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Hospital staff do an X-ray of the lung of a patient suffering from COVID-19 at Hospital del Mar, in Barcelona, Spain, on July 15.NACHO DOCE/Reuters

The Delta variant is the fastest, fittest and most formidable version of the coronavirus that causes COVID-19 the world has encountered, and it is upending assumptions about the disease even as countries loosen restrictions and open their economies, according to virologists and epidemiologists.

Vaccine protection remains very strong against severe disease and hospitalizations caused by any version of the coronavirus, and those most at risk are still the unvaccinated, according to interviews with 10 leading COVID-19 experts.

But evidence is mounting that the Delta variant, first identified in India, is capable of infecting fully vaccinated people at a greater rate than previous versions, and concerns have been raised that they may even spread the virus, these experts said.

As a result, targeted use of masks, physical distancing and other measures may again be needed even in countries with broad vaccination campaigns, several of them said.

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Israel recently reinstated mask-wearing requirements indoors and requires travellers to quarantine upon arrival.

U.S. officials are considering whether to revise mask guidance for the vaccinated. Los Angeles County, the most populous in the United States, is again requiring masks even among the vaccinated in indoor public spaces.

“The biggest risk to the world at the moment is simply Delta,” said microbiologist Sharon Peacock, who runs Britain’s efforts to sequence the genomes of coronavirus variants, calling it the “fittest and fastest variant yet.”

Viruses constantly evolve through mutation, with new variants arising. Sometimes these are more dangerous than the original.

The major worry about the Delta variant is not that it makes people sicker, but that it spreads far more easily from person to person, increasing infections and hospitalizations among the unvaccinated.

Public Health England said on Friday that of a total of 3,692 people hospitalized in Britain with the Delta variant, 58.3 per cent were unvaccinated and 22.8 per cent were fully vaccinated.

In Singapore, where Delta is the most common variant, government officials reported on Friday that three quarters of its coronavirus cases occurred among vaccinated individuals, though none were severely ill.

Israeli health officials have said 60 per cent of current hospitalized COVID-19 cases are in vaccinated people. Most of them are 60 or older and often have underlying health problems.

In the United States, which has experienced more COVID-19 cases and deaths than any other country, the Delta variant represents about 83 per cent of new infections. So far, unvaccinated people represent nearly 97 per cent of severe cases.

Dr. Monica Gandhi, an infectious diseases doctor at the University of California, San Francisco, said many vaccinated people are “so disappointed” that they are not 100-per-cent protected from mild infections. But the fact that nearly all Americans hospitalized with COVID-19 right now are unvaccinated “is pretty astounding effectiveness,” she said.

“There is always the illusion that there is a magic bullet that will solve all our problems. The coronavirus is teaching us a lesson,” said Nadav Davidovitch, director of Ben Gurion University’s school of public health in Israel.

The Pfizer/BioNTech vaccine, one of the most effective against COVID-19 so far, appeared only 41-per-cent effective at halting symptomatic infections in Israel over the past month as the Delta variant spread, according to Israeli government data. Israeli experts said this information requires more analysis before conclusions can be drawn.

“Protection for the individual is very strong; protection for infecting others is significantly lower,” Dr. Davidovitch said.

A study in China found that people infected with the Delta variant carry 1,000 times more virus in their noses compared with the original version first identified in Wuhan in 2019.

“You may actually excrete more virus and that’s why it’s more transmissible. That’s still being investigated,” Dr. Peacock said.

Genomics expert Eric Topol, director of the Scripps Research Translational Institute in La Jolla, Calif., noted that Delta infections have a shorter incubation period and a far higher amount of viral particles.

“That’s why the vaccines are going to be challenged. The people who are vaccinated have got to be especially careful. This is a tough one,” Dr. Topol said.

In the United States, the Delta variant has taken hold just as many Americans – vaccinated and not – have stopped wearing masks indoors.

“It’s a double whammy,” Dr. Topol said. “The last thing you want is to loosen restrictions when you’re confronting the most formidable version of the virus yet.”

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