Michael Coston
Editor, Senior Moderator
UK: Growing Concerns Over The B.1.617.2 Variant's Impact On Reopening Society
Confirmed cases of VOC-21APR-02by week - Credit PHE
Due to a time lag in sequencing (approximately 10 to 14 days) and the prioritisation
of samples of concern, variants cases can be identified weeks after the sample date.
The numbers represent weekly new cases, not a cumulative total for each week.
#15,963
As COVID cases continue to fall across much of the globe, the United States, Japan, the UK, and a number of other European nations have announced plans to relax social distancing requirements and reopen society in the weeks ahead.
Yesterday we looked at the new CDC Guidance on ditching facemasks When You?ve Been Fully Vaccinated, while many states have already announced they are open for business.
On Sunday the UK is scheduled to ease lockdown rules (see UK guidance How the rules will change on 17 May), with an eye towards lifting many of their remaining restrictions on June 21st.
Japan insists - despite its current state of emergency - that they will hold the summer Olympics in August, and the general feeling (at least in many western nations where COVID cases are slowing) is that with the aid of the highly effective COVID vaccine, the worst of the pandemic may be behind us.
While everyone certainly hopes these reopenings can go as planned, there are growing concerns over what is happening with COVID in South East Asia (primarily India, but also neighboring nations), and lingering concerns over Brazil's ongoing 2nd wave.
Both, as far as we can tell, are being largely driven by (different) emerging COVID variants; B.1.617.x in India and P.1, P.2, P.3 in Brazil.
WHO COVID Epidemiological Report As of May 9th
These variants, while most commonly reported in these two hardest hit nations, are spreading globally and appear biologically `fit' enough to compete with the other major variants around the globe.
While the Brazilian variant was atop our watch list a couple of months ago, as India's crisis worsens, the B.1.617.2 variant has recently taken center stage.
Outside of India, the greatest number of B.1.617.x variants have been reported from the UK, and as the graph at the top of this blog post illustrates, it is spreading rapidly. Early reports suggest it is likely more transmissible than the B.1.1.7 (aka `Kent') variant, and there are concerns that the current vaccines may be less effective against it.
Despite plans to loosen restriction in two days time, and hopefully further reduce them in June, the UK's Prime Minister Boris Johnson gave a statement at a coronavirus press conference last night expressing concerns over the spread of this variant, and how it might affect future plans.
But I urge everyone to exercise the greatest caution because the choices we each make in the coming days will have a material effect on the road ahead.
Early on the UK adopted a policy to delay the 2nd COVID shot for up to 12 weeks (rather than the recommended 4 weeks) in order to get as many people their first dose as quickly as possible.
Last night, the PM announced - in view of the threat posed by this new variant - plans to speed up 2nd doses for some vulnerable cohorts, based on advice from their JCVI (Joint Committee on Vaccination and Immunisation).
JCVI advice to mitigate impact of B1.617.2 variant
The Joint Committee on Vaccination and Immunisation (JCVI) has issued advice to the government on the use of COVID-19 vaccines to mitigate the impact of the B1.617.2 variant of concern.
In a separate statement, Health and Social Care Secretary, Matt Hancock, said:
While there is no evidence to show this variant has a greater impact on severity of disease or evades the vaccine, the speed of growth is of note and the government is working quickly to ensure the appropriate action is being taken.
It should be noted that the mantra that there is `no evidence' that this variant is more severe or evades the vaccine is based more on a lack of data than anything else. As the following expert reaction, posted on the Science Media Centre website, makes clear - there is a lot about this variant we don't know yet.
Expert reaction to latest Downing Street Press Conference on the B.1.617.2 variant (?Indian? variant)
At the coronavirus press conference this afternoon Boris Johnson made a statement on the SARS-CoV-2 variant first identified in India, B.1.617.2.
Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:
?The main threat to vaccine success and return to normality has been the emergence and spread of variants that are able to escape the protection offered by vaccines. Evidence so far suggests that the vaccines should still be effective against the variant of concern first identified in India, but this is far from clear.
?Whilst most vulnerable people have had both doses of vaccine, and therefore will have the highest levels of immunity, there is still a large proportion of the population who have only had a single dose or no dose at all, and it is likely that many of these could become infected and potentially transmit the virus. Whilst the vaccines continue to protect the most vulnerable then this should not be a problem, but there is a potential risk of the virus acquiring more mutations, especially if it continues to spread in a partially immune population. That?s why it makes sense to reduce the interval between vaccine doses and ramp up vaccine coverage in potential hotspots.
?Of course, if heightened vaccine programmes can?t control its spread, and hospitalisations start to increase and threaten the NHS, then restrictions are all you have left. We aren?t there yet by any means, but we must keep a very close eye on things to ensure things don?t get out of hand again.
?Keeping the lid on the spread of this variant isn?t going to be easy, but hopefully early indicators of continued vaccine effectiveness against this variant, will minimise its impact.?
Whether B.1.617.x turn out to be a tempest in a teasmade, or something we'll seriously have to contend with in the months ahead, remains to be seen.
But as long as COVID burns, unchecked, anywhere in the world the virus has the ability - and is granted the opportunity - to remake itself into a more formidable foe.
Which means, as tempting as it is, we can't afford to declare victory just yet.
https://afludiary.blogspot.com/2021/05/uk-growing-concerns-over-b16172.html
Confirmed cases of VOC-21APR-02by week - Credit PHE
Due to a time lag in sequencing (approximately 10 to 14 days) and the prioritisation
of samples of concern, variants cases can be identified weeks after the sample date.
The numbers represent weekly new cases, not a cumulative total for each week.
#15,963
As COVID cases continue to fall across much of the globe, the United States, Japan, the UK, and a number of other European nations have announced plans to relax social distancing requirements and reopen society in the weeks ahead.
Yesterday we looked at the new CDC Guidance on ditching facemasks When You?ve Been Fully Vaccinated, while many states have already announced they are open for business.
On Sunday the UK is scheduled to ease lockdown rules (see UK guidance How the rules will change on 17 May), with an eye towards lifting many of their remaining restrictions on June 21st.
Japan insists - despite its current state of emergency - that they will hold the summer Olympics in August, and the general feeling (at least in many western nations where COVID cases are slowing) is that with the aid of the highly effective COVID vaccine, the worst of the pandemic may be behind us.
While everyone certainly hopes these reopenings can go as planned, there are growing concerns over what is happening with COVID in South East Asia (primarily India, but also neighboring nations), and lingering concerns over Brazil's ongoing 2nd wave.
Both, as far as we can tell, are being largely driven by (different) emerging COVID variants; B.1.617.x in India and P.1, P.2, P.3 in Brazil.
WHO COVID Epidemiological Report As of May 9th
These variants, while most commonly reported in these two hardest hit nations, are spreading globally and appear biologically `fit' enough to compete with the other major variants around the globe.
While the Brazilian variant was atop our watch list a couple of months ago, as India's crisis worsens, the B.1.617.2 variant has recently taken center stage.
Outside of India, the greatest number of B.1.617.x variants have been reported from the UK, and as the graph at the top of this blog post illustrates, it is spreading rapidly. Early reports suggest it is likely more transmissible than the B.1.1.7 (aka `Kent') variant, and there are concerns that the current vaccines may be less effective against it.
Despite plans to loosen restriction in two days time, and hopefully further reduce them in June, the UK's Prime Minister Boris Johnson gave a statement at a coronavirus press conference last night expressing concerns over the spread of this variant, and how it might affect future plans.
(Excerpt)
We believe this variant is more transmissible than the previous one ? in other words it passes more easily from person to person - but we don?t know by how much.
I am told that if it?s only marginally more transmissible, we can continue more or less as planned.
But if the virus is significantly more transmissible, we are likely to face some hard choices.
(SNIP)
We believe this variant is more transmissible than the previous one ? in other words it passes more easily from person to person - but we don?t know by how much.
I am told that if it?s only marginally more transmissible, we can continue more or less as planned.
But if the virus is significantly more transmissible, we are likely to face some hard choices.
(SNIP)
So ? and this is a balanced decision - I do not believe on present evidence that we need to delay our roadmap, and we will proceed with our plan to move to step 3 in England from Monday.
But I have to level with you that this could be a serious disruption to our progress and could make it more difficult to move to step 4 in June, and I must again stress we will do whatever it takes to keep the public safe.
Our surveillance and data gathering is now so advanced, that if there was a danger of the NHS coming under unsustainable pressure, we would see the signs in the data very early on and could react in good time, and that gives us the confidence to continue moving forwards for now.
But I urge everyone to exercise the greatest caution because the choices we each make in the coming days will have a material effect on the road ahead.
Early on the UK adopted a policy to delay the 2nd COVID shot for up to 12 weeks (rather than the recommended 4 weeks) in order to get as many people their first dose as quickly as possible.
Last night, the PM announced - in view of the threat posed by this new variant - plans to speed up 2nd doses for some vulnerable cohorts, based on advice from their JCVI (Joint Committee on Vaccination and Immunisation).
JCVI advice to mitigate impact of B1.617.2 variant
The Joint Committee on Vaccination and Immunisation (JCVI) has issued advice to the government on the use of COVID-19 vaccines to mitigate the impact of the B1.617.2 variant of concern.
From:Public Health England Published 14 May 2021
The advice is specific to circumstances in the UK at this time.
Professor Wei Shen Lim, COVID-19 Chair for JCVI, said:
Due to the rapid rise in cases of the B1.617.2 Variant of Concern and notable transmission in parts of the country, the JCVI advises that every effort is made to promote vaccine uptake in those who remain unvaccinated in priority cohorts 1 to 9 ? these people remain at highest risk of severe outcomes from COVID-19.
Where vaccine supply allows, particularly in areas where B1.617.2 is a major threat, the second dose of vaccine should be brought forward from 12 to 8 weeks. This is only possible because everyone in the Phase 1 priority groups has already been offered a first dose.
Alongside these measures, the vaccine programme should continue to be rolled out as quickly as possible. The capacity of vaccination centres should be maximised to enable rapid rollout.
The advice is specific to circumstances in the UK at this time.
Professor Wei Shen Lim, COVID-19 Chair for JCVI, said:
Due to the rapid rise in cases of the B1.617.2 Variant of Concern and notable transmission in parts of the country, the JCVI advises that every effort is made to promote vaccine uptake in those who remain unvaccinated in priority cohorts 1 to 9 ? these people remain at highest risk of severe outcomes from COVID-19.
Where vaccine supply allows, particularly in areas where B1.617.2 is a major threat, the second dose of vaccine should be brought forward from 12 to 8 weeks. This is only possible because everyone in the Phase 1 priority groups has already been offered a first dose.
Alongside these measures, the vaccine programme should continue to be rolled out as quickly as possible. The capacity of vaccination centres should be maximised to enable rapid rollout.
In a separate statement, Health and Social Care Secretary, Matt Hancock, said:
While there is no evidence to show this variant has a greater impact on severity of disease or evades the vaccine, the speed of growth is of note and the government is working quickly to ensure the appropriate action is being taken.
The latest data on the B1.617.2 variant, published by PHE last night, shows the number of cases across the UK has risen from 520 last week to 1,313 cases this week. Most cases are in the North West of England, with some in London.
It should be noted that the mantra that there is `no evidence' that this variant is more severe or evades the vaccine is based more on a lack of data than anything else. As the following expert reaction, posted on the Science Media Centre website, makes clear - there is a lot about this variant we don't know yet.
Expert reaction to latest Downing Street Press Conference on the B.1.617.2 variant (?Indian? variant)
At the coronavirus press conference this afternoon Boris Johnson made a statement on the SARS-CoV-2 variant first identified in India, B.1.617.2.
Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:
?The main threat to vaccine success and return to normality has been the emergence and spread of variants that are able to escape the protection offered by vaccines. Evidence so far suggests that the vaccines should still be effective against the variant of concern first identified in India, but this is far from clear.
?Whilst most vulnerable people have had both doses of vaccine, and therefore will have the highest levels of immunity, there is still a large proportion of the population who have only had a single dose or no dose at all, and it is likely that many of these could become infected and potentially transmit the virus. Whilst the vaccines continue to protect the most vulnerable then this should not be a problem, but there is a potential risk of the virus acquiring more mutations, especially if it continues to spread in a partially immune population. That?s why it makes sense to reduce the interval between vaccine doses and ramp up vaccine coverage in potential hotspots.
?Of course, if heightened vaccine programmes can?t control its spread, and hospitalisations start to increase and threaten the NHS, then restrictions are all you have left. We aren?t there yet by any means, but we must keep a very close eye on things to ensure things don?t get out of hand again.
?Keeping the lid on the spread of this variant isn?t going to be easy, but hopefully early indicators of continued vaccine effectiveness against this variant, will minimise its impact.?
Whether B.1.617.x turn out to be a tempest in a teasmade, or something we'll seriously have to contend with in the months ahead, remains to be seen.
But as long as COVID burns, unchecked, anywhere in the world the virus has the ability - and is granted the opportunity - to remake itself into a more formidable foe.
Which means, as tempting as it is, we can't afford to declare victory just yet.
https://afludiary.blogspot.com/2021/05/uk-growing-concerns-over-b16172.html
