If I were just a hair less bummed about the world being sick, I’d be patting myself on the back for my last post being ahead of its time. Delta is catchy as frak, not everyone you know is vaccinated, mask use is spotty, so maybe it’s a good idea to pause working out with others.
But as a practicing physician, the new CDC announcement and its related stories remind me of the curse of Cassandra. Knowing what will happen is no comfort when your predictions of a slow motion disaster are coming true.
Delta is catchy like chicken pox
We kind of knew that Delta was a hot potato by looking at the numbers: in the first week of June, Delta made up 6% of the new Covid diagnoses in the U.S. and by the second week of July, that number had jumped to 83%. From 1 in 20 to more than 4 out of 5. In just 5 weeks.
An internal CDC slide presentation has compared Delta’s transmissibility to chicken pox and not that far behind that of measles, which is considered super contagious. One person infected with Delta infects 8-9 others: awesome compounding if you’re multiplying an investment, not so fun when you’re talking pandemic spread.
Think chicken pox, but without everyone around you being immune, from a disease that can put you in the hospital, leave you with chronic problems, or worse.
Vaccinated, so you don’t need to mask? Well, about that…
Your risk of dying or ending up in the hospital post vaccination are vastly reduced — still true.
But we used to think that if you caught Covid and had mild or no symptoms — still less likely after being vaccinated — that you’d be less likely to shed virus and infect others. Unfortunately, that’s not nessarily so: viral output can be similar between vaccinated and unvaccinated folks who contract the Delta variant of Covid.
Translation: IF you catch Covid after being vaccinated, you can be catchy as frak. You’ll likely be okay, but you can be shedding virus like a college student with a bucket full of drink beads at Mardi Gras.
Masks are for you and those around you
So hopefully the update to wear a mask when indoors regardless of your vaccine status makes more sense. (The recommendation applies to areas of “high” or “substantial” transmission, and Orange County’s is substantial.)
Highly contagious virus, plus lots of folk still not completely vaccinated (2 weeks or more after the final shot) equals significant exposure risk when out in public.
Indoors with others means an even more concentrated exposure.
Basically, if you’re indoors anywhere but your own home, you should be wearing a mask.
Even if you have been vaccinated, you can still catch a mild case of this super catchy Covid — this is what the term breakthrough refers to — so if you have to be indoors with others, wearing a mask cuts your exposure risk. And if you’re infected and thus infectious, mask use means others at your table and the room are less likely to get exposed.
The older and wiser I get, the more I value not having regrets. And unless you’re a sociopath, you will have regrets if you catch Covid, pass it to a close friend or family member, and hear about them dying or being crippled because you didn’t wear a mask. That’s a Regret that never goes away, and it’s a boat anchor on your soul that as a physician I strongly recommend you do everything in your power to avoid.
Wearing a mask
Wear a mask when indoors in public places. (I think it’s prudent to also mask up in public when surrounded by lots of folks, especially unmasked, especially if there’s lots of laughing, cheering, or singing going on.)
If you find out you’ve had close contact with someone with known or very likely Covid, put a mask on immediately, plan on keeping it on for 14 days, and let your doctor know. If you’ve vaccinated you’ll likely be fine, but you might become a little Covid factory and there’s no need to spread the wealth.
If you’ve been exposed and you get symptoms — and Delta tends toward the head-&-chest cold end of the spectrum, with sore throat, runny nose, cough and headache — plaster that mask on, immediately go home and plan on keeping to yourself for the next 10 days, and let your doctor know.Testing depends on when symptoms or the contact in question began.
And if you’re getting seriously ill symptoms, you most likely haven’t been fully vaccinated, and you should get thee to an ER immediately. The vast majority of folks getting seriously ill from Covid — hospitalized or close to dead ill — are either unvaccinated, or vaccinated with immuncompromising conditions (chemotherapy, HIV/AIDS, or organ transplant recipients on immunosuppressant medications). Difficulty breathing, turning blue in the face/lips, confusion, or persistent pain/pressure in the chest are no bueno.
Why get vaccinated, then?
So you don’t die.
Why wear masks, again?
So you don’t kill someone you know and regret it for the rest of your life.
And what about working out?
The CDC doesn’t explicitly address this, but given the guidelines for indoor public places, the implications are grim for those who love the non-archery martial arts — or any kind of working out with others — done indoors.
Doing jiu-jitsu or any similar close-range martial arts, you’re exerting yourself intensely, indoors, inches away from your partner, and Delta is a whole new ballgame — way more contagious than the original Covid. ONE INFECTED PERSON on the mat, and a good chunk of the class, if not the entire class, will get exposed (and likely infected if they haven’t been vaccinated). Ditto to a lesser degree with standard workout classes: less up-close than martial arts, but more exposure than going to a movie theater and that’s definitely a WEAR A MASK INDOORS scenario.
If you won’t/can’t wear a mask when in indoor public places, you’re a public health risk if you’re doing up-close working out (UCWO). You get Covid — and up-close working out is an AWESOME way to pass Delta around — and going maskless in enclosed public spaces is like being Patient Zero in your own superspreader events.
If you have friends or loved ones who haven’t been fully vaccinated and who aren’t in the best of health, you doing UCWO means your odds of exposing them to a serious infectious disease just by breathing on them has gone up significantly.
If staying home from work for 10 days (or longer, if your symptoms drag on) would derail you or your family’s finances, you doing UCWO is playing with personal bankruptcy.
And if you have chosen to not get vaccinated, doing UCWO means you’re OK with the prospect of getting long Covid or dying like 610,000 of your fellow Americans, many of whom undoubtedly thought they were OK with the odds, too.
There’s more than masking and vaccinating, but…
It can’t hurt to improve the function of your immune system by means of the functional medicine principles I’ve outlined before. That was an idea whose time had come long before the pandemic, and it’s even more vital now: buffing up your immune system improves the odds that you won’t personally suffer a severe case of Covid.
But we now know that asymptomatic as well as mildly symptomatic people can still put out high levels of Delta. The risk to others is still substantial.
You may have heard about the recent Cape Cod outbreak: 882 people tied to an outbreak in Provincetown, Massachusetts, 74% of whom had been fully immunized. Very few got seriously ill, but a whole lot of folks caught the virus and passed it along.
Math is just a shorthand for real world numbers.
The pressure is on, numbers are rising, and north of 97% of those hospitalized with Covid are unvaccinated.
Here’s my back-of-the-napkin math: a) I’ve been fully vaccinated and b) I mask everywhere outside my home, and c) if everyone close to me was 2+ weeks out from their final vaccination, and d) I could afford a 10-day isolation period off work if I came down with symptoms…only then would I consider returning to the mat. That’s a lot of stars that have to align, but knowing what I know as a primary care physician about people getting ill with Covid has made me risk conscious of the hard realities.
If you’re a solo mountain man, more power to you. If you have family responsibilities and variables to juggle, it makes sense to factor them into your calculations and choices.