Dr. Gottesman Discusses the Delta Variant and Its Effects

By Dr. Avraham Gottesman – www.gottesmanmedical.com

Over the past few months, many of us have been confused about the state of the pandemic. Yes, it seems that the worst is behind us. Those of us living in the dense initial hotspots of Covid’s assault may remember quite vividly the wailing sirens and torrent of tragic news, so close to home, from the height of the pandemic. Many have unfortunately lost those near and dear to us to the virus’s vicious grip. But that is all behind us, right?

Hopefully, yes.

We’ve been hearing the news about the delta variant, how it’s more infectious, how hospitals are filling up again. We may have wondered, are we really about to see a repeat of March 2020, or has the equation changed? Is all this hype just that, hype? We know that the politicians and news media, the establishment and big industries, care much more about their own interests than ours. If it bleeds it leads is, after all, the motto of the media. So, why should we trust them?

We shouldn’t.

So, we at Gottesman Medical decided to have a look at the data ourselves. Being that our office primarily serves the Orthodox Jewish neighborhoods of Brooklyn, we figured we should find an area with a similar population and demographics.

Ocean County, New Jersey is a region with diverse demographics about 70 miles south of New York City. Home to approximately 700,000 individuals, with about 130,000 of those being Orthodox Jews living in the Lakewood area, Ocean County is a good analogue for the combined Orthodox Jewish neighborhoods of East Brooklyn.

Like many places, Ocean County is experiencing a significant rise in new Covid-19 cases. Similar to the above Brooklyn neighborhoods, Ocean County got hit very hard by the pandemic in the past, and had a very high prevalence of infection. Ocean County, also like the Orthodox Jewish Brooklyn neighborhoods, has a low vaccination rate, especially among heads of household with many young children (this is important because none of the Covid vaccines are currently approved for children under 12). Unlike the above neighborhoods, Ocean County is ahead of us on the upward curve of new cases. This gives us an ideal comparison to predict where we might be headed shortly. (More granular data for Lakewood specifically has been hard to come by, so we had to rely on a county-to-neighborhood level comparison. Nevertheless, this should be sufficient for the purposes of our comparison).

We went into this hoping, like we are all inclined to do, that the data would confirm there is nothing to worry about. We were thinking that perhaps things really have changed. Early in the pandemic, the following equation was inevitable:

rise in cases = rise in hospitalizations = rise in deaths one month later

Our optimism led us to posit that this time, the equation had changed. Perhaps this equation, once set in stone like a law of nature, had been disrupted, and the three parts had been decoupled; i.e. that more cases would no longer necessarily equal more deaths.

Hopefully, that was.

Unfortunately, our hope did not seem to be correct. Let us take a look at this graph from Ocean County, NJ:

As we mentioned, there is a visible uptick in recent cases, but that on it’s own is not the most concerning trend. For now, note the 7-day average of new cases from July 14.

Below is a graph of coronavirus mortality trends. When we compare the case graph with this one, we can clearly see the tragic implication of the above-mentioned equation:

First, let’s look at the current 7-day average death rate from August 14: 1.4.

Moving back up to the cases graph, we can see the 7-day average case rate from a month earlier, July 14: 27 cases. Let’s keep this in mind for later comparison.

One might argue that a death rate of 1.4, while indeed tragic, is not out of the norm. Indeed, that number may not seem like a lot. But let’s keep in mind that:

A) This is an average of how many deaths there were per day; that’s an average of more than seven deaths per week, just from Covid.

B) A 7-day average death rate of 1.4 is a statistically significant increase from zero. Unfortunately, seeing as both new cases and hospitalizations have recently increased, and how there have been more deaths in the past few days, this trend is, truthfully, concerning.

Regardless, the important question here is: Has the equation changed, or do the numbers still work the same way they did last year?

Let’s take a look at a matching time last year to find out. On November 13, 2020, we find the same death rate as August 14, 2021 (1.4):

Moving once again to a month before that, October 13 2020, we can see how the reported case rate was actually significantly higher than it was on July 14, 2021:

Now, the case fatality rate (CFR) might not have actually gone up since a year ago, but there is certainly not much evidence to say it went down.

Another concerning chart is this one illustrating hospitalization rates. As we can see, Ocean County, unfortunately, is not doing very well:

Yes, we went into this hoping against hope that we would be wrong. And, please G-d, let us be wrong. Though the trends clearly appear seasonal, and it’s looking like it might not be that different this year, we do hope mightily that this won’t turn into another wave. But as of now, the equation still seems to stand:

rise in cases = rise in hospitalizations = rise in deaths one month later

There is a silver lining, though: The equation could change.

But we must be the ones to change it. We are well aware that these figures are not just graphs and numbers. Each point marking a death is, in reality, an untold tragedy. Someone’s mother, grandfather, wife, uncle, daughter. An entire world, lost forever. Each point marking an illness could be a story of immense worry and suffering. Just recently, we had to send a child with likely Covid-19 infection to the emergency room; an otherwise healthy and lively child, now struggling to breathe.

We get it, we can’t just lockdown again, or stop socializing forever! Life must go on, and indeed, it is an honor to those dear departed that we live our lives to the fullest. Thankfully, we now have a new variable we can throw into the equation, one that has the power to mess up this twisted math for good:

Yes, we are talking about vaccination.

The data is clear. No matter which variant or age group, the vaccines — all of them — vastly reduce spread, reduce hospitalizations, and reduce death.

Let’s be realistic, we’re all sick and tired of the constant hype and politicization about lockdowns, event restrictions, etc. None of us want it. We’re tired of hearing the feigned concern of politicians and news media when we all know who’s interests they care about (and who’s they don’t). Yes, lockdowns and restrictions could save lives, and yes, we know we can’t live like that.

But we’re not suggesting more lockdowns or restrictions. Why use a hammer if we could use a fine point needle? Better yet, the fine point needle is far more effective than the hammer. Asking us to lockdown to save even one life at this point sounds, frankly, ridiculous. What’s the point of saving lives if none of us could live life? But that whole discussion is moot. All we need now is to undergo a minor inconvenience. A tiny needle prick or two is all we need now to save just one more life; a world entire.

What about the efficacy against delta? What about the side effects? What about antibodies? What about breakthrough infections? Is it really just a minor inconvenience?

We get it. There are lots of concerns, lots of data, and lots more questions. But there is a very clear signal through the noise: Overall, in the vast, vast majority of cases, vaccines work, vaccines are safe, and they cause little more suffering than some temporary aches and pains — while preventing so much more.

What about all the questions? We could discuss, and we could go on for days. Much ink has and will be spilled on this topic, and that’s OK.

But please: Let us spill ink, and not, G-d forbid, more blood.

As always, please comment in a respectful manner.

And be in touch.