The unsettling uncertainty of a breakthrough case

A close friend sent me a text last weekend with the shocking news that her COVID-19 test was positive. She had been vaccinated since April. Just a few days after mine, she received her first shot.Before that text arrived, I had been reminding my family and friends that COVID-19 is a possibility for some people who are vaccinated. Vaccines don't always work. The number of people who become ill from vaccines will rise when there are more cases than usual, as is the case in New York City. The risk of contracting the disease is even greater for those who are not vaccinated.All of this is what I know. These facts and statistics are what I remember every day as I read studies and check transmission levels across the country. Even with all that information, I found myself convinced for a good day and a bit that I wasn't any better off than before I got vaccinated. I'm still trying to get out of this spiral.After over a year of adjusting to the coronavirus, it is unsettling to find yourself again in uncertainty. The return to fear after spending June in blissful vaccinated freedom is quite shocking. Wired's Eve Sneider reported this week that the United States fourth wave is being driven by the delta variant. This has reshaped our risk perception.She wrote that choices that were once simple and unthinkingly easy in the beginning of summer are now more like skydivesrelacquered by a layer viral risk. Again, I asked: How much freedom can you have?My COVID-19 friend case was a shocking reminder of how delta has changed the gameThe COVID-19 story of my friends was a stark reminder of the impact delta had on the game. This fast-spreading variant has caused surges across the US and is turning back time to reflect the worst pandemics in Louisiana and Florida. High vaccination rates are also struggling as the virus continues to infect the areas that have the highest levels of vaccination. Uncertainty about daily safety is growing everywhere. Although the vaccines have not been able to prevent hospitalizations or deaths due to COVID-19, they are still effective in preventing symptomatic disease and infection. Although breakthrough infections are unlikely, they may still be rare. However, there is not enough data to prove otherwise.Experts had low expectations when vaccine development began in spring 2020. The Food and Drug Administration would be satisfied with a vaccine that was only 50 percent effective. We ended up with vaccines that were clinically proven to be 95 percent effective against COVID-19 symptoms. This was a wonderful outcome many people didn't even know they could achieve. I was buoyed by the giddy promise that this high, high number would be effective against symptomatic COVID-19 all through June. They were brought back to Earth by Delta. Now I am confronted by the gap between 95 & 100. Delta stretched it even further. It feels large enough to guide a cruise ship through, even though it is not statistically significant.my fall plans the delta variant pic.twitter.com/gEB8z892gq kari (@kvrivnne) August 12, 2021My friend felt fine after a few days with what felt like a severe cold. Mentally, my friend had a difficult time. Despite the progress, and despite the delta, vaccines work, even though they are not the solution to all the problems. The rates of COVID-19 in vaccinated individuals are much lower than those who aren't vaccinated. Higher vaccination rates don't see as much hospitalization. It's working for the majority of the COVID-19-vaccinated, but it doesn't always feel like that. When you are sick, it can be difficult to see the big picture safety.It is difficult to fall back into caution after a brief period of optimism and hope. The past week has been difficult. I have spent my time trying to get back on the edge. Public Health England stated this week that vaccines have prevented 23 million COVID-19-related infections and 84 600 deaths in England. I will not forget to remind you that even though the virus is more terrifying than ever, vaccines are still available and keep people alive.Here's what happened this week.ResearchThe C.D.C. endorses Covid vaccinations during pregnancy.A COVID-19 vaccine does not increase the risk of miscarriage in pregnant women. Safety data has shown this. They should be vaccinated according to the Centers for Disease Control and Prevention. (Roni Carryn Rabin/The New York Times)America's Children Face a New PandemicWhile the fast-growing delta coronavirus variant is deadly for everyone, it has been particularly devastating for those children who have not been vaccinated. Children are less likely to get severe complications, but more children get sick from it. (Katherine Wu/The Atlantic)The Unusual Biology of SARS-CoV-2 Delta Variant: A DissectionThe coronavirus Delta is the fastest-spreading. Scientists are trying understand why. Scientists are still trying to understand why it is able to reproduce more quickly or fuse with cells more easily, but there aren't any conclusive answers. (Katarina Zier / The ScientistA new trial will allow kidney transplant patients to test a COVID-19 booster injection.The National Institutes of Health will be testing if the third dose of COVID-19 vaccine can help kidney transplant patients mount an immune response that is more powerful. (Nicole Wetsman/The Verge)DevelopmentPentagon will require COVID vaccine to be administered to all troops by Sept. 15.Military personnel will need to be vaccinated with COVID-19. If the Food and Drug Administration approves the shot, the deadline could be sooner. (Lolita Baldor / Associated Press)Is it a snort? Scientists debate the potential benefits of intranasal Covid-19 vaccinationsSpraying vaccines into the nose may be more effective than shots in the arm to protect the nasal passages. It is not clear if gene-based vaccines can be reformulated for this route. (Helen Branswell / Stat News)We need more vaccines and faster. One tiny tube could make all of the difference.Vaccines are currently made in large vats that can prove inefficient. Scientists think that a continuous-running tube could be a better way to make vaccines. (Roxanne Khmsi/National Geographic)PerspectivesMy research on deescalation was futile. In the first hour, Adams and Powers had checked the vaccine proof of 19 of the 20 divers who made their way up the stairs to the dive bar. Nobody made a fuss. Not even the patron who struggled to find documentation for 10 minutes and then gave up and left.Washington City Papers Laura Hayes expected the worst when a bar required proof of COVID-19 vaccine the first night. It went without a hitch.More than just numbersWe are grateful to all those who have received the 4.5 million vaccine doses that we have distributed thus far.We wish you a smooth road to recovery, to the more than 205202,233 people around the world who have tested positive.Families and friends of more than 4,330.899 people have died around the world, 618.840 in the US. Your loved ones are not forgotten.Everyone, please be safe.