How Delta Changed The Course Of The Pandemic

Contract doctors hold placards during a strike outside the Sungai Buloh Hospital in the state of Selangor in Malaysia on 26 July, 2021, as junior doctors staged walkouts at several hospitals protesting against poor conditions. (AFP Photo)

The Delta variant, first identified in India, poses a threat to us all – not just those countries with larger numbers of unvaccinated people. This is because unlike the Alpha variant, which first emerged in the United Kingdom (UK), the first dose of the vaccine does not offer enough protection against it, meaning people are at risk in the interval period between the two doses.

According to a Public Health England study published on 22 May, a single dose of either Oxford-AstraZeneca’s or Pfizer-BioNTech’s vaccine only reduces a person’s risk of developing COVID-19 symptoms caused by the Delta variant by 33 percent, compared to 50 percent for the Alpha variant. 

A second dose of the AstraZeneca vaccine boosts protection against Delta to 60 percent (compared to 66 percent against Alpha), while two doses of Pfizer’s jab are 88 percent effective (compared to 93 percent against Alpha).

The United States (US) is also grappling with a rise in cases attributed to the Delta variant, with the Centers for Disease Control and Prevention (CDC) reporting on 21 July that the Delta variant now accounts for 83 percent of new cases of COVID. That makes it more urgent than ever that unvaccinated Americans get their shots as this cohort accounts for the vast majority of new cases, hospitalisations and deaths. 

And all three of those are increasing again, with new COVID cases on the rise in all 50 states. It is a situation reflected globally. The World Health Organization’s (WHO) weekly COVID-19 update on Tuesday last week reported cases of the Delta variant in 124 countries, along with 3.4 million new cases of COVID-19 around the world, 12 percent higher than the previous week. 

Nepal and Afghanistan saw a surge in cases attributed to Delta in June, while countries that are better able to contain the virus and suffer relatively low casualties are also seeing a surge in cases.

Meanwhile, there are distressing scenes in Indonesia as the Delta variant spreads across the nation. On Wednesday, 14 July, the total number of cases across the country hit more than 54,000 making Indonesia the new epicentre of the pandemic in Asia. The Delta variant has been detected in 94 percent of the tests carried out in Indonesia over the past two weeks, according to the monitoring site, Our World In Data (OWID), and this is against a backdrop of a country that has only fully vaccinated six percent of its population against COVID-19.

Sinovac Ineffective?

There have been real concerns that the healthcare system is on the brink of collapse as beds and oxygen are in short supply in many hospitals. There is also concern that many of Indonesia’s healthcare workers are becoming seriously unwell with new COVID-19 infections despite being vaccinated.

Indonesia has predominantly relied upon the China-produced Sinovac vaccine to protect its population against the coronavirus, including its healthcare workers. In clinical trials, Sinovac and Sinopharm’s inactivated virus vaccines have been shown to be 50 to 79 percent effective in preventing symptomatic COVID infection, and more than 95 percent effective in preventing hospitalisation. 

While there is no public data on how effective the Sinovac vaccine is against the Delta variant, preliminary studies have suggested its efficacy may be as low as 20 percent. And with health workers who had been fully vaccinated with the Sinovac vaccine succumbing to the virus, Health Minister Budi Gunadi Sadikin said at a press conference on 9 July, that all health workers will now receive a “booster” shot with the US-made Moderna vaccine to protect them against the new deadly wave.

Budi said the ministry had discussed the Moderna “booster” plan with the Food and Drug Monitoring Agency (BPOM) and the Indonesia Technical Advisory Group on Immunisation (ITAGI). “We have agreed that the Moderna vaccine will be given as a third dose to provide maximum immunity to existing viral mutations,” he added.

Studies have shown the Moderna vaccine is more than 94-percent effective at preventing COVID-19 in people who have received both doses. A Canadian study pending peer review has found that a single dose of Moderna is 72 percent effective at preventing symptomatic infections caused by the Delta variant after two weeks. This would mean a relatively improved level of protection for Indonesia’s healthcare workers even after just one booster shot of the Moderna vaccine.

Low Morale

Thailand is also seeing a rise in COVID-19 cases where, according to the chief of the Department of Medical Sciences, Dr Supakit Sirilak, Delta has overtaken Alpha as the dominant variant, accounting for 63 percent of new cases. Thailand’s government has now announced a lockdown in Bangkok and other high-risk regions. The country, which heavily depends on the tourist industry, had only recently opened up to visitors but is now re-introducing restrictions to help curb the spread of infections.

Elsewhere, Pakistan is also seeing a rise in cases after a fall in numbers over the spring, with Karachi recording the highest numbers of Delta cases.  Just two percent of Pakistan’s population is fully vaccinated. COVAX, the WHO vaccine-sharing scheme, is planning to send an additional three million Moderna vaccines to Pakistan to help fight this new surge in cases. 

But the morale of healthcare workers in some of the worst-affected areas is reported to be low, with some in Malaysia saying they are working 36-hour shifts in order to cover for colleagues who are either sick or self-isolating. Exhausted doctors are so fed up with the lack of proper pay and working conditions in the country that they have been walking out of hospitals across the country, including in the capital Kuala Lumpur. 

The Delta variant has shown us how things can change in this pandemic and how the emergence of a variant in one country can quickly become a global problem. Ensuring equity of effective vaccines is key. When a person is fully vaccinated, they are far more likely to mount an immune response against the virus should they come into contact with it, which will kill it before it has time to mutate again. 

It has been said time and time again, but in my opinion, it cannot be overstated: we are only safe when everyone is safe, this means we all need to support the global rollout of effective COVID-19 vaccines. – Al Jazeera