Scientists are warning that the UK has entered a crucial couple of months as the race between vaccination and the spread of the India variant heats up.
The variant, first detected in India and called B.1.617.2 has been flourishing in parts of the UK, particularly in north-west England, while cases of the so-called Kent variant have fallen.
Scientists have warned that while overall case numbers of the Indian variant are low, the coming months will be crucial in determining how the situation develops.
“I think we need to be taking this seriously … all outbreaks start with low numbers of cases, it is what happens next that matters,” said Adam Kucharski, an associate professor at the London School of Hygiene & Tropical Medicine and member of the modelling sub-group of Sage.
According to data from Public Health England (PHE) there were 3,424 confirmed cases of the India variant in the UK as of 19 May, compared with 1,313 the week before and 520 the week before that – although some experts have pointed to early signs new cases a day may now be flattening.
Documents released by the Scientific Advisory Group for Emergencies (Sage) have suggested it is “a realistic possibility” that the India variant could be up to 50% more transmissible than the Kent variant, with data released by PHE on Saturday also suggesting it is substantially more transmissible.
Meanwhile a preliminary analysis by PHE has indicated that the effectiveness of both the Pfizer/BioNTech and the Oxford/AstraZeneca jabs is somewhat weakened, particularly after the first dose, compared with the Kent variant.
Kucharski noted that a combination of factors likely explain why the India variant appears to spread more easily than the Kent variant, including biological changes to the virus, social factors affecting the first groups infected, and some reduced effectiveness of the Covid vaccines.
“There are subtleties around it but if you have anything that means you are going to get ongoing transmission in your population, especially when you have people who are not fully protected, that is going to translate into cases and hospitalisations,” he said.
The warnings come after Dr Jenny Harries, the chief executive of the UK Health Security Agency, said at the weekend that it was good news the vaccines are still considerably effective. The chances of further easing lockdown restrictions in England on 21 June were “looking good” if people continue to follow Covid guidance, she added.
According to documents released by Sage, modelling suggests a variant that substantially escapes immunity or is highly transmissible – more so than the Kent variant – could lead to a wave of infections potentially larger than that seen in January 2021 in the absence of interventions, raising concerns.
At present, less than half the UK population over 18 is fully vaccinated. Martin McKee, professor of European public health at the London School of Hygiene & Tropical Medicine, said that some countries that have high vaccination rates such as Seychelles and Bahrain have seen a rise in infections likely linked to the India variant.
“So, given … the lower [vaccine] efficacy with one dose, and the increased transmissibility, the predictions in the Sage models, which point to the risk of another large wave, seem reasonable,” he said.
Experts say that should another wave take off it is likely to vary from region to region.
“What we will see happen is we will get these clusters develop pretty quickly and put a lot of pressure on local health systems so it won’t be a neat, even wave across the whole country necessarily, it might be in the next couple of months there are these hotspots that are in for a pretty tough [time],” said Kucharski.
“We need to be aware that what may have been working recently may start to struggle, then it is really having additional things on the table,” he said.
“I think we will be in a much better position when we have a large number of adults with two doses. I think we are in a particularly risky couple of months at the moment.”
The impact of the lifting of some restrictions on 17 Mayhas not yet become clear, but Paul Hunter, a professor in medicine at the University of East Anglia, predicted that cases of the India variant will probably rise in the coming weeks as it outcompetes the Kent variant and lead to a third wave of infections.
“The big uncertainty is if the vaccination campaign that we’ve got is enough to keep people out of the hospital even if they get infected,” he said. “If vulnerable people who have been by and large vaccinated, are being kept out of hospital and hospitalisations, then we can probably ride this out.”
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