Delta COVID changes the pandemic struggle: a leaked CDC document and what it means for higher ed

Last night and this morning I worked hard on climate change and higher education, writing up two book chapters and a blog post.  But I’m not going to blog about that today, because the latest COVID developments are so urgent and fast-moving.

Here I’m going to outline a leaked CDC document, then point to some possibilities for higher education.

This week the Washington Post published an internal CDC Powerpoint stack and the CDC’s director admitted its authenticity. The document is a presentation by a task force to the rest of the organization, apparently, and it develops two points: the latest research on the Delta COVID-19 variant and how CDC should best communicate it.

Let me summarize the key points, and share some of the graphics.

Delta is much more infectious than previous COVID variants.  It’s more transmissible than smallpox, akin to chicken pox, not so virulent as measles.  Its R0 value is up to 8 or 9. It’s also somewhat more dangerous to humans, leading to some increases in people being hospitalized, admitted to ICUs, being put on oxygen, getting pneumonia, and dying.

Here’s the presentation’s chart comparing Delta to other COVID-19 variants and to other diseases:

Additionally, vaccines are not so effective with Delta as they are with prior variants. They are still good at massively boosting our odds of being hospitalized or killed, especially if we’re not immunocompromised or living in long-term care. But vaccinated people can catch and spread Delta.to a surprising degree.  A growing number of vaccinated people are showing up with COVID-19 in hospitals: 15% of the total in one sample.  “Vaccine breakthrough cases will occur more frequently in congregate settings, and in groups at risk of primary vaccine failure (i.e., immune compromised, elderly, etc.)”  At worst, “Delta variant vaccine breakthrough cases may be as transmissible as unvaccinated cases.”  Don’t miss that sentence!

Delta infections may also last around 50% longer than do previous variants.  At least one slide (16) notes data showing infections lasting a “median 18 days vs. 13 days for ancestral strains.” (“ancestral” means “prior,” I believe)

For the CDC (and, I infer, public health professionals in general) this presents communication challenges.  Vaccines look less effective than they did just a few weeks ago, but are still crucial.  So the document urges people to talk about how rare transmission and harm is for the vaccinated, compared to the unvaccinated.

There’s actually a series of recommendations, including personal stories played off against broader statistics:

What is to be done?  The presentation is very clear.  First, all kinds of nonpharmaceutical interventions (NPIs), like social distancing, limits on meeting sizes, stay at home orders, etc. should be implemented.  The slideshow above all asks CDC to call for masking at a universal level:

Note the fiery red font and box.

Second, we need more vaccinations, even given their reduced efficacy.  This is especially important for “vulnerable populations”: people with comorbidities, those living in senior housing and long-term care units.

What does this mean for higher education?

We’re already seeing signs of the Delta variant infecting the academic world, acting as the leaked CDC document describes.  One vaccinated university president admitted to testing positive for the variant:

Dear Marquette community,

I’m writing today to share some personal news. After experiencing mild cold-like symptoms, I took the responsible step of getting a COVID-19 test, and although I am fully vaccinated, the results came back positive this afternoon.

— Michael Lovell (@PresLovell) July 27, 2021

As did another.  Elsewhere, the University of Maryland canceled study abroad trips to Britain, due to Delta takeoff there and federal guidance.  Louisiana State University canceled an athletic trip.

Yet right now many academic institutions seem oriented on something close to business as usual.  Reopening for in-person education is widespread.  The Chronicle of Higher Education’s vaccine mandate tracker counts 619 campuses requiring vaccinations, or just  around 14% of the total American sector. One approach to not mandating vaccinations is to mandate testing on the unvaccinated (for example) or to just test everyone (for example).

Some campuses are pushing to increase vaccinations in their populations, and we could see more over the next few days.  The University of Michigan, my alma mater, announced a vaccine mandate as I finished this post. As incentive, Auburn is giving prizes to vaccinated students.  A Florida university tried to mandate vaccines, but changed its mind under pressure from students and possibly politicians.  An online petition spoke thusly:

“Many students have scholarships, or even volatile living situations and giving them an ultimatum regarding the vaccine is immoral,” the online petition’s description said. “Putting anything in your body should be a calculated choice, not a means to avoid social punishment. This move will deter students from the institution and impede on the social, mental health of the students more than it already has.”

The petition claimed EWU’s vaccination requirement for on-campus activities is in violation of Gov. Ron DeSantis’ executive order banning businesses from requiring “vaccine passports” for access or services.

Which gives one glimpse into “hesitation.”

Duke University announced a mask mandate for all campus buildings except dorms, explicitly because of Delta, as did the University of New Mexico.  The University of Kansas didn’t mandate masks, but strongly recommended people wear them indoors.

We may also have to deal with a socio-cultural problem over people who have not been vaccinated, the anti-vaxxers or vaccine hesitant. Some medical authorities argue that America’s failure to get half the population injected made Delta worse.  For example,

If more people had been vaccinated earlier this year, cases would not be rising now and a return to masking wouldn’t be necessary, said Dr. Eric Topol, director and founder of the Scripps Research Translational Institute in La Jolla, California.

“We wouldn’t be in this pickle if we’d had 70% of the population vaccinated,” he said. “When you have more than half your population not (fully) vaccinated, you’re vulnerable.”

How much on-campus friction should we expect about this?  For example, if a student proudly proclaims themselves unvaccinated, how long until someone talks sternly to them, or just clouts them?  How much static, or violence, should campus staff expect in trying to impose public health measures?

I’m thinking of this in part because of an email I received from the right-wing Turning Point group, which proclaimed that “More than 2,500 colleges and universities across the country are essentially forcing students to get the COVID vaccine — regardless of their health or discussions with their own medical doctors.”  Besides being factually wrong (see the Chronicle tracker up above), this could indicate a drive to increase the political nature of the pandemic and our response.

We will also have to grapple with mental health challenges.  Ray Schroeder writes movingly about this in a new column, urging us to recall the long-term psychological cost of the pandemic to date.  If Delta keeps surging through our population, that cost will surely rise even further.

To sum up, American higher ed is responding in our historical fashion of autonomous and diverse decision-making.  It looks like a mix of innovation, imitation, and all too often taking steps which increase the chances of Delta spreading.

Looking ahead, campus leaders may be revisiting the decisions they made in summer and spring of 2020, weighing costs, risks, public opinion, and strategic intelligence.  I don’t know how many are seriously considering alternatives to in-person education, either remote instruction or some form of HyFlex.  I expect to see various forms of mask and vaccine mandates or encouragements.

On a personal note, my wife has been called back to work as a contact tracer for the county next to ours.  Meanwhile, I have a professional trip scheduled for next week and am, well, anxious about it.  I’m also scheduled to teach classes in person starting later in August and am quite keen to see what measures are in place to keep students and myself safe.  Will some or all of this switch online in a few days?

My best wishes to all readers for their sanity and physical health.

(thanks to Ed Vielmetti, the Chronicle of Higher Ed and Inside Higher Ed for some stories, as well as Tom Haymes, Ruben R. Puentedura, and my family for discussions)