Just when we thought we were safe if we were vaccinated, mutations began to indicate otherwise.

Delta is much more contagious than the original strain of COVID-19. It also leads to more severe symptoms and a higher risk of hospitalization and death in the unvaccinated.

Among the vaccinated, breakthrough infections are becoming more common, and while risk of severe disease is low, breakthrough disease in the vaccinated makes them possibly just as contagious as the unvaccinated.

Try as they might, political spin doctors can’t deny the fact that today we find ourselves in the midst of a pandemic of the unvaccinated. Cases in Florida, Louisiana, Arkansas, Missouri, southern Mississippi and Alabama are raging, while hospital capacity is once again stretched to the breaking point. Hawaii also has broken its own record for new cases more than once in the past week, owing primarily to the huge influx of visitors. Hawaii has a fairly high vaccination rate but apparently not enough to stem the tide with so many visitors in town.

SOME COUNTRIES, like Australia, have again resorted to lockdowns. In countries such as France, however, and in some U.S. states, including California and New York, as well as the Pentagon and the federal government, the focus has shifted to vaccine mandates. Short of a vaccine mandate, frequent testing is becoming more common to address those who continue to decline the vaccine.

Delta, which originated in India, is currently the dominant strain in the U.S. It’s now seen in 94% of new cases. A further mutation of alpha, it was first observed in England in December. For now the quality vaccines still keep the vaccinated relatively safe. That could change. It is quite possible that another mutation will arise for which vaccinations are only minimally effective.

Lambda, first found in Peru, is a possible candidate. But whether it is lambda tomorrow or phi next month or omega next year, the risk of a new mutation that gets around today’s vaccines remains a significant risk so long as the global vaccination rate falls short of herd immunity calculated at 60% to 90%. Africa is still at only 3%. The more people there are who remain unvaccinated, the more the virus can spread, increasing the statistical chance that a new, more dangerous mutation will arise.

Delta also has complicated the economic recovery from COVID-19. On the heels of two rescue packages, inflation quickly began to exceed expectations. Now a trillion-dollar infrastructure package is about to pass the Senate.

Several weeks ago Treasury Secretary Janet Yellen raised the specter of increasing interest rates. More recently, Federal Reserve Board Chairman Jerome Powell delicately indicated that quantitative easing could taper off. This raises the possibility that the recovery, uneven and still incomplete, is at risk for another hit from delta.

TAPPING THE brakes on inflation too soon could be disastrous. With recent enormous additions to the national debt and even more planned, a country that does not grow robustly and allows brisk inflation could be hard-pressed to service that debt.

Moratoriums for those who are unable to pay their rent or mortgage are nearly over, while rescue stipends and supplements to unemployment insurance are coming to an end. Unemployment, however, is still far higher than pre-COVID- 19 levels while employers are unable to fill positions.

The combination of supply chain challenges, combined with inflationary pressure on commodities, raging demand in construction and select areas of consumer and discretionary goods, makes for a bumpy and inconsistent economy.

Implementing suitable policy for health and the economy is far more challenging as delta spreads and the risk of even worse mutations becomes evident. Lockdowns still may be a last resort for regions that cannot access vaccinations, or should the existing vaccinations prove to no longer be adequate to protect us. But as long as effective vaccinations are accessible, lockdowns are probably not the way to go. Vaccinations make much better sense.

Ira Zunin, a practicing physician, is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center. Please submit your questions to info@manakaiomalama.com.