The Centers for Disease Control and Prevention's recent COVID-19 guidance recommends that everyone — regardless of vaccination status — wear a mask in indoor public settings in areas of substantial and high community transmission. That now includes all of Massachusetts, except for Hampshire and Franklin counties, which the CDC lists as having a moderate level of transmission.
Dr. Mark Keroack of Baystate Health, based in Springfield, Massachusetts, said the delta variant is very much in western Massachusetts.
Dr. Mark Keroack: We have gone from having only four cases in the hospital about three weeks ago to about 30 in the hospital today, and there are cases in all four of our hospitals — so, Greenfield, Westfield, Palmer and Springfield.
Carrie Healy, NEPM: Are you seeing the same kind of complications due to the coronavirus in western Massachusetts that colleagues across the state at other hospitals are seeing?
Yes, we are. I mean, we basically are seeing the really deadly complications, typically in the unvaccinated, typically in people who are older or who have other comorbid conditions, are in advanced respiratory failure, unable to get oxygen to the blood and a shutdown of the other organs. Those are the people that wind up in the intensive care unit.
People ending up being breathless and on oxygen for days — a frightening symptom, but those are the kind of middle range.
And then we're seeing maybe 5% or 10% of the infections wind up with this so-called long COVID. We've set up a specialized multidisciplinary clinic for people who have those symptoms. And, you know, I'm hearing from the people that it's been busy, it's been oversubscribed.
Fortunately, the great majority of people seem to pull through after a few months of what may be fatigue or achiness or so-called brain fog, loss of taste and smell. And these [symptoms] seem to happen even in people who get mild infection at a small rate — 5, 10%. And so that's another argument for vaccination. Yes, you may well get COVID and just get a mild infection, but you're rolling the dice that you're not going to get this so-called long COVID problem.
The delta variant is one of many variants that health officials are closely monitoring as the virus continues to evolve. What is known about the symptoms of the delta variant among those who are vaccinated? Are those going to be the same symptoms that we've been watching for the past year, plus?
Yeah, I think that if you look among the vaccinated individuals, the delta variant either causes no symptoms at all or will cause a mild kind of stuffy nose, cold or flu kind of symptoms. Occasionally people will feel bad enough that they may want to go to bed for a few days. But it's really a very small percentage of people who end up being sick enough to be in the hospital and having low oxygen levels.
The national figures have shown that among those hospitalized for COVID, 97% are unvaccinated. And among the vaccinated people who end up in the hospital, they're often people who've not mounted a good response to the vaccine because of a weakened immune system.
I'm curious about how you feel about businesses who are making plans for September, a return to office in-person, like we worked before the coronavirus. In light of the decision by Baystate Health to require COVID vaccinations of its employees, do you have any guidance for private companies who are preparing to gather in the office after Labor Day?
Well, I would ask them to strongly consider a vaccine mandate if they're going to bring everybody back together. If they're not going to mandate vaccine, they should certainly strongly encourage it and ask everybody to be wearing masks if they're in indoor situations.
