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Pandemic Journal

Dr Robert Hess: Weekly Omicron Update

Dr Robert HEss

Dr Robert Hess – 12/20/2021

Dr Robert Hess: Weekly Omicron Update

Our Situation report in the run-up to Christmas

The Omicron variant continues on its triumphant march around the globe. According to the World Health Organization, the mutant has already been detected in 89 countries, and more are being added to the list every day. Even in places with high immunity rates, the spread is rapid, and the number of confirmed Omicron cases is doubling every one and a half to three days in some countries. If it continues at its current rate, Omicron will be the prevalent form of SARS-CoV-2 in Europe in around two to four weeks. The UK is one of the first countries to be hit hard – Omicron is already the dominant form there, constituting 60% of new cases. Worryingly, a new study from England does not give much hope for the new variant leading to a significantly milder course of disease.

 

How well a person is protected against Omicron depends on many different factors, for example age, previous illnesses and underlying conditions, vaccination status and length of time since last dose administered. The risk of infection has risen dramatically in Europe, where the transmission rate of Omicron is between 2.5 and 4.3 times that of the Delta variant. For individuals without a basic level of immunity, this presents a huge problem. But it has now become apparent that even double vaccination does not provide sufficient protection against Omicron. The immunity afforded by antibodies against the variant is significantly weakened, as has been confirmed by several recent studies.


According to these studies, double vaccination offers almost 70% protection against the disease taking such a severe course that hospitalization is required. However, the level of protection against actual infection is generally significantly lower than with other variants – some studies estimate it to be as low as 33%.


How will the booster jab perform against Omicron?
Many scientists and virologists warn against inflated expectations and are agreed that even a third dose of vaccine will not provide 100% protection against infection. Although the protection against Omicron increases from a double to a triple vaccination, it is still 4.8 times lower than with the Delta variant. Despite the public exhortations from politicians to the effect of “Get vaccinated and all will be fine again”, this is patently not so. We conclude this from cases of triple-jabbed individuals who have become infected and then gone on to infect others. Particular caution is advised for those who come into contact with high-risk groups.


To predict the growth of the Omicron variant and estimate the degree of immune escape, scientists in the UK analyzed data from all PCR-confirmed SARS-CoV-2 cases in England and published them a few days ago. The results revealed that hospitalization and asymptomatic infection indicators were not significantly different for Omicron, suggesting that there little change in severity compared with Delta. On the one hand, this means that Omicron does not cause worse disease or have higher severity than Delta, but on the other hand, it also means that it is not milder than Delta, as had been initially hoped.


The conclusion we draw from this is that the role played by vaccination status is significantly reduced in terms of immunity to Omicron. The weighting previously given to vaccination is substantially lower than before, so it is now all the more important to take general measures to optimize the immune system. We would therefore once again urge our clients to adhere even more strictly to the recommendations made by us. This includes the personalized elaboration of concepts and measures, as well as the intake of the individually adjusted supplements for the modulation and optimization of the adaptive immune system.


We expect that Delta will have been largely supplanted by Omicron in most countries of Europe by mid to late January 2022. In the United States, this may take a little longer, but it is also the inevitable outcome. It is not yet possible to form a definitive opinion about what will happen in the next few months, with so much being in the realms of speculation, but for the first time, the Omicron variant holds out the theoretical prospect of worldwide herd immunity.

Pandemic Journal

Dr Robert Hess: What next for the SARS-CoV-2 pandemic?

Dr Robert HEss

Dr Robert Hess – 11/02/2021

What next for the SARS-CoV-2 pandemic?

The number of infections worldwide is on the increase, and with it, the number of vaccine breakthroughs. However, it is not only the rising rate of infection that is the root cause of this, but also the waning effect of the vaccines themselves. Nevertheless, individuals without any form of immunization are significantly less protected against COVID‑19 disease, and the mRNA booster jabs seem to be delivering on their promise of offering almost complete protection. There are multiple factors at play here that will continue to occupy our attention this winter. In the meantime, this is how we see the current situation. 

How prevalent are vaccine breakthroughs, and has their number increased? The number of vaccine breakthroughs worldwide is increasing. All manufacturers and vaccines are affected. A vaccine breakthrough occurs when a fully vaccinated person contracts a coronavirus infection with clinical symptoms.

According to the weekly report issued by the Robert Koch Institute (RKI), 95,487 fully vaccinated persons in Germany, have already been infected with the coronavirus since February. In the week of 27th September ‑ 24 October alone, almost 41,000 vaccine breakthroughs occurred among 18- to 59-year-olds. Measured across the entire period since the start of the vaccination campaign in Germany, the percentage of vaccine breakthroughs among symptomatic COVID‑19 cases in this age group has risen to 10.9. However, if we look only at the last four weeks, the ratio is significantly higher at 37.5 percent.
Increases can also be observed in the over‑60s age group, where the percentage of vaccine breakthroughs among symptomatic COVID‑19 cases is 16.1 for the period since the start of the vaccination campaign. And when we take the figures from only the last four weeks, this percentage increases to 58.9.
Other European health authorities are also reporting that, in some regions, half of the new infections are among the fully vaccinated, and the trend is unfortunately upwards. According to the UK government, four out of ten new hospital patients currently being admitted for coronavirus infection have been vaccinated.
In the USA, breakthrough infections were studied in six states – California, Colorado, Massachusetts, Oregon, Utah, Vermont and Virginia – as the authorities there collect the most detailed data on the disease. Whether their findings can be extrapolated to the entire USA is therefore unclear, but breakthrough infections in those six states accounted for 18 to 28 percent of registered cases during September. Among those who had been vaccinated, Johnson & Johnson recipients displayed slightly higher rates of vaccine breakthrough and of related deaths. Additionally, those vaccinated with Pfizer-BioNTech had slightly higher rates than recipients of Moderna, which can most likely be attributed to dosage differences.

Which age groups are affected?
Vaccination breakthroughs are occurring in all age groups. The proportion of breakthroughs is highest among individuals over 60 years of age. In both the EU and the USA, it appears that it is mainly older persons who are being hospitalized with the more acute infections, as well as individuals whose immune system is relatively weak or who have some sort of immunodeficiency. According to CDC data, 74 percent of vaccine breakthroughs occur in adults aged 65 and older.

Why are there so many vaccine breakthroughs?
The statistics show that vaccine breakthroughs tend to increase as more people are vaccinated against a particular pathogen. In the case of SARS-CoV-2, however, this is not the only reason, as multiple factors are involved here. Firstly, the virus now has renewed opportunities to spread, because most countries have relaxed their regulations on social distancing and face coverings, and because the northern hemisphere is entering the colder winter months. Secondly, the dominant form of the virus is still the Delta variant which is more contagious than the original “wild type” (i.e. Wuhan) or successor Alpha variant and also more successful in undermining vaccine efficacy.

In our opinion, the reason why vaccine breakthroughs have increased so rapidly, especially in recent weeks, is due to dwindling vaccine protection. Current studies even indicate that protection could be as low as 20 per cent only four months after the second dose of a COVID‑19 vaccine. Although a double dose is effective against the Delta variant, the protection it affords begins to diminish after only 30 days. A British study in August found that the effectiveness of the vaccine dropped to 90%, 85% and 78% after 30, 60 and 90 days, respectively. The data from such studies may vary, but the take-home message is that we too have observed the phenomenon of rapidly declining protection during the regular antibody level checks we perform on our clients. We therefore have to assume that the antibodies developed as a result of vaccination wane more quickly than was previously thought and generally published.

So, what are the causes of vaccine breakthrough?
Weakened immune system and age: An already weakened immune system will often be a decisive factor. This mostly affects cancer patients undergoing chemotherapy, patients with autoimmune diseases or the elderly. Especially in senior citizens, it is often the case that the immune system no longer responds adequately to immunization.

Mutations: Mutations also impair the effectiveness of the vaccine. The aggressive and significantly more contagious Delta variant reduces the efficacy of the vaccines. This is because this mutation is better adapted than its predecessors to evade the antibodies that are formed after vaccination. Although the current crop of vaccines are also effective against the Delta variant, more antibodies are needed to neutralize it.

Waning effect: As with almost all vaccines, the effect wears off after some time. This seems to be happening somewhat faster with the COVID‑19 vaccines than initially thought. Data from Israel gathered around mid-July 2021 was already indicating that the effectiveness of the BioNTech/Pfizer vaccine had begun to diminish. Israel was therefore one of the first countries to recognize the need for a follow-up booster jab. Their data showed that, after three months, antibody concentration was reduced by about half.

So, is vaccination pointless?
No, on the contrary. Vaccination protects against infection and, above all, staves off a severe course of the disease. Even if the protection against infection declines over time, protection against the potentially severe consequences remains. According to the CDC study, vaccinated people are eight times less likely to become infected and 25 times less likely to be hospitalized and/or die. A survey of intensive care units also confirms that most COVID‑19 patients admitted are unvaccinated. Data from the UK and Europe suggests that vaccination affords 90% protection against hospitalization. Among those aged 60 and older, protection against the risk of hospitalization is 86 percent. Corona vaccines protect against a fatal outcome by as much as 98 percent (87 percent in the over-60s). But in any case, the only sensible way to drive down the rising number of infections is to refresh vaccine protection with a booster jab.

How important are booster jabs?
Due to the rising numbers of vaccine breakthroughs, booster vaccination has taken on a new urgency. Some countries fear they will be entering a fourth wave around Christmas time, and governments are appealing to their citizens to get their booster without delay. But the vaccination program is faltering in many places, and the approach taken by individual countries also varies greatly. In Germany, the booster vaccine is so far only recommended for the over-70s and the immunocompromised. On Friday, however, the German health minister spoke out in favor of offering booster vaccination to all citizens. Sweden and the USA currently offer a booster jab to everyone over the age of 65 and the UK to everyone over 50 (as well as the immunocompromised, health workers, the occupationally exposed, etc.). Israel has already completed the majority of its booster vaccinations. The country was already battling a fourth coronavirus wave in the summer but now seems to have survived the immediate crisis. According to the Israeli health authorities, this is mainly due to the widely administered third vaccination against the virus.

Until now, all booster vaccinations have been given at least six months after the second dose of Pfizer/BioNTech or Moderna. The length of this interval is now up for debate, especially in view of rapidly declining antibody levels. Thanks to our capacity for monitoring the individual antibody levels of our clients, we have been able to ascertain that some would benefit from a booster jab as early as four months after the second dose. If the vaccine administered was J&J, a booster is already appropriate after only four weeks. This is an option that we also recommend, as we have found that the antibody gain from vaccination with J&J is insufficient.

With governments adopting so many different approaches and also national graphs peaking at different times, it will be interesting to see what stage the pandemic has reached in different countries two or three months further along the line.

What do initial data on the effectiveness of the Pfizer/BioNTech booster tell us?
The first full study has shown that a third dose of the Pfizer vaccine provides an “excellent” level of immunity. On 21st October, Pfizer/BioNTech shared results from their Phase 3 study involving more than 10,000 volunteers. These showed that the booster jab conferred 95.6 percent efficacy. In the half cohort who did not receive booster vaccination, 109 persons later became symptomatically infected. In the half who had received booster vaccination, this number was only five. It also showed that those who received a third dose of the Pfizer vaccine almost a year after their first two had higher protection against symptomatic infections than those who had received only two doses. An earlier study based on real-world population data from Israel found a similar increase in protection against serious illness.

Scientists believe that a decrease in the protection afforded by the first two doses is more than compensated for by the third. However, this refers only to a complete and exclusive series of Pfizer/BioNTech vaccination; there are no comparable data yet on the effectiveness of a third dose of Pfizer/BioNTech to top up a course of AstraZeneca or J&J. Two further studies on booster vaccines were also published in the October edition of New England Journal of Medicine. One found that antibody levels to the Delta variant increased almost tenfold after a booster shot of the Pfizer vaccine. We too have observed this antibody increase in our clients who had already received a booster vaccination.

The long-term prospects may at first seem somewhat daunting, but the data speak for themselves. SARS-CoV-2 will remain with us for the foreseeable future, and we will therefore have to learn how best to live with it. Although we may have hoped for even more ways to combat the coronavirus at this point, science never sleeps and we expect that there will be more to come in the future, including not only new vaccines but also drugs to treat a COVID‑19 infection. Apart from having a well-armed immune system, our defenses against a SARS-CoV-2 infection are “limited” to the best available vaccines. But this weapon seems to be effective enough when applied correctly and affords satisfactory protection for the time being. The realization that antibody levels decrease more rapidly than expected after a second dose of vaccine came as a surprise to many, but the phenomenon of diminishing protection over time is nothing new and can also be observed with many other vaccines.

Vaccines and subsequent responses by the immune system are under permanent review and subject to reinterpretation. While constant chopping and changing of rules and regulations may not always be entirely understandable and can at times be unsettling and demoralizing, it is the only realistic way to tackle the pandemic. We learn something new every day. The biggest advantage we see for our clients in this context is that we are not only privy to the latest research findings but can also incorporate them directly into our individual client concept. The specific data on each individual enables us to make precisely tailored recommendations regarding optimal protection against COVID‑19 and to use our own A.I. data sets in the process. Especially against the background of faster than expected decline in antibody levels and T-cell immunity, this puts us at an enormous advantage.

As we cannot yet predict how severe the coming winter will be, we would urge you to continue to maintain your immunity by following our general recommendations and taking your individually formulated supplements regularly. We will keep you informed and continue to advise you individually on booster vaccinations. If you have any questions, do not hesitate to contact our team of consultants.

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Pandemic Journal

Dr Robert Hess: Evidence that Delta does not make children more ill

Dr Robert HEss

Dr Robert Hess – 10/20/2021

Dr Robert Hess: Evidence that Delta does not make children more ill than other variants of the coronavirus.

The Delta variant of coronavirus does not appear to lead to a more severe course of disease in children than earlier forms of the virus, such as the Alpha or Beta variants. This finding emerged from a prospective symptom study conducted in the UK, in which British school-aged children were compared for symptomatic COVID-19 courses over different time periods.

Study results coming in earlier this year had already indicated that the Alpha variant of the SARS-CoV-2 virus does not appear to make children more ill than the “wild” form of the virus which first appeared in China. The prospective COVID-19 symptom study, the results of which were published last week, compared two groups of school-aged children with confirmed SARS-CoV-2 infection: 694 children infected with the Alpha variant between late December 2020 and early May 2021, and 706 children infected with the Delta variant between late May and early July.

Disease profiles (prevalence of symptoms, duration and sevon the course taken by the disease. erity), hospitalization and presence of prolonged (≥ 28 days) illness were assessed. In both groups, half of the children were ill for no longer than five days. Although the Delta variant displayed slightly more symptoms than the Alpha, especially in older children, this was offset by a similar duration of symptoms, whether these were considered individually or for the illness as a whole. Furthermore, very few children in either group required hospitalization, and long periods of illness were rare. The study was, however, limited by the lack of information on differences between the groups that might have influenced the results, such as whether lockdowns were in force and the impact of different seasons on the course taken by the disease.

However, the data suggests that the clinical symptoms of COVID-19 caused by the Delta variant in children are broadly comparable to those of the disease caused by other variants. This also appears to be consistent with data from the US Centers for Disease Control and Prevention (CDC). That is to say, although we are seeing more cases in children, the severity of the disease is not increasing. The reason why more children are contracting COVID-19 is mainly because there are more COVID-19 cases in the population as a whole.

The study contributes quantitative information to the debate on whether there are significant clinical differences in COVID-19 due to the Alpha and Delta variants, and to the discussion on whether it is appropriate or necessary to vaccinate children (especially those in the younger age bracket) against SARS-CoV-2. We will continue to monitor developments here, especially with regard to new approvals for the vaccination of children.

Pandemic Journal

The skepticism of Dr Robert Hess regarding the efficacy of all previous vaccines against the Delta variant has been confirmed

Dr Robert HEss

Dr Robert Hess – 07/20/2021

The skepticism of Dr Robert Hess regarding the efficacy of all previous vaccines against the Delta variant has been confirmed by the announcement from BioNTech/Pfizer that they are working on a vaccine that will specifically target this mutant.

The Delta variant of the novel coronavirus, which is causing concern across the whole of Europe, is now starting to show up in America. BioNTech and its manufacturing partner Pfizer announced last Friday that they are developing an updated version of the Pfizer/BioNTech Covid-19 vaccine that will target the complete spike protein of this latest variant. They also stated that the first batch of this vaccine consisting of approximately 20,000 doses has already been produced at the Mainz plant in Germany. The clinical trials are due to start in August this year.

It was seven and a half months before the original vaccine received official approval, but for the adapted version, the procedure could be accelerated. The urgency is even Dr Robert Hess because scientists have detected new mutations in the meantime that are significantly more complex. This confirms that we were right to express our reservations about the effectiveness of the current crop of vaccines against the Delta variant.

We have always taken with a pinch of salt the headline figures, which tend to be empirical, have so far not been backed up by any clinical study and are primarily intended to shape public opinion. The Pfizer vaccine is the best to have emerged to date, so with the decision by the clear world market leader to go down this route, we see our assessment as being vindicated. Based on information from unofficial sources, we have reason to believe that nearly all vaccine manufacturers are now engaged in developing new vaccines against the spike protein of the Delta variant. So the question now arises as to what happens next with booster vaccines. The Pfizer/BioNTech team are already planning far ahead, having notified FDA, the EMA and other regulatory authorities of their intention to submit an application for a third dose booster jab. We interpret this as confirmation of our assessment that the protection afforded is significantly reduced due to the relatively low antibody production of the vector-based vaccines, and the insufficient T-lymphocyte-based immunization provided by the mRNA vaccines. This is precisely what our Covid-19 antibody and T-cell monitoring has been confirming for some time. The protection conferred by vaccination persists for a much shorter duration than expected, and the purpose of the third jab is to boost immunity sooner than was originally envisaged.

A conservative estimate is that a third dose is needed six months after the first course of vaccination to maintain the highest possible protection. While the FDA has not yet made any response, the EMA is already signaling that it would be premature to issue any statement either way, because there is not yet enough data from the vaccination campaigns and ongoing studies to draw any conclusion. In this matter too, we disagree with the EMA, because there are clear indications that vaccine immunity is significantly lower and lasts for a shorter period than expected. For this reason, we cannot understand the hesitancy on the part of the EMA.

The crucial point is that full vaccination against the Delta variant has to be the priority. With regard to the first round of vaccination, there is an excellent paper from the Pasteur Institute in Paris, which was published in Nature magazine. Here, AstraZeneca and BioNTech/Pfizer vaccines were tested for efficacy against the Delta variant. Only 10% of recipients were protected after a single shot, but the figure rose to about 95% after the second dose. However, we consider these estimates to be wishful thinking. The findings suggest that the first vaccination offers virtually no protection against the Delta variant but that the success rate is significantly enhanced by the second dose. However, all of our Premium clients have already been double jabbed, so they have already jumped over this particular hurdle. There are many millions of people in Europe who have not yet followed up a first dose of AstraZeneca with a second. These people are virtually unprotected against the Delta variant.

The same paper from the Pasteur Institute addresses the question as to whether individuals who have recovered from a first bout of Covid-19 are resistant to the Delta variant, and the answer is an emphatic NO. Survivors must have at least one dose of vaccine to come close to adequate protection against the Delta variant. Unlike the EMA, which recommends that this booster vaccination should not be given until six months later, we believe that the AstraZeneca follow-up jab should be administered 8 to 12 weeks after recovery.

We have identified relevant cases among our Premium clients. Here, the situation is much more transparent, because our immunity testing allows us to give a clear diagnosis of the effects of an infection, based on T-cell immunity and antibody formation. From these results, we make a personalized and individual recommendation as to when a booster vaccination should be carried out and with which vaccine. Because the WHO still does not give a reference value for immunity for both pillars, we are using our own findings as reference values to decide if and when a booster should be administered, or whether it makes more sense to wait for a complete solution based on the next-generation vaccines. Because the picture could change again in the autumn as new variants come along and, depending on the level of immune protection provided by vaccination in each individual, it will be necessary either to start completely “from scratch” with the administration of a next-generation vaccine, or to reinforce existing protection with a booster jab.

 protection with a booster jab.As things stand, we have to assume that a booster is necessary when antibodies, measured as BAU/ml, fall below 2,000. And of these, at least 70% must be neutralizing antibodies, of which again at least 30% fall into the highly effective category. In T-cell immunity, which is ultimately at cellular level, the interferon-Gamma release in the index should not be higher than 5.0, and the interleukin-2 release should not be greater than 2.0. Based on our clients’ own monitoring results, these are the reference values that we currently see as the benchmark for maintaining perfect immune status. They must, of course, be combined with all the other values that signify immunological response. For SARS-CoV-2 in particular, these are our reference values.

The fact that the vaccination campaigns in general are not really getting anywhere near tackling the Delta variant with the existing vaccines is a phenomenon that we have observed for some time in Israel and also in the UK. But in Israel, the trend is particularly noticeable. The country has had by far the speediest vaccination campaign in the world, yet now the daily incidence rate has risen to 450 per 100,000 population. That is one of the highest figures that Israel has had to date, and most alarmingly, 7% of those who have been completely vaccinated fall seriously ill and have to be treated in intensive care units. This is a very high rate, considering that Israel administered mainly mRNA vaccines. In the meantime, face coverings have again been made compulsory in indoor spaces. So here, too, we see the progress made going into reverse. Ignoring the EMA’s hesitant attitude towards approval, the Israeli government has started to administer booster vaccines to certain groups.

For this reason, we are again dubious about the recent statement issued by Johnson & Johnson that its own vaccine is 85% effective against the new mutant and that the immunity it confers will last at least eight months. Frankly, we are astonished by J&J’s assertion that protection lasts eight months when the Delta variant has only been in circulation outside India for the past ten weeks.

The consequences of the Delta variant are enormous. Many countries are initially ignoring the spread of infection, the UK being a notable example. Ultimately, it all comes down to political expediency. And in this context, we think we are heading in a direction where each person, individually and for themselves, devises their own strategy for coping with the pandemic in the coming years, because governments will increasingly withdraw from medical approaches and economic-political factors will instead guide their decision making. One such decision may, of course, be to adopt a policy of so-called “herd immunity” which assumes a 90-95% vaccination rate. This is a prospect that is looking increasingly difficult to achieve. We have had our reservations about the feasibility of herd immunity from the outset and see it as an unattainable goal at this stage.

Some countries remain very cautious, for example Norway, which has postponed its proposed step-by-step reopening. Other governments, such as the French, have gone even further and cancelled arrangements. There are countries where the Delta variant is beginning to circulate which have a very high vaccination rate, such as Chile. High infection rates are already being registered here, with severe cases being treated in intensive care units. This is not exclusively due to the Delta variant, but also to the fact that in these countries inoculation was mainly carried out with Chinese vaccines, most of which are protein-based and achieve efficacy rates of less than 50%. We are convinced that the protein-based vaccines will prove to be even less effective against the more dangerous mutations that lie ahead. And it has to be remembered that the Chinese vaccine products have not passed the rigorous standards of the major regulatory authorities in the western world, not least because data from the critical third phases of testing were never published in reputable peer-reviewed medical journals. There have been no estimates of efficacy in vulnerable, elderly people because too few subjects from this group were included in large-scale trials. Therefore, at least for the time being, the Asian vaccines are playing a negligible part in the fight against the pandemic.

In a recent Keynote, we made our forecast for this autumn in the northern hemisphere. We cannot share the optimistic predictions of a less harsh fourth wave next winter, not least because the mutations already observed are showing another clear change of direction with the Delta variant.

This is where the excellent work being done by the Com-Cov research team in the UK comes into its own. A study on vaccination and cross-vaccination regimens has also begun in Germany. As we reported in a previous Keynote, AstraZeneca and BioNTech (or indeed Moderna) have different strengths that complement each other well. AstraZeneca is particularly good at triggering a T-cell response, whereas BioNTech mainly activates antibody formation. Both vaccines provide the immune system with minimally modified learning material, which is crucial, as was clearly demonstrated in the Com-Cov study. The second BioNTech vaccination is therefore ideal for retraining immune cells already boosted by a first dose of AstraZeneca.

In this scenario, the second vaccination with BioNTech helps the body to remove unsuitable antibodies and T-cells from the body, of which there is an abundance after the AstraZeneca vaccination, thereby enabling the immune system to respond even more efficiently to the pathogen. These additional, unsuitable antibodies are precisely those which, in our view, could constitute the so-called “infection-enhancing” antibodies. We have seen data from the Charité in Berlin that also point in this direction. Should the merits of “mix-and-match” vaccination be confirmed, it will of course be included as an option in the individual strategies we devise for our Premium clients.

Pandemic Journal

According to Doctor Robert Hess, the Delta variant is not the dreaded super mutant

Dr Robert HEss

Dr Robert Hess – 06/18/2021

According to Doctor Robert Hess, the Delta variant is not the dreaded super mutant, but it may be a game-changer in a negative sense.

In various parts of the UK, incidences are rising sharply again; the seven-day rate, which has long been around 20 new infections per 100,000, has recently risen to over 90. Mass testing has now been started in the north-west of England and the vaccination campaign has been stepped up.

Delta has twelve genetic changes in its spike protein compared to the original Wuhan strain discovered in December 2019. However, it has no changes at positions 501 or 484 of the receptor binding site, which I are closely monitoring. These mutations have so far been detected on the Beta (South Africa B.1.3.5.1) and Gamma (Brazil P.1) virus variants and defined as escape mutations. In the case of the Delta variant, however, the relevant change is the L452R substitution in the spike protein. Initial experiments in the laboratory suggest that it significantly boosts binding to the ACE 2 receptors, making it more infectious on the one hand and more dangerous on the other. This means that the risk of infecting a person from the same household is 60% higher with Delta than with the previously dominant Alpha variant; in other words, it is much more easily transmissible. This is apparent not only from the increase in the number of cases but also from contact tracing. The percentage of infected contacts is higher at 12.5% than for persons infected with B.1.1.7 at 8.1%. Data from the UK also indicate that individuals who contract B.1617.2 are at greater risk of ending up in hospital than those who contract B.1.1.7. These statistics make it clear that Delta is not only more infectious, but also more dangerous.

In a study just published in the Lancet, medical experts looked at how effective the antibodies produced by vaccinated individuals are against the Delta variant. The good news is that everyone who received two doses of their particular vaccine developed antibodies against the spike protein of SARS-CoV-2. The bad news, however, is that these antibodies are clearly less able to neutralize the Delta variant than the wild-type virus by a factor of more than 5.8.

For those who have received only one vaccine dose, the effect was even more worrying. 21% did not neutralize the wild type very effectively. For Alpha it was 50% and for Beta (i.e. South Africa) it was as much as 75%. The antibodies produced by a single dose were to all intents and purposes ineffective against the Delta variant in 80% of cases. These findings are clearly at variance with the report issued by Public Health England in which it was stated on a purely empirical basis and without any clinical evidence having been gathered that double vaccination could prevent 96% of hospitalizations. We are deeply skeptical of this claim.

Another study from England with a much better design shows that effectiveness against the Delta variants is clearly reduced, with a single dose of an mRNA or vector-based vaccine protecting against a symptomatic course of the disease in only 34% of cases. By comparison, a single jab protects in 51% of cases caused by the Alpha variant. Efficacy is thus clearly reduced by the new variant. After two doses of an mRNA vaccine, protection against Delta is 88%, slightly lower than the 93% efficacy rate for Alpha. The equivalent rate for two doses of the AstraZeneca vector vaccine is 60% protection against symptomatic disease with Delta and 66% with Alpha. The UK government has already responded by postponing the lifting of all restrictions, originally planned for 21st June, by four weeks. This change was of the utmost urgency, as Prime Minister Johnson announced it immediately after the G7 summit. What has been dubbed “Freedom Day” has now been postponed to 19th July.

The UK is once again at the focus of our attention because, in the western world at least, it is “Delta land” par excellence and, at the same time, it is a leader in the field of gene sequencing. It therefore makes sense for other countries to closely observe what is happening there. The current scenario is also absolutely fascinating for us as scientists. Infections have increased in the UK by 64% in the last few weeks. In the worst-affected areas, cases are even doubling every week. The link between infections and hospital admissions has weakened, but it has not been broken. The number of people in intensive care units is also growing again. According to Public Health England, 91% of new cases are now caused by the Delta variant. Our prediction has been validated, and the race between mutations and vaccination is vividly illustrated here once again. How quickly can the vaccination program be implemented? How well will the vaccines work? And how soon will the next mutation emerge? What is still unclear are the numbers of Delta patients admitted to hospital who had been vaccinated. At the moment, we have three different figures which range between five and twelve percent, so we cannot say that the vaccines are forming a solid wall of defense against these mutations so far. We endorse the four criteria laid down by the UK for mapping the way out of the crisis.

1) the progress made by the vaccination campaign

2) the efficacy of the vaccines

3) the burden on the health system and

4) the risk posed by new mutations.

We predict that the fourth criterion will be the most challenging worldwide.

Looking carefully at the mutations observed in the Delta variant, it is clear that this is definitely not the dreaded super mutant that would ultimately render the entire vaccination strategy futile. It is only a foretaste of what may lie ahead.

Even in other countries that already have a high vaccination rate, such as Chile, the infection rate continues to rise, although the Delta variant has not yet made an appearance there. In Chile, they are still struggling to control the P1 variant. Due to the non-homogeneous vaccination regime in the country, where mRNA- and vector-based vaccines are being administered alongside protein vaccines from China, it is not yet possible to make a definitive comparison of their effectiveness against P1. Ultimately, we have to conclude that, even with a high vaccination rate, a reduction in the number of infections is nowhere in sight, especially as winter is now beginning in Chile.

In Israel, another country that we are observing closely, the vaccination strategy has paid off so far. However, gene sequencing there shows that the Alpha variant still has a monopoly. It remains to be seen whether further mutations will be introduced into the country.

In Moscow, which has taken on the status of “Delta city”, the rate of infection is also soaring and the number of patients requiring artificial respiration in intensive care units has risen sharply.

We are working on the assumption that the antibodies triggered by the vaccines currently in use are therefore less effective. It is possible that, with an overall higher antibody volume, Class 1 of the neutralizing antibodies (i.e. those with the highest efficacy) will also increase and consequently be more effective against the Delta variant. I measure these levels every three months for our Premium clients.