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Delta Variant Outbreak Likely More Prevalent Than Data Shows—But U.S. Could ‘Turn The Corner’ In 3 Weeks, Former FDA Head Says

Topline

In a televised interview Sunday, Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, warned Covid-19’s resurgence in the United States is likely more pervasive than reported data suggests due to undocumented cases, but said that may actually mean the nation is close to “turning the corner” on the new Delta variant outbreak in the coming weeks—at least based on its trajectory in the United Kingdom. 

Key Facts

“I believe there’s more virus than we’re picking up right now,” Gottlieb said on CBS News’ Face the Nation, pointing to factors likely skewing reported case counts lower, such as the growth of at-home antigen tests that aren’t reported to the government and a rise in infections among younger Americans still able to transmit the virus but more likely to be asymptomatic.

He said the possible dearth in unreported cases could mean the nation is “much further” into the Delta variant outbreak than case counts show and forecasted the U.S. could start seeing new cases, which have been steadily rising since the beginning of this month, level off in the next two to three weeks. 

Gottlieb based his prediction on the trajectory of the United Kingdom’s Delta-spurred outbreak, saying the U.S. is about three to four weeks behind in terms of the rate of infections, which rose there for about seven weeks and started to fall on Thursday.

He said experts “don’t have a good sense” about how exactly the case counts could transpire but referenced a prediction by the Centers for Disease Control and Prevention that new weekly cases, currently at about 350,000, could total anywhere from 92,000 to 800,000 infections in the week ending August 14.

Citing “significantly higher” virus levels that make the Delta variant more contagious than older Covid-19 strains, Gottlieb advised even vaccinated Americans to wear masks for protection against the new variant in “high-prevalence” environments—comments echoed by Dr. Anthony Fauci and former U.S. Surgeon General Jerome Adams in separate Sunday interviews.

“We’re going in the wrong direction” with the pandemic, Fauci, who serves as President Joe Biden’s chief medical advisor, told CNN’s State of the Union, calling it a “prudent” decision for officials in cities like Chicago, New Orleans and Los Angeles to once again start mandating indoor mask-wearing, even among the vaccinated.

Crucial Quote 

“If you look at the U.K. in the last seven days, they do appear to be turning the corner,” Gottlieb said Sunday, pointing out the downward trajectory on new cases in the nation. “It’s unclear whether that’s going to be sustained [since] they just lifted a lot of the mitigation they had in place, but if the U.K. is any guide, we are perhaps further into this epidemic and hopefully going to turn a corner in the next two or maybe three weeks.”

Key Background

The highly contagious Delta variant, first identified in India, sparked a third wave of the pandemic in the United Kingdom this summer despite it being one of the most vaccinated countries in the world. New daily cases in the country fell to a months-long trough earlier this year until the Delta variant became its dominant strain, pushing weekly cases up from less than 25,000 in early June to nearly 350,000 in mid-July and forcing the country to delay its reopening for about a month. Daily infections peaked on July 17 and have since fallen about 45%.

Big Number

350,000. That’s about how many new Covid-19 cases have been reported in the U.S. over the past week, up 172% from just two weeks ago and the highest levels since late April. About 49% of all Americans are fully vaccinated.

What We Don’t Know

Another factor likely contributing to under-reported Covid-19 cases, Gottlieb said, is the lack of research on breakthrough infections, which the CDC is currently only tracking when people get hospitalized. “We need to understand whether or not vaccinated people are developing some non-clinical or mild infections and whether or not they can spread the virus, because that’s important,” Gottlieb said. Thus far, he says the U.S. has had to depend on data from nations like Israel, where researchers last week suggested the Pfizer vaccine is only 39% effective against the Delta variant. However, those findings conflict with other studies indicating only slightly diminished degrees of protection against mild illness. Last week, for example, peer-reviewed research out of the U.K. concluded the vaccine was 88% effective after two doses.

What To Watch For

Gottlieb, who sits on the board of vaccine-maker Pfizer, said it’s not likely the U.S. will authorize the company’s Covid-19 vaccine for children under the age of 12 before winter. The clinical data for its ongoing trial, he says, should be available in September, but the FDA is likely to then require up to six months of follow-up testing before moving on authorization.

Further Reading

Former FDA Head Says Delta Will Infect ‘Majority’ Of Unvaccinated Americans—And May Be ‘Most Serious Virus’ In Their Lifetime (Forbes)

Declining Vaccine Efficacy—Particularly Among Older Individuals—Prompting Pfizer’s Emergency Booster Request, Former FDA Chief Says (Forbes)

Delta Variant Could Push US Covid Immunity To 85%, Says Former FDA Head (Forbes)

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