Gottlieb: This Delta wave may end "sooner than we think"

That doesn’t mean tomorrow, former FDA commissioner Scott Gottlieb tells CNBC. The CDC hasn’t provided any modeling on the Delta wave yet, which Gottlieb finds odd, but other academic institutions have produced some models — and those suggest that the peak might come as soon as next month:

“I think the bottom line is we’re going to see continued growth, at least in the next three to four weeks. There’s going to be a peak sometime probably around late August, early September,” Gottlieb said on “Squawk Box.” “I happen to believe that we’re further into this delta wave than we’re measuring so this may be over sooner than we think. But we don’t really know because we’re not doing a lot of testing now either.”

There may be another small bump in infection rates as schools reopen in the fall and become “vectors of transmission” as they did with the B.1.1.7 variant, first discovered in Britain, and now called alpha, said Gottlieb, who led the Food and Drug Administration from 2017 to 2019 during Donald Trump’s presidency.

The range for the peak might extend to early October, Gottlieb says, but that seems to be the far outside of the current models. Some of that is due to Delta’s sheer transmissibility; it moves so fast among the unvaccinated that its saturation point comes that much more quickly. That has some implications for the current data set we are seeing in this new wave, which has not produced the normally corresponding increase in deaths or hospitalizations, although the latter has been ticking up substantially. If the peak hits sooner, it might mean that Delta isn’t as deadly as first feared.

Gottlieb remains skeptical about the push for mask mandates as a means to blunt Delta, even if it’s fully adopted by all. The masks just aren’t going to contain such viral loads that Delta produces, especially among the unvaccinated, which means it’s either N-95 or don’t bother:

Gottlieb also warned that just wearing masks, particularly cloth masks, may not enough to prevent Covid infections from the delta variant in classrooms. He advised schools to create pods, space out children in the classroom, avoid group meals and suspend certain large activities, as well as improve air filtration and quality levels.

“There might be other things you do that actually achieve more risk reduction than the masks in the setting of a much more contagious variant where we know there’s going to be spread even with masks,” Gottlieb said. “If we’re going to tell people to wear masks, I do think we need to start educating people better about quality of masks and the differences in terms of the reduction and risk you’re achieving with different kinds of masks.”

This is complicated by the fact that those choosing not to vaccinate are also largely choosing to remain maskless, too. Mandates are not going to help in changing that behavior. As Kay Ivey said yesterday, we’re better off pursuing the real solution of vaccination than temporary half-measures of masking.

On that issue, we have more good potential news on Delta today. A new study out of Canada argues that the existing vaccines have proven more effective against the dominant variant in real-world practice than most predicted. The study, which has not yet been peer reviewed, says that even one shot of all three two-shot vaccines approved in Western countries provides above-50% effectiveness:

Just one dose of the BioNTech/Pfizer, Moderna or Oxford/AstraZeneca vaccines offers higher protection against symptomatic illness caused by the Delta variant than previous studies have shown, a Canadian study has reported.

The real world study, which isn’t yet peer reviewed, was announced by AstraZeneca Friday but first published on July 16. It compared the efficacy of the BioNTech/Pfizer, Moderna and Oxford/AstraZeneca vaccines against several variants of concern. The authors found that even a single dose of any of the three vaccines provides “considerable protection against symptomatic infection and severe outcomes.”

In particular, protection against the Delta variant, first identified in India, was 56 percent effective against symptomatic infection after one dose of the BioNTech/Pfizer vaccine. Moderna was 72 percent effective, and Oxford/AstraZeneca 67 percent.

Just as a reminder, the FDA considers anything above 50% effectiveness to be a candidate for approval, assuming no widespread serious side effects. That’s a fairly robust response, especially with only half of the recommended regime. The study’s authors emphasize this point to support the delay of second shots where shortages of vaccines exist:

Interpretation Our findings suggest that even a single dose of these 3 vaccines provide substantial protection against these 4 VOCs, and 2 doses likely provide higher protection. Jurisdictions facing vaccine supply constraints might consider delaying second doses to more rapidly achieve greater overall population protection.

It seems like ages ago when the UK had to face this choice in rolling out the AstraZeneca vaccine, but the choice to delay the second shot turned out to be wise then as well. The US doesn’t have to worry about that issue, but nations facing high demand and short supply will. If this study holds up, the Delta variant doesn’t need to change the equation. Better to get more people a single dose than to hold onto doses in pairs. With any luck, that might curtail the Delta wave even more.