As the highly contagious Delta variant of the coronavirus spreads around Utah, some doctors say vulnerable residents should consider a return to pandemic living — even though state and federal guidance hasn’t yet changed as cases (and hospitalizations) rise.
“Individuals at higher risk — older in age, or who have multiple chronic medical problems, particularly individuals who are obese or who have deficiencies of the immune system — really do need to carefully assess their own precaution level no matter what the public health policy is at a community level,” said Dr. Brandon Webb, an infectious diseases physician for Intermountain Healthcare.
“Avoiding public places where there are crowds or where social distancing isn’t possible or where ventilation is poor is probably advisable,” he said.
That goes even for at-risk Utahns who are vaccinated, Webb said — especially if they live in a part of the state where vaccination rates are low.
“The Delta variant is more contagious, and for some individuals, the protection from the vaccine is not as strong,” Webb said.
In some circumstances, even low-risk Utahns should consider fishing their masks out of storage, said Dr. Andrew Pavia, chief of pediatric infectious disease at University of Utah Hospital.
“In a setting where there are a lot of unvaccinated people, high rates of Delta, and extensive crowding, I would consider masking even if vaccinated. Parts of Utah now fit those criteria,” Pavia said.
The U.S. Centers for Disease Control and Prevention has advised that those who are vaccinated generally are safe to resume most indoor and outdoor activities without a mask.
But Dr. Emily Spivak, an infectious disease physician at the University of Utah, has kept masking even before cases began to climb about a month ago.
“I never thought the mask mandate should have been lifted to begin with,” she said.
“And I understand CDC’s guidance, but I don’t know that I totally agree with it because kids under 12 have never been eligible [for vaccines],” she said. “And I have three small kids under the age of 9. So I continue to wear it in the slim chance that I could still get infected and I would get them sick.”
CDC officials have said recent outbreaks of the Delta variant are unlikely to change their advice.
But the World Health Organization has called for masking in light of the Delta variant — even for those who are fully vaccinated — and health officials in Los Angeles County recently revised their guidance to advise that all residents mask while indoors in public places.
“CDC has good intentions, but it’s essentially an honor system. But I’m a little jaded and I know people aren’t going to be honest,” Spivak said. “I pretty much assume a lot of the people unmasked in grocery stores in Utah are actually unvaccinated.”
Policy responses to the Delta variant are challenging in Utah, and in the whole United States, because the virus is now spreading unevenly, hitting places with low vaccination rates much harder than elsewhere.
“The issue we’re seeing is that in communities that are poorly vaccinated, the Delta variant is certainly capable of causing significant pockets,” Webb said.
“The decision about whether to invoke additional public health measures really depends on the level of vaccination in the community and how the variant is behaving in each community,” he said.
In Utah, 14-day rates of new coronavirus case are highest in the two communities where vaccination rates are lowest: Daggett and Uintah counties in northeast Utah (24% vaccinated, with 308 new cases per 100,000 residents), and the Nephi and Mona area in central Utah (26% vaccinated, with 296 new cases per 100,000 residents).
Of the 17 communities with “very high” rates of new cases, less than half of residents are vaccinated in all but one of them — Grand County, whose heavy tourism has caused its case rates to remain high despite having high vaccination rates, local health officials have said.
But, for example, in nearly all the neighborhoods of Salt Lake City, where most who are eligible have been vaccinated, case rates are “moderately high,” with fewer than 100 new cases per 100,000 residents.
The Delta variant is now the most common strain of the coronavirus circulating in Utah, making up about 70% of positive test samples that underwent genomic sequencing last week, according to the Utah Department of Health.
“Where vaccination rates are higher, we’re seeing less impact overall,” Webb said. “It’s just something we’re going to have to continue to track really carefully.”
— Tribune reporter Scott Pierce contributed to this story.
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