A surge in new cases driven by the delta variant last week prompted the federal Centers for Disease Control to add Apache and Navajo counties to a list of counties where even vaccinated people should wear masks indoors.
The rapid spread of delta, a surge in poorly vaccinated areas and disturbing new research on the variant have prompted the CDC to reverse its previous guidance suggesting fully vaccinated people could safely discard their masks in most situations.
Navajo County reported 42 new cases on Friday and two deaths, according to the Arizona Department of Health Services website. The county reported the results of 222 new tests, with 11% coming back positive.
Only 31% of the residents are vaccinated, according to the state website. This apparently reflects vaccination rates off the reservation, since the Navajo Reservation has a much higher vaccination rate. However, the state reported only 80 additional Navajo County residents got vaccinated on Friday.
Apache County’s doing a little better with 17 new cases reported on Friday and no new deaths. The county reported 106 tests, with 10% coming back positive. The state lists the vaccination rate off the reservation at just 18%.
Statewide on Thursday, Arizona reported 1,800 new cases and 15 deaths. Arizona now has the 10th highest infection rate in the nation, based on infections per 100,000.
The CDC has revised its recommendations for mask-wearing as the delta variant spreads, since it’s more than twice as easy to spread as the original strain. The agency had concluded vaccinated people could forego masks even in crowded situations. However, delta has caused a surge in cases overall plus an increase in “breakthrough” infections among the fully vaccinated. People who suffer such breakthrough infections are still much less likely to end up in the hospital, but can still readily pass the virus along even if they have few symptoms.
The impact of delta could account for events like the super-spreader event in a Linden dance hall, where reportedly 24 out of 70 people in attendance got infected – including perhaps nine people who’d been fully vaccinated.
As a result, the CDC now urges people in areas with a high rate of spread to resume wearing masks indoors in public, especially in crowded situations. As of Friday, Apache, Navajo and Gila counties were all on the list of high-risk areas.
Most of the southern states plus Arizona, Utah, Nevada, Colorado and half of New Mexico were all on the list of high risk states covered by the recommendation.
The latest surge amounts to a pandemic of the unvaccinated, say CDC officials – with the biggest increase in cases in the states with the lowest vaccination rates.
However, Arizona Gov. Doug Ducey has said the state won’t allow mask mandates by cities or counties or schools districts. He said the state law also bars vaccine mandates or vaccine passports or school rules that differentiate between those who have been vaccinated and those who have not — like quarantines after an exposure.
Children appear a bit more likely to get infected with delta than the original strain, but they still face relatively low risk of serous illness or hospitalization. However, most students aren’t vaccinated and studies show schools can spawn fresh clusters of cases in the community — especially in areas with low overall vaccination rates.
Gov. Ducey’s position is in conflict at this point with the recommendation of the state health department, which says it will follow the CDC guidelines.
Health Department spokesman Steve Elliott told the Arizona Republic that the state health department now recommends that people should wear masks and distance in indoor settings, except with people they live with. In schools, everyone should wear masks — including students, staff and visitors, said Elliot.
The apparent conflict comes as State Health Director Dr. Cara Christ is preparing to go to work in the private sector as of Aug. 27.
In Arizona, only Cochise and Yuma Counties right now have a low enough infection rate to not be covered by the CDC’s mask recommendations.
Public health officials continue to scramble to keep up with the changes in the virus as well as the latest research.
For instance, a study in Israel concluded that the Pfizer and Moderna vaccines provide less protection over time — which may mean people will need a booster shot. Some medical experts have challenged that idea — especially since most areas of the world don’t have enough shots for even the highest risk populations. The data submitted by Moderna and Pfizer found that while the vaccines provided 95% protection against infection initially, after nearly a year the protection from infection has declined to about 40%. Fortunately, the protection against serious illness and death remains virtually unchanged. It’s possible the Israeli figures reflect the impact of the delta and other variants. It’s also possible that the results are skewed by the fact that the highest risk populations got the shot first. So the observed decline in protection may not apply to the entire, vaccinated population. The small number of vaccinated people getting infected in the study also limits the conclusions you can draw from the results.
Researchers are also scrambling to understand the risk of breakthrough infections among the vaccinated, especially when it involves one of the new, more infectious strains. One study published in the New England Journal of Medicine concluded that people with high levels of virus-blocking antibodies after getting a shot are much less likely to later suffer a “breakthrough” infection. The study centered on data from 11,500 fully vaccinated health workers in Israel. Extensive testing identified 39 who got infected after getting their shots, all or whom had mild symptoms of none at all. About 20% still had some symptoms six weeks after diagnosis. The study compared the workers who had a breakthrough infection to those who didn’t — and found a marked difference in the levels of neutralizing antibodies.
Both Pfizer and Moderna have applied to the federal Food and Drug Administration for approval of booster shots, based on data showing the protection of the two-shot vaccines wanes over time. The vaccine makers submitted evidence that the protection against infection went from 97% initially to about 84% six months later. Even so, the vaccine still provided undiminished protection against serious illness, hospitalization and death.
Other new evidence suggests that vaccinated people who develop a breakthrough infection can still readily spread the virus to other, unvaccinated people — causing serious illness and death among the unvaccinated.
Now that the delta strain has become the dominate strain in the US — including Arizona — epidemiologists are redoubling their plea to the public to get vaccinated – the best way to stop repeated spikes and prevent the virus from evolving into new, even more dangerous strains.
And that message is especially urgent in southern Apache and Navajo counties, with some of the lowest vaccination rates in the country.