WHAT YOU NEED TO KNOW ABOUT COVID-19

Top 5 Things to Know about COVID-19 and the Delta Variant

1. Getting vaccinated prevents severe illness, hospitalization and death; it also helps reduce the spread of the virus in communities.
   • Unvaccinated individuals should get vaccinated and continue masking until they are fully vaccinated.
   • With the delta variant, this is more urgent than ever. The highest spread of cases and severe outcomes is happening in places with low vaccination rates.
      
2. Data shows delta is different than past versions of the virus in that it is much more contagious.
   • Some vaccinated people can get delta in a breakthrough infection and may be contagious.
   • Even so, vaccinated individuals represent a very small amount of transmission occurring around the country.
   • Virtually all hospitalizations and deaths continue to be among the unvaccinated.
3. In areas with substantial and high transmission, the CDC recommends that everyone (including fully vaccinated individuals) wear a mask in public indoor settings to help prevent spread of delta and protect others.
   
   
4. CDC recommends that community leaders encourage vaccination and masking to prevent further outbreaks in areas of substantial and high transmission.
    
5. CDC recommends universal indoor masking for all teachers, staff, students and visitors in K-12 schools, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with layered prevention strategies in place.

Background on Vaccinations and the Delta Variant

Vaccination is the most important public health action to end the COVID-19 pandemic.

• Get vaccinated to prevent severe illness, hospitalizations and death.
• We need more people vaccinated.
  • Vaccination coverage by county in the U.S. ranges from 9% to 89% and remains below 40% in more than half of the counties.
• Areas of low vaccination coverage have rapidly increasing cases.
  • COVID-19 cases have increased over 300% nationally from June 19, 2021, to July 23, 2021, driven by the highly transmissible B.1.617.2 (delta) variant.
  • Importantly, while we are seeing case numbers similar to the wave we experienced last summer, there are more than 70% fewer deaths due largely to the impact of vaccines.
  • Health care systems are being strained in many states with surging cases, imperiling providers’ ability to deliver care not only for patients with COVID-19 but also those with other health care needs.
  • We are in a race against time to increase vaccination coverage before new variants emerge.

We continue to have reliable evidence that our vaccines are safe, effective and provide protection against the variants circulating in the United States.

• Data demonstrates that the vaccines are preventing severe illness, hospitalization and death, and are effective against the delta variant.
• Vaccination is the best way to protect you, your family and your community.
• High vaccination coverage will reduce spread of the virus and help prevent new variants from emerging.

The emerging evidence about the delta variant demonstrates it is more formidable than the original (wildtype) virus.

• Delta spreads more than twice as easily from one person to another, compared with earlier strains.
• Delta has most recently surged to become the predominant variant – from <1% in May to over 80% of cases in July.
• Delta is causing some vaccine breakthrough infections, or infections in fully vaccinated people, than other strains have. But, even so:
  • Most breakthrough infections are mild.
  • Vaccines are working as they should: they are preventing severe illness, hospitalizations and death.

• New data shows that people infected with delta have higher viral loads – meaning more virus in their body – than with previous variants.

• In contrast to the alpha strain, new data shows that fully vaccinated people who are infected with the delta variant might be infectious and might potentially spread the virus to others.

Q&A

What changed from two months ago when you said vaccinated people did not need to mask?

The delta variant is surging. It has quickly grown from less than 1% of cases in May to more than 80% now. Delta spreads about twice as easily from one person to another than previous strains of the virus.

We are constantly evaluating data and monitoring the science to determine what responses may be needed. Given emerging evidence that some vaccinated people can get or spread delta, we are recommending people in substantial and high transmission areas consider masking, even if they’re fully vaccinated. Importantly, the vaccines can help prevent delta from spreading even further. Most transmission happening around the country is among unvaccinated people and in areas with low vaccination rates. We need more people to get vaccinated to stay ahead of changes in the virus.

Should vaccinated people worry they are spreading the virus?

Vaccinated individuals represent a very small amount of transmission occurring around the country. Most vaccinated people are protected from the virus – breakthrough cases occur in only a small proportion of vaccinated people and the vast majority are avoiding serious illness, hospitalization or death. If you get vaccinated, your risk of infection is more than 3.5 times lower, your risk of getting ill from COVID is more than 8 times lower, and your risk of hospitalization or death is more than 25 times lower.

But emerging science suggests some vaccinated people can be contagious if they get delta. In areas of substantial and high transmission, CDC recommends that vaccinated people should wear a mask in public indoor settings to prevent spread and protect themselves and others.

Does this mean the vaccines aren’t working as we expected?

No. The 162+ million fully vaccinated Americans have a very strong degree of protection against the variants, including delta. They are overwhelmingly avoiding severe illness, hospitalization and death. Unvaccinated individuals account for virtually all the hospitalizations and deaths in the U.S.

Despite seeing case numbers similar to the surge we experienced last summer, deaths are down more than 70% thanks to vaccination. This is further proof that getting fully vaccinated is the best thing you can do to protect yourself and those around you.

How rare is transmission by the vaccinated?

We are continuing to monitor available data but we know vaccinated people represent a very small proportion of transmission occurring.

For example, some data out of Israel showed that as little as 13% of vaccinated people with a breakthrough infection were spreading the virus, with 80% not spreading at all.

It’s important to remember breakthrough infections occur in only a small proportion of vaccinated people and of the breakthrough infections, transmission by the vaccinated appears to only be a small part of overall spread of the virus.

If you are vaccinated but asymptomatic, can you spread the virus?

We do not have data to inform the likelihood of asymptomatic spread among vaccinated people but expect that it would be relatively low.

If vaccinated people can spread the virus, shouldn’t everyone wear a mask, not just those in high transmission areas?

If you are in a low transmission area, your overall risk of getting delta as a vaccinated person is lower.

You can still consider whether you want to take the extra precaution of wearing a mask (particularly if you live with someone who is immunocompromised, unvaccinated or at risk of severe disease) but at this time we are focused on reducing transmission and therefore urge everyone to get vaccinated and, in areas with substantial or high transmission, to wear a mask in indoor public spaces.

What data is this decision based on?

We are constantly reviewing emerging data and evidence on the delta variant. This update is based on recent data both here in the United States and in other countries that show a small proportion of fully vaccinated people may be infected with delta and transmit it.

Does this mean businesses in high transmission areas should reinstitute mask mandates for all workers and customers? Reduce capacity? Should large events be canceled?

These are decisions that will be made at the local level by community and business leaders based on what is happening in their area.

Right now, we would recommend that in areas with substantial or high transmission, individuals wear masks in indoor public settings, even if they have been fully vaccinated, and community leaders encourage vaccination and masking to prevent further spread.

What about workplaces or offices? Should people in high or substantial transmission areas be wearing masks at work?

Yes. Employers should encourage vaccination and masking in areas of high or substantial transmission.

What about kids in schools? Should they all be masking, even if vaccinated?

Yes. Given the high mixing of vaccinated and unvaccinated people in schools, and the fact that vaccines are not available to children under 12, we recommend schools do universal masking.

To support in-person learning in the fall, the CDC recommends universal indoor masking for all teachers, staff, students and visitors in K-12 schools, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with layered prevention strategies in place.

If kids get infected with delta, are they at serious risk?

Most children who get COVID-19 have less symptoms than adults. However, the delta variant is more transmissible than other variants, therefore protection against exposure is more important than ever, especially among those who are unvaccinated or too young to be vaccinated.

Based on national antibody studies, we know that children experience COVID-19 infection, even if they have less symptoms. National seroprevalence data show that children (age 0-17) have the highest level of antibodies of any age group (27.8%).

CDC recommends that parents take appropriate protective actions, such as having children older than age 2 who are unvaccinated wear masks in public indoor settings.

To support in-person learning in the fall, CDC recommends universal indoor masking for all teachers, staff, students, and visitors in K-12 schools, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with layered prevention strategies in place.

Should I be more worried about variants like delta?

Variants are expected as long as transmission continues. Delta is more contagious than previous variants and cases due to the delta variant arising rapidly.

With the delta variant, this is more urgent than ever. The highest spread of cases and severe outcomes is happening in places with low vaccination rates and among unvaccinated people.

Should fully vaccinated people put their mask back on?

The greatest risk right now is to the unvaccinated.

The COVID-19 vaccine authorized in the United states protect against severe illness, hospitalization and death from the delta variant. In rare occasions, some vaccinated people can get delta in a breakthrough infection and may be contagious. Even so, vaccinated individuals represent a very small amount of transmission occurring around the country.

Fully vaccinated individuals should wear a mask in public indoor settings in areas with substantial or high transmission to help prevent spread of delta and protect others.

Should communities go back to mask mandates?

As we have always said, localities may make decisions based on their local situation. The CDC urges localities to monitor transmission rates and vaccination coverage, and to add layered prevention strategies when needed to keep their communities safe.

Community leaders should encourage vaccination and masking to prevent further spread in areas with substantial or high transmission. People in high or substantial transmission areas should wear a mask in public indoor settings, even if they are fully vaccinated.

It feels like we are seeing more breakthrough infections than just 10%. How many breakthrough infections are we seeing?

Breakthrough infections are anticipated even with a highly effective vaccine. There are more than 160 million Americans vaccinated – the CDC expects about 150,000 symptomatic breakthrough infections through mid-July based on modeled estimates.

Importantly, breakthrough infections are mostly resulting in mild disease. If you get vaccinated, your risk of infection, symptomatic disease and especially hospitalization or death are far lower than in the unvaccinated.

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