Another COVID-19 endgame take

Trevor Bedford, computational virologist at the Fred Hutchinson Cancer Research Center—and widely regarded expert on coronavirus variants—wrote a useful Twitter thread this week. In the thread, Bedford provides his take on the “COVID-19 endgame.” In other words, what will happen once the virus reaches endemic levels?

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Breakthrough case reporting: Once again, outside researchers do the CDC’s job

Now, Delta is causing the vast majority of cases—and the CDC still isn’t reporting on non-severe breakthroughs. As a result, entities outside the federal government are once again compiling data from states in order to fill in gaps left by the national public health agency. On Friday, both Bloomberg and NBC published breakthrough case analyses.

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Unpacking Delta numbers from this week’s headlines

It’s no surprise that Delta (B.1.617.2) is bad news. From the moment it was identified in India, this variant has been linked to rapid transmission and rapid case rises, even in areas where the vaccination rates are high. This week, however, the CDC’s changed mask guidance—combined with new reports on breakthrough cases associated with Delta—has triggered widespread conversation about precisely how much damage this variant can do.

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Breakthrough cases: What we know right now

While epidemiologists may consider any new outbreak a possible source of new variants, one key way to monitor the virus/variant race is by analyzing breakthrough cases—those infections that occur after someone has been fully vaccinated. Here’s how states and the CDC are tracking these cases now, and what we know about vaccine protection against the variants.

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Delta and Gamma are starting to dominate

Delta, or B.1.617.2, is particularly dangerous. As I’ve written before, this variant spreads much more quickly than other strains of the coronavirus and may cause more severe illness, though scientists are still investigating that second point. Thanks to this variant, it’s now much more dangerous to be unvaccinated than it was a year ago. It’s quickly becoming dominant in the U.S.

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