Is Delta variant COVID clinically different from the "original" strain? This is not so easy of a question for me to answer. As a bedside physician, I see each patient as an individual microcosm with his or her own risk factors, physiology, and clinical course. It's hard to get a big picture of how COVID now compares with COVID before. Nevertheless, looking at news reports and nationwide statistics, I suspect that the Delta strain acts differently than the original coronavirus. Never before have we worried about pediatric intensive care units filling up. And though some of it may be explained by more infections from schools and daycares compared to last year, I worry that COVID has adapted to infect younger patients. This is frightening, especially since we are not yet vaccinating children, and we've already seen outbreaks originating in classrooms.

Similarly, I think the increase in younger adults hospitalized with COVID suggests this Delta variant really is more severe. Although locally, we haven't seen a significant increase in deaths, this is most likely related to our own improvements in hospital protocols, treatment regimens, and clinical care. While we scramble to improve our medical therapies and systems, the virus is mutating to increase its virulence and lethality. Unfortunately, I suspect this parallel escalation will continue.

This is worrisome. There aren't that many diseases which have gotten dramatically worse over time, especially in the short time frame of a year and a half. It makes me think of HIV and its rapidly developing resistance to antiviral medications or maybe the obesity epidemic which has escalated in the last few decades. But there are few comparisons, and this suggests to me that we need new frameworks to think of this disease's danger, not only in the current moment, but also in its unknown potential in the near and far future.