Coming Home

Dr. Nadal: It’s been a while since we’ve had one of these interviews. Let’s just jump right in.

DR. NADAL: Sounds good. Shoot!

Dr. Nadal: Well, it’s been 14 months. You look good. COVID hasn’t killed you, but a bunch of your readers just might. Anyone ever tell you that with all of your constant admonitions about not letting up on vigilance, you make Cotton Mather look like the life of the party?

DR. NADAL: So I’ve heard.

Dr. Nadal: Dude, seriously…. what’s the latest concern? I hear Delta might not be that bad here in the US. What are your thoughts?

DR. NADAL: How are you defining bad? Cases? Hospitalizations? Deaths?

Dr. Nadal: Yes. All of the above. And while we’re at it, what happened to the strains being called by letters and numbers? What’s with the Greek letters lately? Sounds more like Fraternity Row than a pandemic…

DR. NADAL: Scientists are still using the alpha-numeric system of categorizing the strains. But “B.1.617.2” doesn’t roll off the tongue as easily as Delta does. It’s a new system of nomenclature and the WHO has convenient tables for the public to follow.

Dr. Nadal: Gotcha. What happened to referring to the origin of the strain, like the English or Indian strains, etc.?

DR. NADAL: People feel it’s less stigmatizing for nations, which I suppose is true. Too late for the people in Lyme, Connecticut, eh? It will be interesting when we exhaust the Greek alphabet in another year or so, but back to your question on how bad Delta is shaping up. We are in a massive surge right now with numbers today that match the peak of last summer’s surge, with no end in sight.

Dr. Nadal: Because?

DR. NADAL: Because the American people are pretty resolved to keep the throttle wide open on the economy. Because they are weary of the pandemic. Because most reject the use of masks…

Dr. Nadal: Sorry to interrupt, but why use masks when CDC says half the nation is fully vaccinated, with 57% having at least one shot?

DR. NADAL: Because you and I both know that the vaccines do not stimulate the branch of the immune system built into mucous membranes, the very places where the virus enters the body and begins replicating: the eyes, nose, mouth, nasopharynx, throat, digestive tract… The vaccines don’t produce antibodies there, so they don’t stop the process of initial infection or replication there. The vaccines produce antibodies and cellular immunity elsewhere in the body, which is why they have been highly effective at preventing serious disease in the immunized. In fact, 97% of all new hospitalizations are UNvaccinated people.

Dr. Nadal: So what’s the big deal with Delta? Why is it spreading more than twice as fast as the original strains?

DR. NADAL: A report a few days ago in the British Journal, Nature,tells us that people with the Delta strain produce up to 1,260 times as much virus as those infected with the original strain. So that means much, much more virus is being emitted by the infected, assuring that more people are receiving an infective dose.

Dr. Nadal: Dude, I think you made a mistake there. Do you realize what you just said? Not TWO times the viral load. Not TEN times the viral load. Not One Hundred times the Viral load of the original strain… ONE THOUSAND TWO HUNDRED AND SIXTY times the viral load as the original strain?????!!!! You must have misread the article.

 Dr. Nadal: No mistake. Here’s the quote:

“Individuals infected with Delta also had viral loads up to 1,260 times higher than those in people infected with the original strain.”

Dr. Nadal: Do you understand the implications of those numbers?

 Dr. Nadal: I do. Fully. It means that infections are going to spread like wildfire, and we’re seeing increasing numbers of breakthrough infections in the fully vaccinated, along with an 8% drop in efficacy in the mRNA vaccines at preventing serious disease, and about a 10% drop in the J&J vaccine efficacy. I also agree with CDC Director, Dr. Rochelle Walensky, that we may only be a few mutations away from the virus largely evading our current vaccines. It’s also going to force our bishops to revisit giving latitude for people to attend Mass virtually.

Dr. Nadal: Well, yeah. No kidding?! With 1,260 times more virus coming out of noses and mouths… Boy, you really DO make Cotton Mather look joyful!

DR. NADAL: Thanks…

Dr. Nadal: No, seriously. You haven’t played politics with this thing, and God knows nobody can accuse you of telling people what they want to hear, but let me ask you this: How bad do you think it’s going to get with Delta? It was pretty bad in India…


DR. NADAL: Yes. India is shaping up to be much worse than many surmise. The official death toll there is 421,000. Many believe that to be a gross undercount, and that the real death toll could be well over a million. But getting back to how this might play out here. We certainly have a more robust medical infrastructure here than in India, but we also have a population with a ghastly high number of obese, hypertensive, diabetic patients, as well as all the other comorbidities. We are seeing increased hospitalizations among the younger set with Delta, people in their 20’s and 30’s…

Dr. Nadal: Sorry for cutting you off, but is that really fair to say? 89% of the 65+ population is vaccinated, so of course what we are seeing is younger people…

DR. NADAL: I know where you’re going with this, but let’s recall that so many younger people have NOT gotten vaccinated because the original strains caused serious disease in older people with comorbidities. The landscape has shifted beneath our feet and we’re seeing younger people who are healthy being admitted to the hospital in serious condition, and some are dying. We’ll know better by the end of August just how bad Delta is going to be.

Dr. Nadal: Best guess?

DR. NADAL: As we’ve discussed before, pandemics are behaviorally moderated. What signs do you see that people are remotely willing to return to masking, distancing, minimizing contact, or increasing rates of getting vaccinated? I’m not seeing that. BOTH political parties have politicized this. Dr. Fauci has lied repeatedly. CDC has made a hash of things. WHO has been even worse. I don’t blame people for being cynical and distrustful. It’s that cynicism and distrust, however, that’s going to boost our death toll to 700,000 by Christmas if we’re not really careful.

Dr. Nadal: So, do people have time to get vaccinated?

DR. NADAL: Given the speed at which Delta is spreading, time is not an ally. If people get their first dose tomorrow, we’re looking at 5-6 weeks before they possess full immunity with the mRNA vaccines. If they are on the fence, today would be a good day to discuss things with their physician, and I stress that repeatedly: Discuss the vaccine with your doctor before getting it. Make sure it’s okay for you with your unique health profile!

Dr. Nadal: Hey, speaking of vaccines, people have a lot of questions….

DR. NADAL: How about another sit-down in a day or two and let people digest this one first?

Dr. Nadal: Sounds like a plan. Did you have a graph from CDC showing the latest surge?

DR. NADAL:Yes. Post it below our interview.

Dr. Nadal: Until next time…

DR. NADAL: Ciao!