The number of COVID-19 cases continues to rise as the delta variant marches onward. (Chris Clark | Spectrum Health Beat)

Another COVID-19 surge is keeping the contagious virus in the news and on our minds.

For guidance on how to protect ourselves and loved ones amid the many changes, Liam Sullivan, DO, a Spectrum Health infectious disease specialist, addresses some frequently asked questions.

Q. Can you give us your perspective on what we are seeing in the pandemic?

“I think it’s pretty clear that infections are rising,” Dr. Sullivan said.

In July, positive tests results hovered in the 2.5%-3.5% range. Last week, more than 12% of tests performed at Spectrum Health turned out to be positive for the virus.

“What is pretty crystal clear is the spread is being fueled by the delta variant,” he said. “That is responsible for all the cases we are seeing right now of COVID-19 in the state of Michigan and in the country, too.”

Q. What can you tell us about breakthrough cases—in which a vaccinated person becomes infected with COVID-19?

Such cases are relatively rare, he said. And the vast majority do not require hospitalization.

“Most have mild or asymptomatic cases,” he said.

In the hospital, half of the cases of COVID-19 in vaccinated patients were discovered incidentally. Admitted for another reason—perhaps illness, injury or a scheduled procedure—the patient was tested and the virus then detected. In many of those cases, the patients have no symptoms of infection.

Many of the other breakthrough infections involve patients who are immunocompromised because of an underlying condition, their medication or their age.

Overall, the data shows: “The vaccines are doing the No. 1 job they were designed to do. That is to keep people out of the hospital and to keep them from dying or getting severely sick with COVID-19,” he said.

Q. Do we test for the delta variant in Spectrum Health hospitals? And what do we know about the efficacy of the vaccines against the delta variant?

Because of the complexities involved in variant testing, all the testing is done by the state of Michigan, Dr. Sullivan said.

Spectrum Health sends a random sampling of positive COVID-19 tests to the state every week for variant testing.

Evidence shows the vaccines are not quite as effective against the delta variant as against previous variants.

However, all three of the vaccines—Pfizer, Moderna and Johnson & Johnson—are more than 90% effective at keeping people out of the hospital when they are infected with the delta variant, he said.

Q. For those who have had the COVID-19 virus, is the vaccine still necessary?

“I definitely think it is,” Dr. Sullivan said.

For people with a history of COVID-19, some studies suggest possible increased risk for breakthrough infections by the delta variant. A more recent study, however, suggests that natural immunity is at least as good as, possibly better, against the delta variant.

What is definitely clear is that people with natural immunity benefit from vaccination because it significantly increases their antibodies against variants such as delta and thus further decreases the risk for reinfection.

For those who have had COVID-19, “If you get the vaccine, that is going to give you a much, much higher degree of immunity,” he said.

Q. Why are we going back to mask recommendations—and even for those who are vaccinated?

Again, the delta variant is a factor.

Studies show the virus replicates in the respiratory tracts of vaccinated patients almost at the same rate as it does in the unvaccinated.

Although they may not show symptoms, vaccinated people who become infected may still spread the virus to those around them.

A face mask would reduce the amount of virus they could spread.

Q. How do we know the vaccine is safe?

Although there is not yet long-term safety data on the vaccines, Dr. Sullivan said it’s important to look at the history of vaccine trials. History shows us the side effects that would keep a vaccine off the market surface within the first four to six weeks.

“If you don’t see side effects in the first four to six weeks, you don’t see them later on,” he said.

Vaccine trials often take longer because of challenges in recruiting enough participants and because researchers test how long they are effective.

Dr. Sullivan noted that COVID-19 vaccine trials are ongoing, and researchers continue to gather data on their safety and effectiveness.

“If you look at the history of vaccines, there has been no vaccine that has been under as much scrutiny and microscope as these vaccines,” he said.

The vaccines for polio, shingles and measles, for example, did not receive this level of scrutiny.

“What is amazing is their overall safety record has been excellent,” he said.

Q. What keeps you going? And do you think we will ever get out of this?

“COVID-19 fatigue is a very real thing,” Dr. Sullivan said.

He sympathizes with the public’s frustration with the ongoing challenges of COVID-19.

“Health care workers are just as tired. We are absolutely exhausted right now,” he said. “It has been challenging physically, emotionally and mentally.

“If the COVID-19 pandemic has proven anything, it is that it is unpredictable. It continues to throw curveballs at us and is probably going to for the foreseeable future.”

Dr. Sullivan predicted we will see an end of the pandemic someday. The goal is to make COVID-19 a mild respiratory tract infection, one that does not cause severe illness and is of short duration.

Vaccines can help us reach that point.

“We have never, ever defeated a virus and ended a pandemic from a virus without mass vaccinations of people,” he said. “Smallpox, polio and measles are three primary examples.

“The only way those pandemics ended was through mass vaccination of the human population. COVID-19 is not going to be any different.”