WASHINGTON, July 30, 2021 (BSS/AFP) - The Delta variant of the
coronavirus is as contagious as chickenpox, probably causes more
severe disease, and breakthrough cases in vaccinated individuals may
be as transmissible as unvaccinated cases, according to a leaked US
government document.

   The internal slide presentation produced by the Centers for Disease
Control and Prevention (CDC) stresses that "the war has changed" as a
result of Delta.

   It was first reported by The Washington Post and has been verified by AFP.

   CDC director Rochelle Walenksy cited the presentation this week to
justify a return to masks for vaccinated people in high-risk areas,
and it is expected to be published soon.

   One of the biggest takeaways is the finding that breakthrough
infections in vaccinated people are highly contagious, with the data
coming from previous studies and a new analysis of an outbreak in
Provincetown, Massachusetts.

   Experts rely on a number called the cycle threshold (Ct) value to
indicate how much virus an infected person harbors, with lower numbers
indicating higher viral load.

   In Provincetown, there was "no difference in mean Ct values in
vaccinated and unvaccinated cases," the slides say.

   The outbreak of nearly 900 was related to July 4 festivities, where
more than three-quarters were vaccinated, according to local reports.

   But unlike previous mass outbreaks, hospitalizations are low --
only seven so far, according to news website MassLive, and so far no
deaths.

   "This is a key point which is part of the reason the CDC changed
its guidance," Celine Gounder, an infectious diseases physician and
professor at New York University, told AFP.

   "It's not really so much for your own protection: as a vaccinated
person if you have one of these breakthrough infections, you may have
mild symptoms, you may have no symptoms, but based on what we're
seeing here you could be contagious to other people."

   Jennifer Nuzzo, an epidemiologist at Johns Hopkins University,
added that a key point to note about the Provincetown outbreak is that
it occurred in a setting where community transmission was low -- and
as such, the CDC's new masking recommendation wouldn't have applied
there.

   "Moreover, public reporting around that outbreak investigation
suggest(s) that exposures were likely at places like bars and house
parties, where mask wearing would be unlikely," she told AFP.

   - Breakthroughs not as rare -

   The CDC slide set also indicates breakthrough infections are not as
rare as previously thought -- and at present account for "35,000
symptomatic infections per week among 162 million vaccinated
Americans."

   A review of findings from other countries shows that while the
original SARS-CoV-2 was as contagious as the common cold, each person
with Delta infects on average eight others, making it as transmissible
as chickenpox but still less than measles.

   Reports from Canada, Singapore and Scotland also suggest it might
be more deadly, with higher odds of hospitalization, ICU admission and
death.

   Vaccine efficacy estimates vary across countries, but in its
concluding slide, the CDC estimates the risk of severe disease or
death is reduced 10-fold or greater in the vaccinated, while risk of
infection is reduced three-fold or greater.

   That is equivalent to at least 90 percent effective against severe
disease and death, and at least 67 percent effective against
infection.