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What You Need to Know about Variants
Numerous variants of the virus that causes COVID-19 are being tracked during this pandemic, Dr. Keyur Vyas talks about the nature of viruses and how to protect yourself against them.
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Learn more about Keyur Vyas, MD
Keyur Vyas, MD
Keyur Vyas, MD, is an Associate Professor of Medicine in the Internal Medicine Division of Infectious Disease at the University of Arkansas for Medical Sciences. He graduated from UAMS with his Doctor of Medicine in 2002.Learn more about Keyur Vyas, MD
Transcription:
What You Need to Know about Variants
Caitlin Whyte (Host): Numerous variants of the virus that causes COVID-19 are being tracked during this pandemic. So, today we are joined by Dr. Keyur Vyas, an Infectious Disease Specialist to discuss the nature of viruses and how to protect yourself against them.
This is UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences. I'm Caitlin Whyte. So, Doctor the new hot topic when it comes to COVID is variants, what do we know about them so far?
Keyur Vyas, MD (Guest): Well, one thing that it's important for people to, to know is that all viruses over time, mutate. Some mutate very quickly. Some it takes a much longer period of time. And so when we hear the term variants, it just means that this is a strain of the virus that has changed in some way or fashion from the, the original identified strain. And so the WHO and CDC have come up with a system to track these mutations that may be medically important, either because they make people sicker or they're more easy to spread between people, or they're somehow different in the way that they behave.
Perhaps they evade some of the coverage provided by our vaccine. So, there's a lot of different things that they keep in mind. And there's a two tier system. They look for variants of interest, which are, you know, things to have on the radar. They keep an eye and say, there's something new here. And we just need to watch it to see if it's going to become something that is concerning.
And then there are variants of concern. Some of the variants of concern are like from the original strain, include the, the Alpha variant, which was the one that first came from the United Kingdom. And then this spring spread around the world and in the US became the most common COVID variant that was in the country.
And then obviously currently the one that we're worried about is the Delta variant, which was originally identified in India. And then later this spring spread to the US and then now comprises the vast majority of new infections, certainly in Arkansas, probably over 90%, but also across the country.
Host: So, we're talking so much about Delta right now. We're also beginning to hear a bit about Lambda. I mean, how do these compare to the virus as we knew it, you know, a year ago, what does this all mean heading into the fall?
Dr. Vyas: Sure. Well, we know a lot about Delta variant now having had to deal with it for the last several months. And there have been studies out of various places, including, you know, Scotland and England that look at Delta compared to both the Alpha variant, as well as the original strain from last year.
It looks like for the Delta variant, that it is much more transmissible between people. So, this study is out of the United Kingdom, showed that it was okay twice as, as transmissible, as the Alpha variant, which was twice as transmissible as the original strain from a year ago. It also seems to make people sicker and looks to be the about twice as many people will require hospitalization with the Delta variant, then they might have with the original strain. Also studies out of China showed that it seems that people become sicker quicker with the Delta variant. So, from the time of exposure within three or four days, people will start shedding virus in their nose and become detectable on our, on our usual PCR tests.
Whereas with the original strain, it often took 5, 6, 7 days before that occurred. The time to people developing symptoms is, is shorter. And what we're also seeing here is that people are ending up in the hospital in a shorter period of time compared to what we would've seen a year ago. So, a year ago, people would have been at home for several days and felt bad before they might've progressed. And we would talk about days seven till 11 being sort of the period of time that we were really worried about somebody potentially needing to come into the hospital or the ICU. Whereas with Delta, that timeframe seems to be compressed. And we see people that come into the hospital within four or five days of even their exposure, not just from the time their symptoms started.
So, the Delta variant is much easier to spread among people. It's also making people sicker and making them sicker quicker.
Host: Now, what does all of that mean for vaccinated folks?
Dr. Vyas: The good news is that the vaccines still have very good efficacy for preventing death as well as preventing hospitalization. So, it's vitally important that people get vaccinated. What we do know is that it's really important that people get fully vaccinated. So, they get their first, as well as their second shot, the first shot efficacy seems to be around 30% for the Delta variant. Whereas the second shot pushes us up to the 80 to 85% range. So, it's really important to get the full benefit of vaccine that people get both doses.
Now that is a little bit less and most people remember that when our vaccines were available in the studies that the efficacy was listed at about 95%. Both of those numbers, you know, 80%, 85%, 95%, those are phenomenal vaccine efficacy numbers. And what we know is that when people are fully vaccinated, even, you know, there is a possibility that they can still get the virus, but when they do, it ends up being a much milder illness for the vast majority of people compared to if they were unvaccinated.
And we see that in the hospital, you know, we're seeing the, the vast majority, you know, 80% above of our patients that are in the hospital are un-vaccinated, especially when we talk about people in our ICUs and on ventilators. When we see patients that are in the hospital that are testing positive for COVID and they've been vaccinated, oftentimes it's either that they test positive when they're in the hospital for something else, maybe they're coming in for a car accident or a heart attack, and we test them and we find that they are positive, but they're not really showing much in the way of symptoms of, of COVID. And maybe they may have mild symptoms or what we're seeing is people we know are less likely to have full response from the vaccine. So, they may be immunocompromised, you know, having had a transplant or cancer chemotherapy, or be on certain medicines that suppress their immune system. And we know that with any vaccine, when your immune system is weakened, they may not be able to drive the full protection from a vaccine, still important to get vaccinated, because it may still be a milder illness than they would have gotten if they had not been vaccinated.
But that's what we're seeing is that when we talk about the burden of severe illness ending up in the ICU and unfortunately dying from COVID-19, that burden is still being carried overwhelmingly by, by individuals that are not fully vaccinated.
Host: So, as of this recording, it's August 17th. What can you tell us? Or just some, you know, things that might calm our nerves as we head into the fall with this Delta now kind of at the top of our news feeds?
Dr. Vyas: I think that the most positive thing compared to a year ago that we have is that we have effective the vaccines that are safe. We know that they're very effective, they're free for everyone and they're readily available across our state and our country. And so that is definite positive compared to where we were a year ago. It's not a situation where there are shortages or people are having to really go long distances to get vaccinated. But we do have to, have to have a large proportion of our population, ideally everyone over the age of 12 vaccinated in order for us as a, as a state and a community to, to derive the benefit of the vaccine. Because if it's anything less, then there's a chance that new variants can emerge, that would potentially evade some of the vaccine protections. And the good news with these vaccines that we have available is that there is the possibility if they need to be modified, there's a lot of news in the last two or three days about potentially third doses or booster doses to help provide additional protection.
So, I think that it's an exciting time. It's very positive that we have these tools to try and stop the spread of this virus and really the unfortunate situation that's keeping us from controlling this pandemic is a lot of the, the hesitancy and reluctance on the part of many people to, to get the vaccine. And some of that is driven by, you know, legitimate questions and concerns. And we can, we can address and discuss and provide factual information. Unfortunately, there's a significant proportion of the population that have been given misinformation and heard that repeated often enough that, that they are very much against getting vaccinated, despite all of the data that we have to show the efficacy and safety of these vaccines.
So, the other aspect of, as far as a positive spin, you know, we, we know how to prevent the spread of this infection. It does involve people getting vaccinated, but it also involves, you know, simpler measures that all of us can, can take and that's wearing our masks when we're around other people that are outside of our household, especially in, in public places, you know, staying home when we're, we're sick so that we don't inadvertently infect other people. If you're sick, get tested, there are testing sites in most communities. And now there are at home antigen tests that are widely available that people can take if they feel sick. Again, if a person tests positive or they feel sick, staying home and helping to prevent the spread is really important.
And then avoiding crowds and, and gathering. So, if we can hold off for a little while longer and, you know, take these measures of maintaining our masks, avoiding crowds, staying home when we're sick, along with getting vaccinated, then we can really drive down the spread of this virus and getting large proportions of our population vaccinated will hopefully help us emerge from this. So, we have the tools available. We just have to continue to work, to build trust with people that are, that are hesitant and, you know, are just ready for this pandemic to be over. And I think all of us are, but we really have to work together and look out for each other and do these measures for a while longer to be able to emerge from it.
If we don't and we have continued transmission of these strains, then there's always the risk of, of new variants coming around. That's what a virus does is, you know, its only purpose is to, is to replicate and make more copies of itself. And every time that a person becomes infected, every time that the virus has a chance to make more copies of itself is an opportunity for new variants to emerge.
And you know, the Delta variant is certainly bad enough. We don't want anything to add to its capabilities as far as being even easier to spread or evading our vaccine protection. And so it's really important that we do everything we can to prevent the spread of this virus.
Host: Well, Doctor, just chock full of information. Is there anything else we didn't touch on that you want to add?
Dr. Vyas: I think that it's, it's important for people to realize if they haven't already, the, our healthcare systems are stressed, not just in Little Rock and across Arkansas, but, but across the south and really across the country, that, that if we don't take these measures seriously that we're really putting significant proportions of our population at risk because at this point in many parts of our country, in many cities, especially here in Arkansas, having adequate numbers of, of beds and ventilators and, and healthcare workers that are able to provide the level of quality medical care that we're used to receiving, that those are all starting to be in short supply.
So we, we really have to do everything we can to try to stop the spread of this virus and getting vaccinated is, is a really important step. Again, vaccines are safe. They're effective. They're free to everyone, regardless of documentation or location. And they're readily available. So, we really need everyone to get vaccinated. It takes a few weeks for immunity to develop and so people have to maintain these other precautions as well, maintaining their masks, avoiding crowds, staying home, if they're sick or exposed.
Host: Great. Well, Dr. Vyas, thank you so much for giving us a few minutes of your time today. And for all the work you've been doing over the last year and a half. For more information, visit uamshealth.com. And thank you for listening today. This has been UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences. I'm Caitlin Whyte. Stay well.
What You Need to Know about Variants
Caitlin Whyte (Host): Numerous variants of the virus that causes COVID-19 are being tracked during this pandemic. So, today we are joined by Dr. Keyur Vyas, an Infectious Disease Specialist to discuss the nature of viruses and how to protect yourself against them.
This is UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences. I'm Caitlin Whyte. So, Doctor the new hot topic when it comes to COVID is variants, what do we know about them so far?
Keyur Vyas, MD (Guest): Well, one thing that it's important for people to, to know is that all viruses over time, mutate. Some mutate very quickly. Some it takes a much longer period of time. And so when we hear the term variants, it just means that this is a strain of the virus that has changed in some way or fashion from the, the original identified strain. And so the WHO and CDC have come up with a system to track these mutations that may be medically important, either because they make people sicker or they're more easy to spread between people, or they're somehow different in the way that they behave.
Perhaps they evade some of the coverage provided by our vaccine. So, there's a lot of different things that they keep in mind. And there's a two tier system. They look for variants of interest, which are, you know, things to have on the radar. They keep an eye and say, there's something new here. And we just need to watch it to see if it's going to become something that is concerning.
And then there are variants of concern. Some of the variants of concern are like from the original strain, include the, the Alpha variant, which was the one that first came from the United Kingdom. And then this spring spread around the world and in the US became the most common COVID variant that was in the country.
And then obviously currently the one that we're worried about is the Delta variant, which was originally identified in India. And then later this spring spread to the US and then now comprises the vast majority of new infections, certainly in Arkansas, probably over 90%, but also across the country.
Host: So, we're talking so much about Delta right now. We're also beginning to hear a bit about Lambda. I mean, how do these compare to the virus as we knew it, you know, a year ago, what does this all mean heading into the fall?
Dr. Vyas: Sure. Well, we know a lot about Delta variant now having had to deal with it for the last several months. And there have been studies out of various places, including, you know, Scotland and England that look at Delta compared to both the Alpha variant, as well as the original strain from last year.
It looks like for the Delta variant, that it is much more transmissible between people. So, this study is out of the United Kingdom, showed that it was okay twice as, as transmissible, as the Alpha variant, which was twice as transmissible as the original strain from a year ago. It also seems to make people sicker and looks to be the about twice as many people will require hospitalization with the Delta variant, then they might have with the original strain. Also studies out of China showed that it seems that people become sicker quicker with the Delta variant. So, from the time of exposure within three or four days, people will start shedding virus in their nose and become detectable on our, on our usual PCR tests.
Whereas with the original strain, it often took 5, 6, 7 days before that occurred. The time to people developing symptoms is, is shorter. And what we're also seeing here is that people are ending up in the hospital in a shorter period of time compared to what we would've seen a year ago. So, a year ago, people would have been at home for several days and felt bad before they might've progressed. And we would talk about days seven till 11 being sort of the period of time that we were really worried about somebody potentially needing to come into the hospital or the ICU. Whereas with Delta, that timeframe seems to be compressed. And we see people that come into the hospital within four or five days of even their exposure, not just from the time their symptoms started.
So, the Delta variant is much easier to spread among people. It's also making people sicker and making them sicker quicker.
Host: Now, what does all of that mean for vaccinated folks?
Dr. Vyas: The good news is that the vaccines still have very good efficacy for preventing death as well as preventing hospitalization. So, it's vitally important that people get vaccinated. What we do know is that it's really important that people get fully vaccinated. So, they get their first, as well as their second shot, the first shot efficacy seems to be around 30% for the Delta variant. Whereas the second shot pushes us up to the 80 to 85% range. So, it's really important to get the full benefit of vaccine that people get both doses.
Now that is a little bit less and most people remember that when our vaccines were available in the studies that the efficacy was listed at about 95%. Both of those numbers, you know, 80%, 85%, 95%, those are phenomenal vaccine efficacy numbers. And what we know is that when people are fully vaccinated, even, you know, there is a possibility that they can still get the virus, but when they do, it ends up being a much milder illness for the vast majority of people compared to if they were unvaccinated.
And we see that in the hospital, you know, we're seeing the, the vast majority, you know, 80% above of our patients that are in the hospital are un-vaccinated, especially when we talk about people in our ICUs and on ventilators. When we see patients that are in the hospital that are testing positive for COVID and they've been vaccinated, oftentimes it's either that they test positive when they're in the hospital for something else, maybe they're coming in for a car accident or a heart attack, and we test them and we find that they are positive, but they're not really showing much in the way of symptoms of, of COVID. And maybe they may have mild symptoms or what we're seeing is people we know are less likely to have full response from the vaccine. So, they may be immunocompromised, you know, having had a transplant or cancer chemotherapy, or be on certain medicines that suppress their immune system. And we know that with any vaccine, when your immune system is weakened, they may not be able to drive the full protection from a vaccine, still important to get vaccinated, because it may still be a milder illness than they would have gotten if they had not been vaccinated.
But that's what we're seeing is that when we talk about the burden of severe illness ending up in the ICU and unfortunately dying from COVID-19, that burden is still being carried overwhelmingly by, by individuals that are not fully vaccinated.
Host: So, as of this recording, it's August 17th. What can you tell us? Or just some, you know, things that might calm our nerves as we head into the fall with this Delta now kind of at the top of our news feeds?
Dr. Vyas: I think that the most positive thing compared to a year ago that we have is that we have effective the vaccines that are safe. We know that they're very effective, they're free for everyone and they're readily available across our state and our country. And so that is definite positive compared to where we were a year ago. It's not a situation where there are shortages or people are having to really go long distances to get vaccinated. But we do have to, have to have a large proportion of our population, ideally everyone over the age of 12 vaccinated in order for us as a, as a state and a community to, to derive the benefit of the vaccine. Because if it's anything less, then there's a chance that new variants can emerge, that would potentially evade some of the vaccine protections. And the good news with these vaccines that we have available is that there is the possibility if they need to be modified, there's a lot of news in the last two or three days about potentially third doses or booster doses to help provide additional protection.
So, I think that it's an exciting time. It's very positive that we have these tools to try and stop the spread of this virus and really the unfortunate situation that's keeping us from controlling this pandemic is a lot of the, the hesitancy and reluctance on the part of many people to, to get the vaccine. And some of that is driven by, you know, legitimate questions and concerns. And we can, we can address and discuss and provide factual information. Unfortunately, there's a significant proportion of the population that have been given misinformation and heard that repeated often enough that, that they are very much against getting vaccinated, despite all of the data that we have to show the efficacy and safety of these vaccines.
So, the other aspect of, as far as a positive spin, you know, we, we know how to prevent the spread of this infection. It does involve people getting vaccinated, but it also involves, you know, simpler measures that all of us can, can take and that's wearing our masks when we're around other people that are outside of our household, especially in, in public places, you know, staying home when we're, we're sick so that we don't inadvertently infect other people. If you're sick, get tested, there are testing sites in most communities. And now there are at home antigen tests that are widely available that people can take if they feel sick. Again, if a person tests positive or they feel sick, staying home and helping to prevent the spread is really important.
And then avoiding crowds and, and gathering. So, if we can hold off for a little while longer and, you know, take these measures of maintaining our masks, avoiding crowds, staying home when we're sick, along with getting vaccinated, then we can really drive down the spread of this virus and getting large proportions of our population vaccinated will hopefully help us emerge from this. So, we have the tools available. We just have to continue to work, to build trust with people that are, that are hesitant and, you know, are just ready for this pandemic to be over. And I think all of us are, but we really have to work together and look out for each other and do these measures for a while longer to be able to emerge from it.
If we don't and we have continued transmission of these strains, then there's always the risk of, of new variants coming around. That's what a virus does is, you know, its only purpose is to, is to replicate and make more copies of itself. And every time that a person becomes infected, every time that the virus has a chance to make more copies of itself is an opportunity for new variants to emerge.
And you know, the Delta variant is certainly bad enough. We don't want anything to add to its capabilities as far as being even easier to spread or evading our vaccine protection. And so it's really important that we do everything we can to prevent the spread of this virus.
Host: Well, Doctor, just chock full of information. Is there anything else we didn't touch on that you want to add?
Dr. Vyas: I think that it's, it's important for people to realize if they haven't already, the, our healthcare systems are stressed, not just in Little Rock and across Arkansas, but, but across the south and really across the country, that, that if we don't take these measures seriously that we're really putting significant proportions of our population at risk because at this point in many parts of our country, in many cities, especially here in Arkansas, having adequate numbers of, of beds and ventilators and, and healthcare workers that are able to provide the level of quality medical care that we're used to receiving, that those are all starting to be in short supply.
So we, we really have to do everything we can to try to stop the spread of this virus and getting vaccinated is, is a really important step. Again, vaccines are safe. They're effective. They're free to everyone, regardless of documentation or location. And they're readily available. So, we really need everyone to get vaccinated. It takes a few weeks for immunity to develop and so people have to maintain these other precautions as well, maintaining their masks, avoiding crowds, staying home, if they're sick or exposed.
Host: Great. Well, Dr. Vyas, thank you so much for giving us a few minutes of your time today. And for all the work you've been doing over the last year and a half. For more information, visit uamshealth.com. And thank you for listening today. This has been UAMS Health Talk, the podcast by the University of Arkansas for Medical Sciences. I'm Caitlin Whyte. Stay well.