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by Sept. 3.

Delta is two to three times more transmissible than the wild strain, Snyder said. It has a 1,000 percent higher viral load in the average infected person. Health officials identified the Delta variant in the United States in the spring. Snyder said she hoped it would die out naturally, as other strains have, or that it could be contained. But by June, she realized it was likely coming to Pierce County, and in July, feels fairly confident it was here although Pierce County doesn’t have the sequencing abilities to prove it.

Two percent of cases in Pierce County since January have been breakthrough cases from those who are fully vaccinated, and that number will likely increase as vaccinations and cases increase, Snyder said. Vaccinated people with Delta are typically very mildly symptomatic or asymptomatic. According to the Wisconsin Department of Health Services, the rate of breakthrough cases reported among those fully vaccinated is 1 percent in all reporting states. The death rates among fully vaccinated people with COVID-19 are effectively zero, which shows the vaccine is still highly effective against hospitalization and death, Snyder said.

“Because Delta is here, even for vaccinated people, be very cautious,” Snyder said.

Currently, Pierce County health officials are seeing outbreaks in long-term care facilities after going many months with none. Outbreaks have also occurred from school-based activities, though not in the River Falls School District, Snyder added.

“In Pierce County, we are lagging behind the state in vaccinated people,” Snyder said.

In the county, 47.4 percent of individuals have received at least one dose of the vaccine. The lowest age group is those 18-24 at 25 percent. In the River Falls School District (which also includes a portion of St. Croix County), 52.7 percent are vaccinated.

The Food & Drug Administration (FDA) formally approved the Pfizer-BioNTech COVID-19 vaccine on Monday, Aug. 23, which will be marketed as Comirnaty, for the prevention of COVID-19 in those 16 years and older.

“This is yet another signal that the vaccines are safe and that they are effective,” Snyder said. “We hope that this will further encourage people that might’ve been on the fence to consider speaking with their doctor about getting the vaccine.”

As for masking, even fully vaccinated people should mask in areas of substantial or high transmission, Snyder said, because no vaccine is 100 percent effective and new data shows that fully vaccinated people who become infected with the Delta variant can transmit it to others, even if they show few or no symptoms.

“The Delta variant has changed the game,” Snyder said. “If you are one of the unlucky, fully vaccinated people who contracts Delta, you can spread it with similar efficiency as an unvaccinated person due to a 10-times higher viral load.”

Fully vaccinated people may choose to mask regardless of the transmission rates, if they or someone in their household is immunocompromised or ineligible for the vaccine. Unvaccinated people should wear a mask indoors no matter the transmission level, Snyder said. When it comes to close contact and quarantine, vaccinated people do not need to quarantine unless symptoms develop, Snyder said. After exposure, they should mask for 14 days and should consider getting tested three to five days after exposure. Unvaccinated people need to quarantine for 14 days (ideal); 10 days, but should mask and monitor symptoms until day 14; or seven days with a negative test result on days six or seven, but they should mask and monitor symptoms until day 14. You can be vaccinated during the exposure period as long as you’re not symptomatic, Snyder said.

Many people want to know when we can stop masking. In most settings, vaccinated people can stop masking when the CDC’s transmission levels are listed as moderate or lower. Unvaccinated people should mask for longer than that, Snyder said. At least until children age 6 and older can be vaccinated and the U.S. gains control over the Delta variant.

Third vaccine doses, called “boosters,” were approved in August for select immunocompromising conditions. All local clinics, Freeman Drug, Walgreens, and PCPH will offer the booster, which is only for mRNA vaccines. Ideally, the booster should be the same type as the vaccine you had, but it’s not required, Snyder said. Boosters, which are common for many other immunizations, should be available by late September and will be timed eight months after the initial dose. More details will come in the next few weeks.

Q& A from Council

After Synder’s presentation, council members had a chance to ask her questions. They and their answers are listed in a Q& A format:

From Alderperson Benjamin Plunkett: Lack of genomic surveillance abilities has hindered your ability to give council an early warning (about the Delta variant). Are there possibly political considerations that have prevented you from providing the early warning that could’ve been useful to the members of council or the public as a whole?

Snyder: It doesn’t matter if you have the Delta variant or previous strain of the virus.

“The public health actions and the clinical actions that we take would be exactly the same,” Snyder said. “I think the public was well aware of the threat based on the national news.”

The State Lab of Hygiene sequences a limited number of samples from every county and hospital. So far, Delta has not been sequenced in Pierce yet, but that is due to not having the capability here.

Plunkett: In regards to modeling, what is a reasonable expectation for rates of infection in our K-12 students?

Snyder: “That’s difficult to say because there are so many variables,” Snyder said.

These include vaccination levels, school board policy decisions regarding masking, close contact tracing and symptom exclusion; and more.

“I am very concerned, because what we’re seeing right now is higher-paced levels than we saw this time last year right before school started and that has indicated to me that we cannot build up the type of immunity we need as a community to protect our schools this fall,” Snyder said. “If we don’t take proper mitigation measures now, we’re going to have outbreaks in schools.”

Plunkett: What mitigation techniques could the council or city take to reduce the likelihood of having to shut our schools down?

Snyder: “Masking in our community is no longer the norm,” Snyder said. “I think people have been lulled into a false sense of security with vaccines, whether or not they got one themselves.”

She told council members they can reinforce masking etiquette and encourage people to stay home and get tested if sick or exposed.

“I think it’s re-sensitizing our community to the need to be cautious,” she said.

Plunkett: What type of masks should people use?

Snyder: N95 masks are prioritized for health care workers and can be tough to fit properly on people, especially those with beards or facial deformities. It can take three to four fittings for health care workers to get the right fit.

People should choose masks that have at least two layers of washable, breathable fabric; completely cover the nose and mouth; fit snugly against the sides of the face with no gaps; and have a nose wire to prevent air from leaking out the top.

Don’t choose masks that are made of fabric that is hard to breathe through, such as vinyl, or have exhalation valves or vents which allow virus particles to escape.

Alderperson Diane Odeen: Gov. Tony Evers announced a $100 reward to Wisconsinites who get the first dose of any COVID19 vaccine between Aug. 20 and Sept. 6. Other municipalities and states have incentive programs. Do you think it would be effective for the 18-24 population?

Snyder: “What we do know from behavioral economics and from health incentives that have been used in the past, we do know that incentives and reverse incentives can be effective in promoting health behaviors,” Snyder said. It has to be the right type of incentive that speaks to that group.

“The $100 will not help with those who are resistant to the vaccine, but those who are indifferent,” Snyder said.

Alderperson Alyssa Mueller: What events does PCPH have planned for River Falls School District after Labor Day?

Snyder: PCPH would provide vaccine clinics anytime the district asks. PCPH and the district have shared messaging promoting the benefits of the vaccine.

“I do know that some loud voices in the River Falls community have made sharing that information very painful for the school district,” Snyder said. “And so, they have to be ever-thoughtful in how they share that.”

Alderperson Nick Carow: Are there synergies where we can promote working together?

Snyder: Be an advocate for the vaccine and share the news of the incentive program.

Alderperson Sean Downing: To what capacity are you working with private employers in our community to develop virus mitigation within workplaces?

Snyder: PCPH developed a business operations toolkit with best practices for employees and customers, which is available online. It includes advice on how to lay out space, social distancing, when to send an employee home, etc. PCPH also works in conjunction with the state occupational health program.

Downing: Is PCPH properly funded?

Snyder: Public health as a whole has never been properly funded, Snyder said. The county department has 13 employees and does not have unlimited funds and resources like many believe. Two environmental health inspectors also serve as liaisons to county businesses.

Public health in general has “been left in the dust as far as funding goes for decades,” Snyder said. “We were not staffed to deal with a pandemic.”

Alderperson Scott Morrissette: What steps are taking place so St. Croix and Pierce counties work together so there aren’t orders differing on each side of Division Street?

Snyder: “Decisions made at the state level have tied health officers’ hands,” Snyder said. “Different communicable disease ordinances give public health officers different authority.

“Unless we have the same corporate counsel, the same county boards and the same communicable disease ordinances, we probably won’t arrive at the same answers 100 percent of the time and I don’t have a solution.”

Morrissette: What can both counties do in concert with each other? It’s frustrating to look at Division Street as a divisive geographic boundary.

Snyder: St. Croix County Public Health Officer Kelli Engen and Snyder speak for an hour each day and their guidance usually matches regionally, but mandates and orders may differ based on county.

For more information, including vaccine availability, visit www.covid-piercecountywi. hub.arcgis.com

Chart courtesy of CDC Covid Data Tracker