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Understanding the Delta variant

THE Delta variant, with its high transmission rate ( twice as contagious as the Alpha variant), has resulted in a spike in reported cases across the world. Malaysia has not been spared.

Since 2019, when Covid-19 was first identified in Wuhan, China, the world has seen various mutations of the virus.

International Medical University infectious disease consultant and head of the division of medicine, school of medicine, Professor Dr James Koh, says mutation is a natural process but it does not necessarily allow a virus to become stronger or more deadly.

"Most times the mutations do not confer any benefits to the virus, but with enough time and opportunity, a mutation can occur that brings an added ability to the virus for it to survive," he explains.

This means that if we are not on guard and do not control the spread of the virus in our community, we leave the door open for further variants to appear.

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With the Delta, the virus has gained better transmissibility through its mutation.

Dr Koh says it's true that the protection the vaccines have against the Delta variant is not as strong compared to the Alpha, Beta and Gamma variants. "When the vaccines were produced, they were targeting the original spike protein of the virus and now with the Delta variant the spike protein has changed somewhat."

However, he stresses that vaccines still give us some protection. Our current vaccines are still able to stimulate antibodies that can recognise the spike protein in the Delta, although it may not neutralise the virus as effectively as previous variants.

Scientists are now quite confident that the coronavirus is largely spread through aerosol particles.

If we are carrying the virus and we speak, sing, shout or even breathe quietly in a room where the air is very still, the released viruses will remain in the air.

According to studies, the virus can linger in still air between three to nine hours.

"We are exposed to the virus largely from breathing contaminated air that is around us."

Contrary to earlier beliefs, evidence points to the fact that touching contaminated surfaces does not quite contribute to the spread of Covid-19.

This is why SOPs shouldn't just stop at social distancing, wearing masks, washing hands and wiping surfaces. Focus has to be given to additional measures such as ensuring good airflow and ventilation, as well as encouraging double masking and wearing face shields.

Getting vaccinated is still one of the most important layers of protection.

That said, Dr Koh reminds us that even if we are fully vaccinated, we are equally at risk of contracting the virus.

However, the vaccinated do better in overcoming the infection, but those with comorbidities can still land in the ICU. Living a healthy lifestyle is another important layer of protection.

Researchers have shown that even the vaccinated who are exposed to the Delta variant produce the same amount of virus load as unvaccinated people. This means that both the vaccinated and unvaccinated are just as infectious when infected.

The only difference between the two is that vaccinated people don't stay infectious for as long as an unvaccinated person.

"A vaccinated person may be infectious for a couple of days while an unvaccinated person will stay infectious for much longer," says Dr Koh.

HERD IMMUNITY

The concept of herd immunity has been much talked about in the past year and it is based on achieving a vaccination rate of 80 percent of a population.

This 80 per cent of people who are vaccinated will then act as a barrier or protection wall against the infection of people who are unable to get vaccinated, such as those who may have conditions that do not allow them to be vaccinated.

Dr Koh says Malaysia is currently vaccinating people at a very high rate and we are already seeing the fruits of this drive.

In Selangor, for example, where herd immunity has been achieved, cases have dropped drastically.

However, he adds that to maintain herd immunity, the community has to be static.

Once borders are opened and people start to travel in and out of states or countries then the ratio of vaccinated to unvaccinated will be in flux.

There will be no way to know if we still have herd immunity, he says.

He explains that this is the reason why we need to look at the problem globally.

"Get everybody vaccinated if possible. If you are not yet vaccinated, I encourage you to do so. No one is safe until everyone is safe. Only then can we say that the world is a safer place."

Regardless of whether you are vaccinated or not, for now you need to be mindful of the next person—the person sitting next to you, the person we pass by. Keep sticking to the SOPs until we are all vaccinated, he says.

"People ask me when we can go back to normal?' I tell them that this is the normal. We will not go back to a pre-pandemic normal. We will learn to live with the virus, make changes and adapt."

We may even one day not have to wear a mask. But the virus itself is not going to go away.

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