A Blog by Jonathan Low


May 15, 2021

Indian Covid Variant Cases In UK Double In One Week, Puts Easing In Doubt

To meet the spike in cases of the Indian Covid variant, the UK is considering various alternatives including surge testing and vaccinating in the most affected areas or increasing the number of first shots in order to provide some protection to greater number of people over a wider area. 

The problem is that that because the UK has not cancelled travel from India, infected people are getting in, even if required to quarantine. The result has been a growth in community transmission across the country. Most of the newly infected are younger and thus already of the mindset that the pandemic is over, which increases the threat. Easing of national restrictions scheduled for later this month may have to be postponed. JL 

Becky Morton and Doug Faulkner report in the BBC:

Lifting restrictions on 21 June is in doubt because of the Indian variant. Cases in the UK have more than doubled. The Indian variant is spreading in younger, unvaccinated people but if cases increased in the elderly so would hospital admissions. A 30%-40% more transmissible variant combined with relaxing restrictions in May and June could lead to more hospital admissions than in the first wave.

Second vaccine doses could be brought forward and local restrictions introduced to help tackle the Indian variant in the worst-affected areas, the UK government has said.

Minister Nadhim Zahawi said steps could also include vaccinating younger people in multi-generational households.

Meanwhile, a top scientist has warned lifting restrictions on 21 June is in doubt because of the Indian variant.

Cases in the UK have more than doubled to 1,313, Public Health England said.

The figures released on Thursday have risen from 520 cases recorded by PHE up to 5 May.

Most of the cases - 1,255 - are in England, while there are 35 in Scotland, 12 in Northern Ireland and 11 in Wales, according to PHE.

However, Prof Paul Hunter, who sits on a number of Covid advisory committees for the World Health Organization, said current figures were around two weeks out of date and would now be higher.

He told BBC Radio 4's Today programme the Indian variant was now in most regions of the UK, with the possible exception of Yorkshire and Humber and north-east England.

More than 30% of cases are in London, followed by 25% in north-west England, 12% in eastern England, 10% in the East Midlands and 8% in the South East, PHE said.

Four people have now died with the Indian variant of concern as of 12 May, according to PHE.

According to Friday's government figures, a further 17 people have died in the UK within 28 days of a positive test and another 2,193 coronavirus cases have been recorded.

The Department of Health and Social Care said there was "no firm evidence yet to show this variant has any greater impact on severity of disease or evades the vaccine".

But experts believe it may be more transmissible.

And the department said ministers could not rule out imposing local restrictions if they were necessary to suppress a variant which vaccines are less effective against.

Vaccines Minister Mr Zahawi said the government was also considering reducing the gap between vaccine doses for people in areas where the variant is spreading.

He added that pilots of vaccinating younger people in multi-generational households in Luton had been successful.

Prof Hunter said there was "possibly" a case for targeting vaccines in certain areas - but jabs took two to three weeks to work. This would mean diverting doses from other areas, where the Indian variant could also soon be spreading.

He added that he thought it was more important to administer as many first doses as possible than boost the number of second doses at this stage.

Lockdown easing 'in doubt'

The next major easing of restrictions is due to take place on 17 May.

But Prof Hunter said step four of the roadmap out of lockdown, which is due on 21 June and would see all legal limits on social contact lifted, "is in doubt".

Currently, he said the Indian variant was spreading in younger, unvaccinated people but if cases increased in the elderly so would hospital admissions, putting pressure on the NHS.

Mr Zahawi said easing restrictions on 21 June depended on the government's four tests being met - including that vaccines continue to be effective and the risks are not fundamentally changed by new variants.

Why could the Indian variant be a problem when the vaccination programme is doing so well?

The issue is that we are only part way through even though those most at risk have been prioritised.

There is still debate about how transmissible the new variant is.

But modelling by the University of Warwick has estimated that a 30%-40% more transmissible variant combined with relaxing restrictions in May and June could lead to more hospital admissions than in the first wave.

It would be a very different situation if we were in the autumn when overall levels of immunity would be making it harder for the virus to spread.

Instead, we are in the delicate phase where restrictions are being eased as the vaccine is taking over the burden of suppressing the virus.

One option being considered is closing the gap between the first and second doses.

This would give vulnerable people, who have already been offered their first jab, extra protection more quickly.

However, there could be a trade-off as studies suggest the current 12-week gap between doses leads to a better immune response than the originally planned three-week gap.

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Asked whether local lockdowns were being considered, Mr Zahawi said nothing was "off the table", including further regional or national measures.

However, he said surge testing was the "most effective way" of dealing with variants.

Surge testing is already taking place in 15 areas across England, including Bolton, Blackburn, London, Sefton and Nottingham.

This is when increased testing and enhanced contact tracing is carried out in specific locations to try to prevent the spread of outbreaks.

Greater Manchester's Labour Mayor Andy Burnham told BBC Breakfast local lockdowns "can't be the answer" and urged ministers to deliver more vaccines to areas where case rates are highest.

The Conservative leader of Bolton Council, David Greenhalgh, also appealed to the government not to enforce a local lockdown, saying people would simply travel to pubs and restaurants in neighbouring areas.

He said he had also asked the health secretary for more resources and vaccines, including for younger people, to tackle the surge.

Mr Greenhalgh said talks on the introduction of vaccines for younger age groups had been "very constructive" and "all the soundings" were that the government was looking to progress this as soon as possible.

PHE said mobile testing units had been set up in Bolton, and door-to-door PCR testing had been offered to 22,000 residents. A PCR test is the most accurate way to check for Covid.

More doses have been delivered to the town, which has also set up a vaccine bus to increase uptake among those who are eligible.

Extra clinics will open in Blackburn and Darwen in Lancashire from next week to offer the vaccine to those who are eligible under national guidelines.

But the area's public health director, Prof Dominic Harrison, said he was "furious" the government had refused a request to extend vaccinations in Blackburn.

On Thursday, the council initially said all over-18s would be offered a jab, before later stating only those with underlying conditions could book an appointment.

Meanwhile, the R number - or reproduction number - in England is estimated to have risen slightly from between 0.8 and 1.0 to between 0.8 and 1.1, according to the government's Scientific Advisory Group for Emergencies.

If the R number is above one then the number of cases keeps increasing.


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