Today we await the arrival of May 17th and a further re-opening of society in Britain. But whatever elation we may have had has been tempered by rumors of a new threat which might cause a third wave and send us scurrying back to the safety of our isolated households. Those who read yesterday’s report from the COVID actuarial response group may have missed a late-in-the-day update which focused on the variant and its impact.
Judge for yourself the likely risks and worry or not, based on your scientific judgment, not on baseless rumor
Prevalence of Variants in the UK
Concern continues to mount with regard to the “Indian” variants, and in particular B.1.617.2, which continues to grow quickly, and now accounts for nearly 8% of all the cases sequenced, with 793 identified in the most recent data.
Mapping differences between the Variants of Concern and Variants of Interest
Since September 2020 we have heard an increasing amount about Variants of Interest (or Variants under Investigation) and Variants of Concern. Variants have mutations in the RNA genetic code of the virus that translate into different amino acids affecting the shape of viral proteins. Interest has intensified in the last week as the India variant B.1.617.2 is spreading rapidly in particular hotspots in the UK, as described above.
The Advisory Committee on Immunization Practices (ACIP) in the USA is a group of medical and public health experts that develop recommendations on vaccine usage, and have developed a number of very informative and useful presentations. Their most recent (link) illustrates similarities and differences between the main variants. Note that, while ACIP list B.1.617.2 as a Variant of Interest, it has been classified as a Variant of Concern by Public Health England and a Variant of Global Concern by the World Health Organisation. A Variant of Interest only can become a Variant of Concern once a risk assessment is carried out.
All of the Indian variants show the L452R alteration which has been associated with increased transmission in the Californian variant B.1.427. Further investigations are ongoing to assess whether the ability of the E484Q alteration which is found in some Indian variants is comparable to that of the E484K alteration.
Population studies from the Seychelles (link), whose population is 80% plus vaccinated and where the Indian variants are spreading widely, have indicated that 37% of new infections and 20% of hospitalisations are in those who have received two doses of either the Sinopharm or AstroZeneca vaccines. This illustrates why there is particular concern over the ability of the B.1.671.2 variant in particular to escape prior immune responses and to lead to more sustained outbreaks in the coming months.
To date, there hasn’t been a noticeable impact on overall case levels reported by PHE, which are currently broadly level, although hotspots are developing, most notably in the North West. (As an example, Bolton’s latest 7 day rate is 165 per 100k, compared with 22 for England as a whole.) It is suspected that B.1.617.2 is causing these hotspots, and evidence is growing to support this.
Although the vaccination programme has protected the majority of older lives, it is of concern that the hotspots to date are in areas where take-up has been relatively low, and thus may have a greater impact than might otherwise be expected.