know Delta is far more contagious and transmissible than other variants that have come before it. It is not a stretch to explain the case counts in numbers that were seeing here.

Marisa Wojcik:

Do we have any understanding of what that difference looks like, how prevalent it is, and is the sharp increase in hospitalizations the true indicator of how this variant is taking hold?

Nasia Safdar:

Well, different I think the metrics tell us slightly different things. For instance, we have to know how many cases are there so we have a better sense of what the magnitude of the problem is and widespread it is. Whatever the numbers we have are likely an underestimated true state of events as not everybody is getting tested. It is safe to say the vast majority of cases that were seeing here is the Delta variant that’s responsible for them, and so, you know, once the variant spreads like that, it quickly replaces whatever else was circulating before it, and so at the moments its really all Delta for an intents and purposes. I think the hospitalization piece is important because it tells us besides being more easily able to transmit is also leading then to more people getting sick enough they need medical care and hospitalization, and, so far, what we see is, yes, people are hospitalized, but the majority of them are not vaccinated, and so that additional layer of protection we would otherwise have is not there, and that results in them getting more sick than they would otherwise.

Marisa Wojcik:

Now, yesterday, the legislative rules committee voted that UW campuses will have to have any requirements of vaccination, testing, or mask wearing be approved by the republican majority committee? What is your reaction to that?

Nasia Safdar:

You know, so my feeling on is we have a suite of public health solutions we know do work for containment. For a while there, we relaxed them as Delta was not around as much, and we, you know, did not face the same evolution and state of pandemic we face now, and now what we face now is an all-hands-on deck approach, and so testing and vaccination and masking are all very important parts of that suite of solutions, and so whatever way we can get them easily deployed seems like the right thing to do.

Marisa Wojcik:

Also, yesterday, President Biden announced vaccine requirement for federal employees, many other places have announced a vaccine requirement like this or be subject to regular testing. Should large institutions like the UW system require a COVID-19 vaccine for staff and students as we’re looking towards the fall semester?

Nasia Safdar:

I think it is really important for everyone who is eligible for the vaccine to get it. Now, some people will choose to get it on their own and whether requirement is necessary or not may be a moot point, but the end goal is, I think, everyone who is eligible should be given the opportunity and should really want to take the vaccine and want the vaccine. This is a highly effective intervention, really, the major effective intervention we have to halt the course of this pandemic’s transmission so any and all measures allowing people to get the vaccine are likely to be useful.

Marisa Wojcik:

The CDC is now saying that those who are vaccinated can spread the virus just as easily as the unvaccinated. New guidance saying that everyone should be masking indoors, and I personally have not really seen many people masking. Should everyone be masking, and in what circumstances?

Nasia Safdar:

You know, I think this is a case of where there’s been a clear shift in the thinking, but because of this variant compared to what we have seen before, and so it’ll take a while for us to catch up to what we now need to do to prevent the transmission of Delta. I think that the vaccines are doing exactly what we know the vaccines are capable of doing, which is preventing severe hospitalizations, severe symptoms, and complications. What the vaccines cannot do completely is prevent transmission of people who don’t have symptoms, and so that’s where masks come in handy. For a while there, we were of the mind set we don’t have to mask anymore, and if not for Delta, this would not have been true, but this variant has an advantage over us in the light it’s shed by people who are vaccinated so masking needs to come back.

Marisa Wojcik:

Are children who can’t yet get vaccinated at risk, is there a way to protect them? Is there a concern that when all children go back to school at the end of the month, it is really going to be a mixed bag?

Nasia Safdar:

You know, I think with respiratory virus season around the corner we’re probably going to see a whole array of viruses circulating. Many of them we typically see every year, and sars-cov-2 will be there this year and with people together in close quarters, there’s more circulation, and as a group,and this is a broad generalization, but as a group, you know, children fared better with sar-cov-2 than other population groups. That’s not to say there’s not several thousand cases around the country. There have been, of course, and that’s why I think, all mitigation measures we do for people who are not vaccinated and for those who are vaccinated are going to be important. That will include, you know, distancing to the extent that’s possible, remain elements of testing, and it may include masks, and all of those things should not be — they should be continued.

Marisa Wojcik:

Now, Ive heard a lot of confusion about this term, this phrase called “breakthrough cases,” and what it really means. It’s ranged from vaccinated people can transmit the virus to vaccinated people can get very sick. So, can you explain what does breakthrough cases really mean?

Nasia Safdar:

So, what breakthrough cases mean is that even in people who are vaccinated, they can still have COVID-19. So, there’s a couple of explanations for it. One is that, you know, no vaccine is 100%, and even though vaccines are highly, highly effective, even 95% effective vaccine means some people will get the infection despite being vaccinated. The reason that happens could be the underlying immune system or the vaccine did not take for whatever reason. The numbers are expected to be very low for this kind of breakthrough. The other kind of breakthrough infections we see are mild infections happening in people who are fully vaccinated, and there is it is a misnomer to call it a breakthrough as a vaccine is not intended for that particular situation. It is intended for the hospitalization and complications. As we see more so-called breakthrough infections, these mild infections in people, this is a reflection of there’s a lot of circulating viruses, and the vaccine is doing what it is supposed to, but it can’t prevent all the mild infections out there.

Marisa Wojcik:

There have been at least 500 cases, positive cases, confirmed that came from the dear district when the celebration of the Milwaukee bucks was happening. Is this an issue? Are we going to have to go back to preventing crowds from gathering? They were outside, yet they were very much packed together. Lots of events are planned and back on this summer and going into the fall. Do we need to rethink those?

Nasia Safdar:

You know, I hope that we don’t have to, but I think that the challenge with some of these events is they look like indoor events in the sense they are close together, not much masking, and people are packed in close quarters. I remain worried about indoor events more than outdoors, but some sort of population in the sense not having people packed together in outdoor events I think would be in our best interests. The challenge of the Delta variant is you need interventions in response to what we are seeing in front of us. If you know this variant is very easily transmissible, then distance between people is one way to prevent that, and masking is another. They are not mutually exclusive.

Marisa Wojcik:

So, are you monitoring the media and how much misinformation is being passed around? Do you think that is having an impact on this more contagious variant being able to take an even stronger hold?

Nasia Safdar:

I think there is certainly a lot of misinformation, and I think it is also there’s pandemic fatigue, and I think people are doing the best they can for a year and a half, and now to be confronted with a variant like this, you know, it is, of course, unwelcomed news. I think, though, that we have to stick to what we know is that we have this array of highly effective vaccines, and a mild disease, of course, no disease if one can help it, but mild disease is preferable to a severe one. If vaccines help us mitigate that, they are worth their weight in gold.

Marisa Wojcik:

Now, roughly half the state is vaccinated. The rate of new vaccinations has just plummeted, and health officials at this point are begging people to get vaccinated, providing incentives, and so if this rate of vaccination, this level pretty much stays the same, as well as our ability to enforce public health measures has been considerably strict, what do you think the picture of this virus is going to look like going forward?

Nasia Safdar:

Well, I think if we remain at less than ideal vaccination levels, what’s likely going to happen is the virus will continue to circulate, and it will amplify in those groups who are unvaccinated, and eventually, we’ll be in a situation where we may have more variants perpetuated because of the uncontrolled rampant transmission, and so I think that, you know, whatever we can do, this is a whole of everyone response here, and we are all accountable for our own protection and that of others, and so there is not anything that’s higher priority than getting the vaccination numbers up high as we can get them.

Marisa Wojcik:

What are you bracing yourself for in the future?

Nasia Safdar:

I think that we are concerned potentially about other new variants emerging. I think having seen the stuff that Delta can do, for instance, giving us a better picture of what to expect in the future, and I think, eventually, though, with, you know, even more effective vaccines or perhaps the boosters or some other elements of protection that may come about, I think that what is likely to happen is that sars-cov-2 and its various variants will be embedded as part of the usual respiratory viruses we see if we get it to a point where the disease is mild and vast majority of cases, then it becomes into one of those viruses, but we are a far cry from there at this point.

Marisa Wojcik:

What is the best advice you have for someone who is vaccinated, unvaccinated, and anyone in the state of Wisconsin as we’re kind of looking at this new phase of the pandemic?

Nasia Safdar:

I think what I would suggest is vaccination, of course, number one, and then masking, I think, just like we were doing in the earlier days of the pandemic, it is not going to be a forever thing, but it needs to be until Delta is under control, and so vaccination, masking, encouraging people for physical distancing, and, you know, it is a bit hard to tell people they shouldn’t engage in activities that give them joy because it’s been so long into the pandemic, but to the extent possible, opt for outdoors rather than indoor activities.

Marisa Wojcik:

All right. We leave it there. Dr. Nasia Safdar, thank you very much for joining us.

Nasia Safdar:

Thank you.

Marisa Wojcik:

For more from Here & Now and PBS Wisconsin,you can visit PBSWisconsin.org/news, and thank you so much for joining us on “Noon Wednesday.”