What Is The India Variant And Where Are Cases Rising In The UK?

Professor Chris Whitty said cases linked to the variant of concern have “gone up very sharply”.
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Cases of the “highly transmissible” so-called India variant have “gone up very sharply” in England, the country’s chief medical officer has said.

The latest Public Health England data show cases of the variant, which was first detected in India, have risen from 520 to 1313 cases this week in the UK.

At a press conference, Professor Chris Whitty said most variants are “relatively stable and not increasing at a great rate” in the UK. However, the one that is “slightly concerning” is the variant from India.

He noted this variant is at least as transmissible as the B117 (Kent) variant, and added it might even be more transmissible.

Boris Johnson confirmed these concerns at Downing Street on Friday when he warned that the India variant could “pose a serious disruption” to plans to ease restrictions and “could make it more difficult” to end them as hoped in June 21.

“I’m told that if it is only marginally more transmissible we can continue more or less as planned but if the variant is significantly more transmissible we’re likely to face some hard choices,” the prime minister told the press conference.

“I do not believe that we need, on the present evidence, to delay our road map and we will proceed with our plan to move to step three in England from Monday.

“But I have to level with you that this new variant could pose a serious disruption to our progress and could make it more difficult to move to step four in June.”

Health secretary Matt Hancock has also shared his concern over the variant. In a separate interview, he told Times Radio: “We are worried about the Indian variant.” There is “enhanced” tracking and tracing in operation for all of the Indian variants currently circulating in the UK, he added.

What is the variant?

There are a few variants that originated in India doing the rounds, but one is causing more worry than others. The strain – B1617.2 – is one of three related variants that have been detected in the UK. The others are B1617.1 and B1617.3.

There were originally four variants of concern (VOCs) in England – the so-called Kent, South Africa, Brazil and Bristol variants.

All three India variants were originally designated as variants under investigation, however Public Health England (PHE) confirmed B1617.2 had become the fifth variant of concern as of May 7 due to the rising cases.

Initial data suggested there were 202 cases of the B1617.2 variant, 193 confirmed cases of the B1617.1 variant, with 61 more cases confirmed since then, and five cases of the B1617.3 variant. On May 7, PHE confirmed cases of B1617.2 had shot up to 520 in the space of a week. Almost half the cases were related to travel or contact with a traveller. This figure has since more than doubled again.

The World Health Organisation (WHO) is also monitoring the India variant, which was first discovered in October 2020. Just this week it classified the variant as one of “global concern”, noting that it had spread to more than 30 countries.

Where is the variant circulating?

Cases have been reported in the North West – predominantly Bolton and Blackburn – as well as London, Bedford and South Northamptonshire.

Boris Johnson urged people to “think twice” ahead of travelling to areas with higher incidences of the Indian variant and staying with family and friends within those areas.

“We want people in those areas to recognise that there is extra risk, an extra threat of disruption to progress caused by this new variant and just to exercise their discretion and judgment in a way I’m sure that they have been throughout this pandemic,” he said on Friday.

What is a variant of concern?

There are around one to two mutations of SARS-CoV-2 per month, which means thousands of mutations have developed since the virus first emerged.

Professor Lawrence Young, a virologist and expert in molecular oncology from Warwick Medical School, explains: “Most of these mutations have no effect on the behaviour of the virus but occasionally a mutation occurs that alters how quickly the virus spreads, how infectious it might be or even the severity of the disease it causes. It is then the virus becomes a variant of concern.”

Is the Indian variant more transmissible?

Evidence suggests this variant is at least as transmissible as B117 (the Kent variant). The other characteristics of this variant are still being investigated.

Dr Deepti Gurdasani, a clinical epidemiologist and senior lecturer at Queen Mary University of London, told The Guardian “at the current doubling rate, [B1617.2] could easily become dominant in London by the end of May or early June”.

Professor Chris Whitty
WPA Pool via Getty Images
Professor Chris Whitty

Does the variant cause severe illness?

There is insufficient evidence to indicate that any of the variants recently detected in India cause more severe disease.

Professor Steven Riley, from Imperial College London, said there are currently no signs that infection is leading to rising hospital admissions.

He told Times Radio: “I think there’s two key things that have got to be kind of evaluated – if infections go up, how quickly will they go up? But then after that, are they linked to the hospitalisations?

“The top-line government policy is driven by protecting the NHS, so even if infection starts to go up, we then need to assess whether that’s bringing a lot of new cases into hospitals, and there’s certainly no sign of that at the moment.”

Do the vaccines work against the variant?

There is no evidence so far that the B1617.2 variant can sidestep vaccine immunity and health experts have said they “haven’t seen any hint” of a current Covid variant that can fully evade the effectiveness of vaccines, which is promising.

PHE said it is carrying out laboratory testing, in collaboration with academic and international partners, to better understand the impact of the mutations on the behaviour of the virus.

At Monday’s press conference, Prof Whitty said early evidence suggests the India variant would not escape vaccination as effectively as the South African variant.

But on Friday, Boris Johnson said there is “no evidence to suggest that our vaccines will be less effective in protecting people against severe illness and hospitalisation”.

What is being done to stop the Indian variant in the UK?

Surge and community testing will be deployed where there is evidence of community transmission, PHE said. This is in addition to work that is already underway to trace and test all contacts of cases.

Boris Johnson said on Friday that the army would be deployed on the streets of Blackburn and Bolton handing out tests to help the surge testing efforts. Everyone in the affected areas will be asked to get a test, even if they don’t have symptoms. If someone tests positive, they must isolate to stop the spread.

“Surge” vaccinations could also be targeted on areas showing spikes in rates if government scientists propose the idea, Downing Street has said.

In the meantime, the public is being urged to: work from home where possible, continue following the guidance on mixing with others, take up the offer of free lateral flow testing, and to get vaccinated when called to do so.

Dr Susan Hopkins, Covid-19 strategic response director at PHE, said: “The way to limit the spread of all variants is the same and although we are all enjoying slightly more freedom, the virus is still with us. “Keep your distance, wash your hands regularly and thoroughly, cover your nose and mouth when inside and keep buildings well ventilated and meet people from other households outside.”

She urged people to get tested if they’re asked to get one or if you’ve been in contact with anyone who tests positive for the virus.

The current evidence suggests that the other variants detected in India are not variants of concern, but this will be kept under constant review.

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