It was the quote heard around the country: “The war has changed.” That was how the CDC described the current threat posed—including to vaccinated individuals—by the now-dominant Delta variant of coronavirus in an internal presentation that surfaced in media reports on July 29. And our collective response was, “But what does that mean?”
The “Delta variant is a game changer,” explains Pia MacDonald, an infectious disease epidemiologist and the senior director of applied public health research at RTI International, a nonprofit research institute. “There are things that have shifted dramatically in terms of the pandemic.”
According to MacDonald and other infectious disease experts, there are several reasons why the Delta variant has changed the pandemic landscape so severely.
“One is that it is much more transmissible,” says MacDonald. “As in one person is at higher risk of transmitting it to 5 to 10 people. The earlier variants, those were less transmissible. One person would likely spread it to 1, 2, or 3 people. So there’s more risk of it amplifying quicker, meaning that the outbreaks can grow much faster.”
With the earlier variants, the prevailing science indicated that vaccinated people infected with the virus didn’t carry a very high viral load “and so their risk of spreading it was very low,” MacDonald adds. “What we’re seeing now [with the Delta variant] is that regardless of vaccine status, people can still spread this.”
That is why masking, physical distancing, and continuing to get tested even when just mildly symptomatic “is extremely important,” says MacDonald.
What hasn’t changed in the era of Delta, according to Dr. John Swartzberg, professor emeritus of public health at UC Berkeley, is how critical it is to get vaccinated. He says that “if you are fully vaccinated and you do get a breakthrough infection, that infection is much more likely to be asymptomatic or very mild, even moderate, but not wind you up in the hospital and not causing death.”
Dr. Thomas Russo, chief of infectious diseases at the University of Buffalo’s Jacobs School of Medicine and Biomedical Sciences, adds, “The fully vaccinated are [still] largely protected from getting infected.”
Russo notes that while the efficacy of the vaccines has dropped somewhat with each variant, it still remains impressively high, even against the Delta variant. For the Pfizer and Moderna vaccines, “It’s about 88 percent efficacy we believe. It’s not perfect. We started at about 95 percent for the earlier versions of the virus . . . but 88 percent is still pretty good.”
But, adds Dr. Russo, “If you’re unvaccinated, you’re at maximum risk—obviously.”
In the United States, COVID-19 cases have risen to more than 100,000 new cases per day, numbers that were only last seen during the winter surge. However, hospitalizations and deaths, while climbing, are doing so at a much lower rate. As of August 6, exactly half (50 percent) of Americans are now fully vaccinated.
“From a very positive perspective, we have a vaccine now which prevents severe illness and death quite effectively. We also have a growing pipeline of effective therapeutics and much more experience on clinically treating this illness when people do get sick. We also have public health measures that we know work such as masking, physical distancing, increasing testing to find cases quickly before they can spread to a lot of other people. So, there’s a lot of good things out there,” says MacDonald.
Given the new Delta reality and how much has changed over the past few months, we asked our readers to submit questions regarding the Delta variant and upcoming travel plans. Here are some of the queries that were posed and experts’ responses to them.
What does the Delta variant mean for travelers?
For one, it means that we’re already seeing, and will likely continue to see, changes in travel restrictions and public health measures.
Not long after countries in Europe, as well as the U.K., Canada, and numerous other destinations announced reopening plans, we’ve started to see some countries (such as the Bahamas) that were allowing vaccinated travelers to enter without a COVID-19 test add a testing requirement. The United States is considering instituting a vaccine requirement for foreign travelers. Some destinations have implemented a vaccine requirement for entering into venues such as restaurants, theaters, museums, and hotels, including in France, Italy, Puerto Rico, and New York City.
“Lifting travel restrictions is made complicated by the fact that globally countries have varying degrees of immunization and varying epidemics,” states Dr. Tom Kenyon, chief health officer for international healthcare NGO Project Hope and former director of global health at the CDC.
“We have to remind ourselves that COVID-19 is not over for any country. Even here in the U.S., [many] Americans have not yet chosen to be vaccinated, leaving a large population reservoir for proliferation of more infectious variants, such as the Delta variant,” adds Kenyon.
Mask mandates have started to return, too, in places including Los Angeles, San Francisco, St. Louis, and Washington, D.C. They come as the CDC issued a recommendation on July 27 that even vaccinated individuals should go back to wearing masks indoors in parts of the U.S. where COVID is surging due to the fact that the Delta variant can spread even among the vaccinated.
What is the risk level? Can I travel if I’m vaccinated and pro-mask?
“It’s not an absolute no, but I would be very cautious right now about traveling. You’re putting yourself and others at risk. We’re back to where travel should be reserved for those circumstances where it’s just critical. The calculus for each individual is going to be different because different people have different risk tolerance,” says UC Berkeley’s Dr. Swartzberg.
He adds that current projections indicate that we’re going to continue to see the number of COVID cases increase through August and through some if not most of September “before there’s a leveling off and then sometime in October there’s a decline in cases.
“If [the travel is] urgent, that changes the calculus, but otherwise, if you could put it off until sometime in October it will probably be a much safer time to travel.”
Am I at risk to others on arrival, even if I’ve been fully vaccinated?
Whether you are vaccinated or not, “It’s the same for everybody in terms of recognizing that you can spread this to other people, so you have an obligation to other people as well,” says Dr. Swartzberg.
For that reason, he says, it’s important to have a mask on even if you’re fully vaccinated, “particularly inside around other people, but really even if you’re outside around lots of other people.”
If I have to travel, how can I do so safely?
All of the infectious disease experts responded to this question by reiterating many of the same travel-risk calculations we were prescribed in 2020. Traveling by car to uncrowded destinations that aren’t experiencing surges still remains among the less risky ways to travel. The more people you potentially come into contact with during your travels—for instance on planes, in airports, or on trains—the bigger the risk. The same goes for the community transmission occurring where you’re headed, the higher the transmission rates, the higher the risk.
For those who must travel, wearing masks and wearing them well is critically important, according to MacDonald. “I really want people to understand that there’s a large range in terms of the quality of the masks that are available and what people use. What you’re looking for is extremely good fit on your face and lots of filtration,” she says.
She added that testing for COVID before and after arrival is another way to reduce the risks.
Travelers should also assess the full spectrum of risk, including the individual health risks and factors that pertain to each individual traveler in the group as well as to those who you may be visiting and those you may be interacting with both in the destination and upon return. That includes their vaccination status and whether they have underlying health conditions that could put them at higher risk if they were to become infected.
Which trip insurance covers COVID-related trip cancellation?
Rajeev Shrivastava, CEO of VisitorsCoverage.com, a travel insurance comparison and shopping site, sent us these tips on protecting your travel plans amid the ongoing pandemic.
- Purchase trip insurance that ensures that nonrefundable costs can be recouped if travelers need to change or cancel plans.
- Add the Cancel For Any Reason (CFAR) option to a trip insurance policy so that you can literally cancel for any reason—this will come in handy if a country suddenly implements tighter travel restrictions or experiences a rise in Delta variant cases.
- Your U.S.-based health insurance might not cover medical costs while abroad. Purchase travel medical insurance to get help covering unexpected health emergencies.
How should I organize a “Plan B” trip—just in case an original trip abroad is canceled? What destinations in the U.S. could mimic trips to foreign locations?
We have a lot of experience with this thanks to 2020, when we compiled all of our best ideas for a socially distanced vacation and rounded up domestic destinations that make you feel as though you are in Europe. We have become full-fledged experts in road trips and in seeking less crowded and the most underrated national parks.
We’ve pulled together lists of our favorite secluded cabin vacation rentals and Airbnbs on the beach that we love. If you’re having trouble securing a reservation, we’ve gathered together a list of vacation rental companies that aren’t Airbnb so that you can cast a wider net.
There’s also our ultimate first-timers guide to taking a RV trip, for those who never had a chance to get in on the RV craze last year.
Should I wait it out?
“The comments of today could be very different in two months. We just need to sort of be patient and wait and see, recognizing though, we didn’t get back to normal, we got to a new normal again,” says MacDonald regarding how travelers should be thinking about the coming weeks and months.
“We need to build up as a society recognition that we cannot control the entire trajectory of this virus because there are so many unknowns still. It’s a novel pathogen to humans as of a year-and-a-half ago. It’s been sending twists and turns towards us this entire time, including the Delta variant, which is something a lot of people didn’t anticipate.”
She adds, “Am I going to make travel plans for winter? I’m holding off personally. I need to see how things are going to go.”