Delta

 
The Greek letter delta (▲)  is used in mathematics to indicate an incremental change in a variable.  We are fond of acronyms in medicine, so I combined an acronym with a symbol – No sig D, MOTS, which means, “no significant change, more of the same.”  Unfortunately, our current “delta” doesn’t only imply a change in status but also is the SARS-CoV-2 mutation du jour that has taken over the world. It is now the dominant strain in the United States and Minnesota. Luckily current vaccines are effective against the delta variant, at least when they have induced antibody formation after being injected into a body.  The delta variant and its effects are a nuisance to some from the United States and a point of continued denial for others.  The same is not true for much of the rest of the world, where the delta variant could be described as apocalyptic. 
 
At the recent Surgical Infection Society meeting, Mayur Narayan, a surgeon at Weill Cornell Medicine, poignantly described losing nine family members in India. Nine! That is a far different story than the one we are living in the U.S. They died at home because there were no hospital beds, let alone oxygen. The COVID-19 pandemic in the United States is nothing like that of the rest of the world.  This perspective changes the significance of personal liberty from mask-wearing and other restrictions when people are dying because there is no oxygen, hospital beds, or ventilators.  In the worst of our surges, we still had enough even when we feared we wouldn’t. Knowing the rest of the world’s COVID story makes it trite to quibble about the vaccine, pharmaceutical companies’ nefarious interests, government conspiracies, if the CDC is changing its narrative, or the differential risk of the vaccine vs. the disease. The rest of the world doesn’t understand the United States’ vaccine controversy.  
 
As our society considers, debates, resists, and potentially faces new “restrictions” due to this new and different SARS-CoV-2 virus, it helps to keep a global perspective. And by the way, the CDC has changed its narrative because the virus is different.  Not only did the page in the story change, there is a new chapter. If you are worried about the vaccine, please come and talk to me.



Jeffrey G. Chipman, MD, FACS
Frank B. Cerra Professor of Critical Care Surgery
Division Head, Critical Care, and Acute Care Surgery, 
University of Minnesota
Executive Medical Director, Critical Care Domain, M Health Fairview