Just when we thought the COVID-19 pandemic rollercoaster was slowing down to let us off, a new variant might be taking everyone back up for another loop.
But just how scary a ride it will be this time is hard to say.
Cases in Chicago and Illinois are increasing, though the daily averages are far lower than previous points in the last year. Hospitalizations and deaths have seen a slight uptick, but still remain low. And after the Centers for Disease Control and Prevention last week dubbed more than half of Illinois’ counties as areas of “substantial” COVID-19 transmission, some public officials in the state began recommending everyone go back to wearing masks indoors.
Less than two months after Illinois fully reopened, all signs are pointing to another surge, health and public officials say, but some say this one may not be as alarming. And that’s because of how many people have been vaccinated already.
“Numbers are on the rise. Delta is here, it’s more than 80% of the cases that we’re diagnosing. … But the vaccines continue to be highly protective, especially against severe illness,” said Chicago Public Health Commissioner Allison Arwady on Sunday. “We have no goal or current plans to close down Chicago again. But we need people, please, once again to step up [and get vaccinated].”
Other health experts WBEZ contacted expressed some concern about the recent uptick, but also reiterated that vaccinations may be key to protecting against serious infection.
“We’re headed in the wrong direction,” said Dr. Tina Tan, a pediatric infectious disease physician at Robert H. Lurie Children’s Hospital of Chicago and professor at the Feinberg School of Medicine at Northwestern University. “The numbers are going to increase until we can vaccinate more individuals, and until people start to adhere to the mask mandates and the other protective protocols.”
The Washington Post first reported the news that the delta variant of COVID-19 is about as contagious as chicken pox and that even vaccinated people may be carrying high amounts of the virus that may be passed on to others.
“We have something that is just not your grandma’s COVID,” said Dr. Mia Taormina, infectious disease specialist with the DuPage Medical Group. “This is not the COVID we saw last year.”
But just how long it might last is unknown.
“There are some models that show that this is going to be fast and furious and as quick as it’s coming up, it can turn back down,” Taormina said. “And there’s other models that show that this particular surge may not peak until a couple of months from now.”
COVID-19 numbers going up, but still low
Cases of COVID-19 increased in Illinois by 46% last week, the Illinois Department of Public Health reported on Friday, with 11,682 cases reported over the week.
In Chicago, the 7-day average of new daily cases hit 206 on Friday, up from an average of 131 the prior week.
While those numbers remain far from the daily averages seen during last winter’s surge, they are still increasing rapidly after months of decline.
However, some health experts say there’s a big difference between this rise and those of the past year.
“The critical thing that’s different about this surge versus any other wave that I’ve experienced before, is we are experiencing this surge in the context of a majority of people being vaccinated,” Taormina said.
About 51% of Illinoisans were fully vaccinated against COVID-19, as of Friday. Vaccination rates have slowed significantly and there’s little evidence so far the delta variant is spurring more people to roll up their sleeves.
Chicago Mayor Lori Lightfoot joined Arwady Sunday in urging vaccinations, emphasizing the need in particular for six South and Southwest Side ZIP codes where less than 50% of the population has been vaccinated. Across suburban Cook County and downstate, there are several towns and counties where vaccination rates continue to lag. In some cases, barely a third of all residents have rolled up their sleeves.
Taormina said the preliminary data from the CDC about the delta variant’s higher viral loads in vaccinated people is a cause for concern, but is not a sign that vaccines don’t work.
“We knew that there was going to be an uptick this fall, but we’re sitting here at the end of July, early August and we are on the up and up,” she said. “Get it now so that you are well protected for the fall.”
Hospitalizations, deaths ticking up
While hospitalizations and deaths are on the rise again, it is mostly unvaccinated people who are needing in-patient medical care.
Several hospitals tell WBEZ that their operations remain steady, but warn they could be experiencing the calm before the storm.
“The reality is … things remain slow,” said Tobin Klinger, a spokesperson for Rush University Medical Center. “That said, with Lollapalooza this weekend, things might be different in the coming weeks… and we are well prepared should things start to ramp up.”
Taormina said earlier this summer, there were essentially no COVID cases in the hospitals where she works.
“We started to see the tables turn shortly after the Fourth of July and then into the back half of this month,” she said. “Every hospital where I’m on staff, presently, has at least a handful of cases, and most hospitals have some in the ICU.”
Cook County Health spokeswoman Alexandra Normington said hospitalization numbers remain steady, and the vast majority of people in the COVID unit are unvaccinated.
Dr. Rachel Rubin, a senior medical officer with the Cook County Department of Public Health, explained the current low hospitalization rates this way: While unvaccinated people are more likely to end up hospitalized or dead from COVID-19, many unvaccinated people in Illinois and across the country are younger, and better positioned to survive a COVID infection at home.
“But that doesn’t mean that they can’t spread it to somebody else that is potentially at risk for getting severe complications,” Rubin added.
That would include the state’s elderly population, which suffered the brunt of deaths in the pandemic. Still, nearly 80% of Illinois’ 65 and older population are already fully vaccinated.
Concern over breakthrough cases
Data from the CDC indicates nearly half of Illinois’ new COVID-19 cases are now from the delta variant. But it’s not clear what percentage of the cases are occurring in vaccinated people.
So far this year, 169 fully vaccinated people have died of COVID-19, in Illinois, according to IDPH. That’s just 2.4% of this year’s nearly 7,000 COVID-related deaths.
Overall, though, data show that vaccinated people are still far less likely to get a severe case of COVID-19.
On Friday, the CDC released findings from a case study on the spread of the delta variant in Provincetown, Mass., after the 4th of July holiday. The outbreak identified more than 450 cases, of which 75% were in fully vaccinated people. But there were just 5 hospitalizations and no deaths.
Though Cape Cod is 1,000 miles from Illinois, there are questions and concerns that similar mass gatherings, like Lollapalooza, could lead to similar outbreaks, even among fully vaccinated people.
“There’s a lot of concern that we are heading to a point where, especially amongst the unvaccinated, that these cases are going to keep going up and then it’s going to impact the people who are vaccinated, which we’re already starting to see,” said Dr. Shikha Jain, an oncologist at University of Illinois Health who helps lead a coalition of health care professionals called IMPACT.
“There’s also a concern that with the spread in the unvaccinated that we’re going to see more variants come up. And with these more variants that are coming up, they’re going to become more contagious, or might even get to a point where they can avoid our vaccines.”
Normington, of Cook County Health, said the system has seen 30 breakthrough cases since April, but most have been asymptomatic cases caught through other routine screening.
Arwady, the commissioner of CDPH, said Thursday that her department is tracking every breakthrough case closely, but that they still are very rare in Chicago.
Concern for unvaccinated children
Dr. Tina Tan said the rise of the delta variant is particularly concerning for children under the age of 12 who are not yet eligible to be vaccinated.
“You’re talking about a vulnerable pediatric population that can become infected with the delta variant, as with any COVID-19 variant, and some of these kids can become quite ill with it,” Tan said.
The CDC updated guidance earlier this week, recommending universal masking in schools this fall, even among vaccinated teachers and kids over the age of 12.
Taormina said there has been a sentiment that because children don’t often get as sick with COVID, there’s little need to worry. But that was “last year’s COVID” and may not be true of the delta variant.
“Now, we are looking at a very real possibility that children … may simply carry more virus, and if they carry more virus, they may be drivers of this infection unintentionally to someone who’s vulnerable,” Taormina said.