Beating the Delta Variant (Or Losing The World to It)
(Complete With Childish Drawings of Covid-19 Viruses)
It’s been a rough summer dealing with the Delta variant of Covid-19. The virus is spreading fast, kids are being hospitalized at higher rates than ever, and after everything we’ve been through, Delta just seems like a crowbar to the kneecaps. With a leaked CDC slide deck (which probably shouldn’t have been taken as seriously as it was) saying it should be treated like “a whole new virus” and that “the war has changed” it can seem apocalyptic. So, what has make Delta so different from anything that came before in the pandemic?
First off, it’s not a whole new virus. Delta is different by virtue of being just more. It’s extra, as they say on the internets. Not magical, not evil, just better at being a virus. It’s the same SAR-CoV-2 virus, just more efficient.
What Makes a Virus so Virusy?
There are two ways a virus can mutate to defeat our body’s defenses.
1. The virus can change its shape enough that our immune system doesn’t recognize it anymore. This is called immune escape. You might have been imagining viruses and the immune system as some kind of incredibly complicated, inscrutable thing, making as much sense as a hacking scene in a movie, but it’s nothing like that. The immune system mostly works on shapes. Specifically, the shape of a part of a thing it wants out of the body. That can be the knobbly bit of a virus (like this one) or a bacteria, or a part of a toxin, or even your own cells changing shape as they go cancerous.
If the immune system knows a shape that occurs on the surface of something it wants to kill like a virus, it can make antibodies that stick to it, clogging its machinery, and send out other cells that just eat whatever the antibody is sticking to. Of course, the immune system is actually incredibly complicated, but it’s also as simple as playing with Legos. If SARS-CoV-2 evolves in a way that changes the shape of the part the immune system likes to stick to enough, the immune system has to figure out the new shape to attack it — defenses defeated, at least for a time until the immune system learns the new shape.
2. If a virus is very good at binding to cells, getting inside them, and quickly getting the cell to make as many copies as it can before it dies, it can move incredibly fast with a huge army of virions (the word for an individual particle of a virus) all over the body. This is what Delta is good at. It’s just really, really damn fast, which means there’s a much higher number of virions in your body, doing their viral thing much faster than any variant before it.
And now the world is asking “What the hell, Delta?”
Delta has a few mutations that make it very good at attaching to a cell, invading it, and then getting that cell to make thousands of baby Delta viruses which are also very good at attaching to cells, invading them, and then getting those cells to make thousands of baby Delta viruses. That process moves fast, and it’s overwhelming — every time a cell is infected, it dies. Whatever that cell was doing, protecting, producing, etc., is not happening now. If enough die together, that can tear a tiny hole in the part of the body they were in. That’s how a virus kills: one cell at a time — but it adds up.
Because it is very good at getting into our cells, the best Covid virus so far, it takes a smaller number of individual virions to cause an infection. And once in the body, the population of virion babies the body has to deal with grows much faster. So much faster that it’s hard for the body to respond before the virus is overrunning the area it has infected. When the body does respond, it can be catastrophic; overreacting to everything in ways that makes Covid-19 far more dangerous. The only way it has to stop the virus once it is in a cell is to kill the infected cells. When the disease gets bad enough, it’s both the virus and your own immune system ripping tiny bits of your body apart.
It’s likely how many Delta particles someone is exposed to matters. Because the virus reproduces in your cells with fast exponential growth once it gets in the body, a small initial dose can give your body time to react; a large initial dose of virions will look like a Walmart Black Friday sale from the Before Times.
Either way, once Delta is in the body and reproducing, it can create a lot more copies of itself, until the body catches on and mounts a fight against the virus. When the body is fighting back, it covers the virions in antibodies, sends other immune cells to kill any cells infected with the virus before they can explode out in a flurry of new virions, and even eats the virions and infected cells, which is hella metal. After that, the infected person will poop them out. The question is, can the body start fighting back before the virus is everywhere and covering everything, destroying cells all over the body? Can it react in time, and strongly enough to kill and dispose of all those tiny virions floating around the body, but not so strongly that it kills the body? How many Walmart Black Friday sales all over the body can a person take?
In the case of vaccinated people, the answer is overwhelmingly that they will beat the virus, even with a lot of virions to deal with. They don’t have to learn about the virus’ shape or get the engine going to make the immune cells that kill and/or eat the viruses and infected cells. Those systems are already in place when Delta gets in. They can get started early, which is very important when you’re dealing with a nasty customer like Delta.
For the unvaccinated, it’s a lot dicier. The unvaccinated body is going to take a while to figure out what’s happening, what Delta is shaped like, and get the antibodies (and T-cells, which do a lot more things than antibodies do) out fighting back the ever-growing flood of virions trying to rip your cells apart. Without the vaccines, the body can be in for the fight of its life against so many damn virions. It may not win, or when it wins, the immune system may have had to be so brutal to get rid of the virus that it’s also torn up the lungs, or heart, or brain, or really any part of the body where an overstimulated immune system fought it out with the virus.
All of these variables can change what will happen when someone gets Covid-19, and they’re all pretty much unknowable in any individual case of the disease. Individual bodies vary in how hard and fast they react to infections. It will always be faster and better when someone is vaccinated, but people are different.
People come in varieties: some are fast, slow, overwhelming, shy, introverts, extroverts, and so on. The same holds true with immune systems — our immune systems are as individual as we are.
But Why Do Vaccinated People Get Delta?
Let’s step back — what do we mean when we say someone “gets” a viral disease? That may seem like a straightforward question, but it’s not. If it’s a question of any virus entering the body, then you “get” viruses all the time and never know, possible thousands a day, but they’re not compatible with your cells. They become so much organic dust you flush out of your body, because they have failed to find their natural victim cell. When virions that can attach to your cells get into to you, but they are something your body knows how to fight, they may in fact reproduce for a short while before your body overwhelms them and turns them back into that organic dust to flush out. You may have the virus, but never really have the disease per se. But there’s a fuzzy period there, a brief window, where a few virions can reproduce, and maybe even leave your body again, before being dealt with — especially if there were a lot of particles up front, or it takes a moment for your body to respond. Generally that doesn’t matter. But with Delta, being so damn Delta, it can.
During that moment, during that not quite infected but not quite free of the virus moment, there’s a slim potential to test positive or even pass a very aggressive virus, though that chance is terribly slim for most viral diseases. But then, there’s Delta, the Try-Hard of coronaviruses, reproducing as much as it can before it gets squashed. With a good initial dose or a sluggish response, it might be detectable in a a vaccinated person. It might even be transmissible for a brief time. Did that person get Covid-19? Usually not in any medically significant way. Sometimes, because Delta is so very aggressive, they get Covid-19 a bit before their body’s immune system kicks into action. But that immune system will always move faster if you’re vaccinated than if you’re not — that’s just the nature of immunity.
But do vaccinated people get Covid-19 in an epidemiological way? That’s the hard question, and the question at hand. It seems sometimes yes. In the vaccine breakthrough cases, where this try-hard virus meets a slacker immune system, people definitely do. It’s not very dangerous to most people unless the immune system is quite bad at its job. But that can be the case for the immunosuppressed, whether that’s a constant and known state such as HIV+ or organ transplant patients, or just a bad moment for your body.
It’s Not A New Virus
What Delta doesn’t do is fool the immune system. It’s basically the same shape as all the SARS-CoV-2 virus we are vaccinating against. People with strong natural immunity or vaccination will eventually manage the horrific Black Friday flood of viruses, like a ninja army of Walmart greeters. (If you’ve had Covid-19, how can you know if you have strong immunity? You can’t! Exciting! Mysterious! Get Vaccinated. Seriously.) So as bad as Delta is because of how good Delta is at doing what a virus is made to do, it’s not so bad that we need a new vaccine. What’s more, a new vaccine might not really help that much, since this isn’t about whether the immune system knows the virus, but how fast it acts. Vaccinated people probably don’t need boosters, unless someone has a lazy or damaged immune system that just needs to be poked (literally) into action. This is why there is a recommendation for boosters specifically for the immunocompromised. But if you’re not immunocompromised, and your body is behaving normally, not only do you not need a booster, you probably wouldn’t get that much out of one. It wouldn’t be a wasted dose per se, but it wouldn’t be as useful as giving it to someone unvaccinated.
It Could Get Much Worse.
It is inevitable that if SAR-CoV-2 continues to cycle through enough human bodies, it will change shape enough that our current vaccines won’t work, and we’ll need new ones. That’s the immune escape part of the puzzle, and so far, that hasn’t managed to happen in a variant that also has Delta’s speedy and efficient infectivity. If it does happen before we vaccinate the world, this 2 year pandemic could become a five year, 10 year, or more, pandemic.
If we’re always giving boosters to people in high income countries and letting the virus evolve in unprotected populations, it will become a new virus. There are thousands of types of coronaviruses in the world, and we are making a huge breeding ground for many more varieties of Covid. This is why the ever-patient and struggling World Health Organization is trying to talk rich countries out of providing boosters (except in medically special cases). If you’ve gotten vaccinated, you’re really not in much danger. But if we continue to let most of the world languish without vaccination in the time of Delta, we could be dealing with something really bad — as infective as Delta, and better at slipping past the all-important T-cell immunity. It is a humanitarian imperative that the world come together to vaccinate the entire globe. But it’s also the most informed way to be selfish, egocentric, and self-centered — even if you only care about yourself and your people, you still want to see every person in Africa, India, South America, and so on, vaccinated, so some poor HIV+ kid somewhere doesn’t churn out the SARS-CoV-3 that reproduces like viral bunnies and starts killing everyone. WHO is right: vaccinate everyone before you do boosters, because viruses don’t care about geopolitics.
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