By Dr Sheri Fanaroff  MBBCh FCFP MFamMed, a Family Physician, practicing in Melrose, Johannesburg. Fanaroff is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for  #voicesthatcare on the GGPC Facebook page.

Alpha, Beta, Gamma or Delta Variant. Why you should care?

You may say, “All this sounds like gibberish to me” but what do these names mean in Covid 19 speak?

  • Alpha = First identified in the UK (B.1.1.7)
  • Beta = First identified in South Africa (B1.351)
  • Gamma = First identified in Brazil (P.1)
  • Delta = First identified in India (B.1.617.2)

 

The Delta Variant is driving the 3rd wave 

Breaking news confirms what doctors and paramedics in Gauteng have suspected for a few weeks already. The massive spike in Covid cases and exponential growth is being driven by the Delta variant, which originated in India.

Tulio De Oliviero from KRISP, where genome typing takes place, announced that the Delta variant has now become the dominant strain in several provinces in South Africa, and has displaced the Beta variant (which originated in South Africa). Randomly selected samples over a large area of the country, show 48 out of the last 68 genomes typed, over a wide area, were the delta variant. The available data is about two weeks behind, and already shows Delta variant in 75% of samples in KZN, with data from Gauteng awaited next week, but expected to be similar.

 

Is the Delta Variant more transmissible?

  • The Delta variant is highly transmissible, more than all other variants and spreads far more easily amongst people.
  • It is 30% to 60% more contagious than Beta and 100% more than the original strain.1
  • We are usually seeing whole households of people becoming infected, not just one or two people.
  • It may spread very quickly – in other words, close contact doesn’t necessarily need to be for longer than 15 minutes for someone to get infected. Any close contact, especially in a closed room, or any contact without masks, is significant.
  • ** People who have already been infected with Beta variant are still susceptible to Delta (in other words, people who had Covid prior to April/ May 2021 may still be able to get Covid again). However, they should still have some immunity, particularly if they had severe disease.

Does the Delta Variant cause different symptoms?

  • There is not yet evidence that it causes more severe disease than other variants.
  • However in this wave in Johannesburg, we are seeing people staying sicker for longer periods, and also people deteriorating to significant lung disease at a later stage than previously. (So we are needing to monitor some patients longer than the typical ten day isolation period).
  • The symptoms may be a bit different with the most prominent reported symptoms being:
  • Headache
  • Sore throat
  • Runny nose, sneezing, congestion
  • Loss of taste and smell are less common than with Beta variant (but we do still see this)
  • Cough
  • Body pains
  • Fever

Are vaccines still effective against the Delta Variant?

The data looks quite promising 😊

  • Pfizer vaccine showed a 33% effectiveness against Delta after a single dose of vaccine (compared to 49% against Alpha).
  • Pfizer showed an 88% effectiveness after TWO doses of vaccine (compared to 93% against Alpha).
  • Pfizer showed very high levels of protection against hospitalisation with the Delta variant (94% effective after a single dose and 96% after two doses).
  • It was reported that J and J “seems effective” against the Delta variant (There is not enough data on this yet. If you were infected with Covid after receiving a J and J vaccine as part of the Sisonke trial for health workers,  please click here to report it 
  • Anecdotally, in the last two weeks, I currently have had nine patients who have developed Covid-19 infection after having J and J vaccine over four weeks ago – of these, most have mild infection, but one is in hospital. I have had several patients who have developed mild Covid within three weeks of a single Pfizer vaccine, of which two had pneumonia, but were not hospitalized.

Delta Variant wear masks

 

Stricter Covid protocols required- masks and more

The Covid protocols remain the same in every interaction, but should be even more stringent :

  • wear a good well-fitted 3 layer mask covering nose and mouth when you leave home
  • double masking is a good idea (cloth mask with a surgical mask over, or two surgical masks)
  • a visor or glasses will give extra protection
  • excellent hand sanitising
  • maintain social distance : at least 1.5 metres away from others, don’t eat with anyone outside of your bubble
  • stay in ventilated spaces (outdoors is preferable if you need to meet up with someone, but masks must be worn)

Conclusions

  1. The third wave is expected to continue to escalate; now accelerating in Gauteng but other provinces are likely to follow.
  2. With 11 500 cases reported in Gauteng yesterday and hospitals already full, we can expect more and more pressure on medical services, to the point where they can’t cope.
  3. The Delta variant driving this wave is highly transmissible, and there is a significant risk of reinfection if you have previously been infected with another variant.
  4. Although it has not been shown to be more severe, the sheer numbers of people infected means that there will be a higher number of hospitalizations. Lack of resources (oxygen, hospital beds, emergency services) will mean that the morbidity and mortality rate will be higher.
  5. Vaccines are proving to be effective against severe illness, hospitalisation and death. Remember to remain cautious even if vaccinated while the community infection rates are so high.
  6. If you have been exposed to someone with COVID-19, you need to quarantine for ten days, regardless of getting a negative test result. Vaccinated people and those previously infected are NOT EXEMPT from quarantine and isolation as they can still transmit the virus and may still be able to get infected.

You do not want to get infected at this time when hospital bed availability is at its lowest.

PLEASE STAY HOME, STAY SAFE AND SANITISED. PROTECT YOURSELVES AND YOUR LOVED ONES.

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