Despite having excellent access to COVID-19 vaccines, the United States and Canada are both experiencing surges in the number of cases of the virus. This massive spike has been attributed to the rise of the Delta variant, a strain that is characterized by higher transmissibility than the original SARS-CoV-2 strain that emerged in December 2019. Notably, the Delta variant is affecting unvaccinated and partially vaccinated individuals across both countries and around the world.
On August 30, 2021, the US had 119,642 cases and 589 deaths due to COVID-19, and 93,863 people were hospitalized. Exactly a year before, 31,074 people were hospitalized. In Canada, many provinces are currently experiencing a “fourth wave”, with more than 13,000 active cases in mid-August — double the number of COVID-19 cases from two weeks prior. According to Dr. Theresa Tam, Canada’s Chief Public Health Officer, hospitalizations due to COVID-19 have also gone up by 12% in the same two-week period.
With so much data thrown at the general public, understanding the numbers can seem difficult. The most important thing is that the Delta variant is transmitting faster than ever, putting unvaccinated individuals in hospitals at an accelerated rate.
The Nature of the Delta Variant and Possible Solutions
The Delta variant (B.1.617.2) of COVID-19 was discovered in India in December 2020 and quickly spread to the United Kingdom due to its increased transmissibility. The strain now accounts for the majority of COVID-19 cases in both Canada and the United States.
To describe the sheer contagiousness of the Delta variant, F. Perry Wilson MD, an epidemiologist at Yale Medicine, explains that “the average person infected with the original coronavirus strain will infect 2.5 other people.” In comparison, he estimates that the Delta variant can spread up to 4 people under the same conditions. While these numbers seem small at first, they can lead to accelerated and exponential growth in cases, as we are now seeing around the world.
An effective way to decrease cases of symptomatic illness and to lower the chances of hospitalization and death is COVID-19 vaccines. Preliminary studies have found that the Pfizer-BioNTech vaccine is 88% effective at preventing symptoms and 96% effective at preventing hospitalization. Even the AstraZeneca vaccine, which is no longer being administered in Canada due to blood clotting risks, has been found to have a good success rate of 67% against symptomatic disease.
As of the latest findings, fully vaccinated individuals are still capable of spreading the COVID-19 virus, especially now with the widely circulating Delta variant. Fortunately, two doses of a COVID-19 vaccine are proven to significantly reduce the risk of death or serious illness due to the Delta variant. Many researchers now agree that COVID-19 vaccines are not aimed at eradicating the virus. Instead, these vaccines are meant to reduce the severity of health risks associated with the virus.
Vaccine Hesitancy in the US and Canada
Although trials have demonstrated that COVID-19 vaccines are incredibly effective in lowering COVID-19 related hospitalizations and deaths, vaccination rates have slowed significantly in certain areas of the US and Canada. In certain American states, such as Mississippi and Alabama, the percentage of the eligible population which is fully vaccinated is as low as 39.57% (as of September 10, 2021). 53.4% of the total US population has the full dosage of the vaccine, at a time where any American over the age of 12 looking to get vaccinated can receive both doses free of charge.
The slowdown in vaccination rates cannot be pinpointed to one cause, but rather a combination of factors including mistrust in government and health officials, misinformation surrounding the vaccine, a lack of urgency, and the overall politicization of the COVID-19 virus. For example, data shows a significant gap in vaccination rates between American counties that voted for Joe Biden and those that voted for Donald Trump in the 2021 presidential election. States with more Republican supporters have much lower vaccination rates, as well as higher levels of mistrust in government officials.
To combat these barriers, it could be beneficial for citizens to be educated about the potential benefits of COVID-19 vaccines from their family doctors and employers. For those who are also unreceptive to guidance from healthcare professionals, “cash bonuses or other incentives” in the workplace could lead to more vaccinations, as found by the Kaiser Family Foundation COVID-19 research project.
There is also a significant racial disparity in vaccination rates across the US and Canada. According to Dr. Ato Sekyi-Otu, leader of the healthcare task force of the Black Opportunity fund, “there’s a 20-point gap with respect to the rate of vaccination[s] in Black Canadians compared to the [national] average.” He attributes this to an increased likelihood for Black Canadians to work in jobs that discourage them from missing work to get vaccinated, even when paid time off is available. In addition, general fear and mistrust in the healthcare system due to historical trauma and current racial disparities in medical care play a significant role in vaccine hesitancy.
The same concerns have been expressed by Indigenous Peoples, who have been historically “vulnerable to medical experimentation and abuse” perpetrated by the Canadian government. To address these important concerns, more should be done to ensure that BIPOC community members play an active role in providing culturally sensitive information regarding vaccines.
Each of these factors can be investigated in more depth, as every individual has a unique reason why they chose to get vaccinated right away or why they have held off for the time being. In the US, the recent full FDA approval of the Pfizer vaccine has pushed more university campuses to begin requiring vaccinations. New information also indicates that there was a small rise in first doses of COVID-19 vaccines in the week after the FDA announcement. While these initial changes seem promising, it will probably take a lot more than FDA approval to push almost50% of Americans to get fully vaccinated, but only time will tell.
Future Mutations and Delta Plus?
Epidemiologists already know that when a virus spreads at such a large scale it will inevitably mutate over time. Some scientists are signalling that a new variant has emerged, called the “Delta Plus.” For now, Delta Plus does not seem to be overpowering the Delta variant. With new mutations on the horizon, removing various levels of stigma surrounding the vaccines and mitigating vaccine hesitancy should be prioritized by state governments to protect more vulnerable people from getting COVID-19. These steps are essential and increasingly time-sensitive with cases rising and vaccine rates slowing down in the US and Canada.