Should vaccinated Americans panic about the Delta variant? 'Maybe panic a bit.'

The COVID-19 pandemic has now officially resulted in 200 million cases and 4.25 million deaths worldwide, and the extremely virulent Delta variant is erasing many of the gains achieved through time and remarkably effective vaccines.

"For public health officials and the Biden administration, the Delta variant is the biggest communication conundrum we've seen in a while," Politico health care editor Joanne Kenen writes in Wednesday's Nightly newsletter. "Don't panic, they tell us in one breath. Well, maybe panic a bit, they tell us in the next, urging us to put our masks back on and think twice about how, when, where, and with whom we gather indoor." This "'panic/don't panic' conundrum," she writes, is exacerbated by the many, many things we still don't know about the Delta strain.

The one clear thing is that "this latest surge, as public health officials remind us, is largely an outbreak among the unvaccinated," Kenen writes. "The best way to protect ourselves and others, to contain the pandemic, is by getting vaccination rates way up." And until enough people are vaccinated, in the U.S. and the world, COVID-19 will be a problem for everyone.

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U.C. San Francisco's Dr. Bob Wachter calls this Delta outbreak perhaps "the most confusing time in the pandemic." The "bottom line is that my thinking has changed," he wrote in a Twitter thread Tuesday night. "Six months ago, I felt like I understood all of the key variables when it came to the virus and vaccines," but "now I see that it's best to assume that nearly every parameter is different — usually for the worse" — with the Delta variant.

In lower-vaccination, high caseload states like Florida, Texas, and Missouri, the unvaccinated majority is "no better protected vs. COVID than they were in early 2020," but the virus is now "2.5 times better at its job of infecting people," Wachter writes. "It's obvious what an unvaccinated person should do: get vaccinated ASAP," and "be very afraid" and "super-safe" until two weeks after your second shot.

"What should a vaccinated person do? That's trickier," Watcher concedes. "Everybody's got to choose their own risk tolerance, which'll depend on your psychological state and your risk factors for a bad outcome," plus the prevalence of COVID-19 in your area. "You'll make your own choices, but don't underestimate Delta," he adds. "As the CDC said, it's a new war."