Could spread of Indian variant jeapordise plans to end UK lockdown?

Could spread of Indian variant jeapordise plans to end UK lockdown?

Could spread of Indian variant jeapordise plans to ease lockdown? Strain is now DOMINANT in four areas and may be behind 12% spike in Covid cases nationally as minister warns tiered restrictions are still on the cards amid rise of hotspots in the North

  • EXCLUSIVE: Indian strain is now dominant in four local authorities in England, surveillance data revealed
  • Hotspots Bolton and neighbouring Blackburn with Darwen are now also seeing infections start to rise
  • But Public Health England has only launched surge testing in Bolton to root out cases of the strain
  • SAGE minutes reveal scientists fear the strain may be even more infectious than the Kent variant
  • Early reports suggest, however, that it is still susceptible to vaccine-triggered immunity to the virus

India’s Covid variant is now dominant in four local authorities in England and its rapid spread could jeapordise plans to ease lockdown, experts fear.

Analysis by one of the UK’s biggest variant trackers warns the strain is focused in hotspots Bolton and neighbour Blackburn with Darwen, where outbreaks have exploded with numbers of positive tests from all variants rising 93 and 86 per cent in a week, respectively – more than half have been proven to be the Indian strain.

The mutant virus is also confirmed to make up more than 50 per cent of infections in Bedford and South Northamptonshire, although outbreaks in the two areas are still small. And up to half of all cases in London are thought to be down to the B.1.617.2 variant.

Boris Johnson said in a statement to Parliament today that the variant was ‘of increasing concern’, warning that a variant that could slip past vaccines would have ‘potential to cause even greater suffering than we endured in January’.

Experts warned today the variant may be behind the 12 per cent spike in Covid cases across the country, after the number of cases in the last week rose to 15,895 from 14,165 in the week before. 

It comes after a Government minister refused to rule out tiered lockdowns in England when national restrictions come to an end next month. Environment Secretary George Eustice added they were ‘closely monitoring’ several outbreaks that had cropped up in recent weeks. 

Public Health England has launched surge testing in Bolton to root out cases of the B.1.617.2 variant, but no other area has yet seen enhanced surveillance. For the South Africa variant, by comparison, door-to-door swabbing has been ordered in dozens of boroughs.

There are three Indian variants but only B.1.617.2 has sparked major concerns because cases have more than doubled in the past week, with 520 spotted since the first positive sample was detected in late February. It now makes up six per cent of cases nationally, a leap from fewer than one per cent last month.

No10’s top scientists fear it may be more transmissible than the currently dominant Kent variant (B.1.1.7), which triggered the brutal second wave. But early lab trials suggest it is still susceptible to vaccines, and more than two in three adults — or 35.4million — have already had at least one jab. 

Some scientists have criticised Boris Johnson’s plan to push on with lockdown easing on Monday, warning the rising cases and spread of the Indian variant suggest he should ‘absolutely’ hit the pause button until further research is carried out on its impact on the jab.

Other critics, however, argue there is no need to panic just yet because early studies show jab-triggered immunity can still stop the variant. Pfizer said in a report this week that there was ‘no evidence’ its shot would need to be updated to fight off the current variants.  

India’s Covid variant is now dominant in five local authorities in England, official data reveals. There are mounting concerns that it is more infectious than the currently dominant Kent strain

Cases in Bolton have begun to rise in recent days as the variant takes hold in the area

Blackburn with Darwen is also seeing virus cases beginning to tick up, reversing a four-month long trend of plummeting infections

Bedford, where the variant may make up more than 70 per cent of cases, is also seeing a rise

South Northamptonshire is starting to see its Covid cases rise, official data shows

A Government minister today refused to rule out tiered lockdowns returning when England’s national measures are planned to end next month. 

Environment Secretary George Eustice revealed No10 was ‘closely monitoring’ several localised coronavirus outbreaks that have cropped up in recent weeks.

Analysis shows that while national infections have continued to plunge, there are 12 boroughs where cases have doubled in a week. 

Mr Eustice said scientists were unsure what was driving the flare-ups — predominantly in the North of England — but suggested people may have become ‘too lax’ with Covid rules, or the highly-infectious Indian variant could be driving cases. 

Scotland has already refused to ease restrictions in Moray when the rest of the nation takes the next step to freedom on Monday because of the area’s growing outbreak.

Asked if local restrictions could be reimposed in England to squash local outbreaks during a round of interviews today, he said: ‘We can’t rule anything out.’ 

He told Sky News: ‘But our plan that’s been set out by the Prime Minister, the reason we’re being incredibly cautious about exiting lockdown, is we want this to be the last. We want to try and avoid having to get into a tiered system and regionalisation. We tried that last autumn, we know that in the end we had to go for a full lockdown.’

Most social distancing restrictions in England are to be lifted on June 21 as part of the final step in No10’s roadmap out of lockdown. Boris Johnson this week raised hopes that an end to Covid measures may be sight, suggesting social distancing could be scrapped completely by next month. 

The tiered system last summer was heavily criticised for being too convoluted, with people in neighbouring streets often living by a completely different set of rules.

The Prime Minister himself admitted they were ‘confusing’ as he struggled to explain the difference between restrictions imposed in the North East in September. 

Sanger Institute figures on the variants aim to exclude cases from international travellers and surge testing, revealing how troublesome variants spread in the community.

For this reason their data do not include every case of the Indian variant identified. It is also impossible to sequence a strain from every swab because some contain too few virus particles.

Bolton had the most cases of the Indian variant in England over the week to April 24, their data showed. There were 47 samples spotted (55 per cent of all cases in that area). 

It was followed by neighbouring Blackburn with Darwen, with lab sequencing spotting 19 genetic matches (55.7 per cent). 

Ten were also found in Bedford over the same period (53.8 per cent) and five in South Northamptonshire (76.9 per cent).

But University College London mathematician Professor Christina Pagel cited other Sanger Institute data suggesting the strain may already be responsible for more than 65 per cent of cases in the hotspots.

She found 75 per cent of those in the community in Blackburn with Darwen were down to the variant, and as many as 73 per cent in Bedford and 69 per cent in Bolton.

Department of Health data shows Covid cases were ticking upwards in all three areas in the week to May 9, a reversal on a four-month trend of plummeting infections.

Surge testing was only launched in Bolton four days ago, but officials say it will take about a week before it shows up in the statistics.  

Bolton has registered 707 new Covid cases over the two weeks since April 24, which means the true number of cases of the Indian variant spotted there could be in the region of 400. Cases jumped by 93 per cent in the space of a week.

And Blackburn with Darwen had 229 infections over the same time period, indicating they may have more than 130 cases of the strain. This was a jump of 86 per cent. 

When official data was broken down to a more granular level it showed that five of the ten worst-hit neighbourhoods in the country were in Bolton. 

This is despite more than 50 per cent of people in the same postcode areas having already been vaccinated.

Dr Gabriel Scally, an epidemiologist at Bristol University and Independent SAGE member, warned the Indian variant becoming dominant in some areas was a cause for concern.

‘Its coming to dominance in the local area shows it has the potential to out-compete other strains of the virus,’ he told MailOnline.

‘It also reminds us that when lockdown ended last summer, we now know that there were several local authorities which still had high levels of virus infections. They formed the nucleus of the resurgence of the virus at the end of the summer.

‘We are in difficulty if it becomes ingrained in some local authorities, particularly if those share characteristics such as a high level of deprivation, overcrowding, BAME, because we know that all those factors are associated with transmission of the virus.’

He criticised the Prime Minister’s decision to push on with stage three of lockdown easing, which will allow pubs and restaurants to serve indoors again.

‘There is some concern the fourth test seems to be being set aside at the moment,’ he said.

Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, warned the Indian variant was ‘really taking off’ at present and may be sparking the rise in cases nationally.

He said: ‘In the last seven days there have been 15,895 cases reported which is a 12 per cent increase on the previous seven-day period. This represents the largest week-on-week increase since early January.

‘Looking at public data from the COG-UK website, which suggest an increasing proportion of the cases they sequence are the Indian variant B.1.617.2, this may suggest the increase in infections may be due to the spread of this variant.

Public Health England has divided the Indian variant into three sub-types. Type 1 and Type 3 both have a mutation called E484Q but Type 2 is missing this, despite still clearly being a descendant of the original Indian strain. Type 1 and 3 have a slightly different set of mutations. The graphic shows all the different variants that have been spotted in Britain

This map shows the spread of the Indian variant across the UK. It is focused in key hotspots, and around Greater London

Environment secretary George Eustice revealed No10 was ‘closely monitoring’ several localised coronavirus outbreaks that have cropped up in recent weeks

‘As discussed at the Downing Street press briefing on Monday, this variant has been increasing rapidly in recent weeks.

‘There has been a lot of debate about when and if a further wave of infection will happen in the UK. The reports today suggest that this wave may have already begun.

‘That hospitalisations have yet to increase would be consistent with the view that the vaccine is still effective at reducing the risk of severe disease and gives hope that this new wave, if it indeed continues, will be less damaging to the NHS.’ 

And Professor Pagel warned that the situation was ‘not looking good at all’ with the Indian variant. She tweeted: ‘In England, within two weeks to May 1, B.1.617.2 went from one to 11 per cent of cases. A massive increase.

She added that the roadmap should ‘absolutely’ be slowed until ‘we either know for sure it’s not more transmissible or vaccine resistant, or we’ve stamped out the outbreaks or we’ve got further in the vaccine programme’.

Where could be in line for local lockdowns?

Scotland yesterday held back Moray from lockdown easing plans, stopping the borough from being allowed to enjoy extra freedoms from Monday.

But two parts of England currently have bigger coronavirus outbreaks than Moray: Erewash in Derbyshire (187.2) and Bolton (133.5). 

Erewash has seen cases rise by around 10-fold in the space of a week, according to Department of Health statistics.

Health chiefs in the Midlands say Erewash’s spike in cases is down to a cluster of infections at a secondary school in Long Eaton. 

Derbyshire’s director of public health Dean Wallace warned the Covid figures looked so bad because infection rates were so low, meaning ‘any increase’ can skew the figures.

But he said it was a ‘timely reminder that Covid hasn’t gone away’ and urged the borough’s 115,000 residents to ‘use their judgement to keep everyone safe’ when restrictions are eased on Monday. 

Bolton is also being hit by an increase in coronavirus cases, which experts fear may be linked to the spread of the highly-infectious Indian variant.

Officials have ordered surge testing in the Greater Manchester borough to flush out cases of the mutant B.1.617.2 strain.

Testing data shows it makes up around half of all cases spotted in Bolton. But other experts monitoring the outbreak say the true figure could be closer to 70 per cent.

Infection rates have also spiralled in other parts of the nation, with 12 boroughs having seen cases double over the same time period.

After Erewash, Fylde saw the biggest week-on-week increase in Covid cases (184 per cent) — but, overall, the Lancashire borough’s outbreak remains tiny. Just 17 positive tests were spotted in the week ending May 6.

Mr Johnson confirmed on Monday that England would be steaming ahead with easing further restrictions on May 17, in a positive sign that No10 does not consider the Indian variant to be a significant concern.

The irreversible roadmap has four tests that must be met before moving to each stage, including that the risks are not ‘fundamentally changed’ by variants and that cases are not rising in a way that risks more hospitalisations and deaths due to the virus.

From next Monday current plans will see restaurants, pubs and bars again allowed to serve customers indoors, foreign holidays permitted, and Britons allowed to have visitors indoors for the first time since last year.

Scotland has already slammed the brakes onto plans to ease restrictions in Moray when the rest of the nation takes a further step to freedom on Monday because of a growing outbreak — but this is not thought to be down to the Indian variant. 

But Mr Eustice today did not rule out whack-a-mole lockdowns for some areas should cases begin to spike.

He said scientists were unsure what was driving the flare-ups in cases — predominantly in the North of England — but suggested people may have become ‘too lax’ with Covid rules, or the highly-infectious Indian variant could be driving the cases. 

Asked if local restrictions could be reimposed in England to squash local outbreaks during a round of interviews today, he said: ‘We can’t rule anything out.’

He told Sky News: ‘But our plan that’s been set out by the Prime Minister, the reason we’re being incredibly cautious about exiting lockdown, is we want this to be the last. We want to try and avoid having to get into a tiered system and regionalisation. We tried that last autumn, we know that in the end we had to go for a full lockdown.’

The average infection rate in the UK has fallen by 15 per cent to 40.1 per 100,000 people in the fortnight up to May 4, according to latest statistics.

But analysis shows that 28 local authorities in England, four in Scotland and two in Northern Ireland are recording double the national case rate.

Quizzed about the hotspots this morning, Mr Eustice told Sky News: ‘We are not sure what could be driving it, whether it’s particular variants that have taken hold of people being a bit too lax about restrictions that are in place.

‘We are not sure about that but we are monitoring the situation closely.’

Asked if it meant restrictions could be imposed, he said: ‘We can’t rule anything out. We want this to be the last (lockdown) and want to avoid going back into a tiered system. 

Boris Johnson last night announced a major loosening of lockdown rules for next Monday

‘We know that in the end, we had to go for full lockdown.’

On local lockdowns, he added: ‘We tried that last autumn, we know that in the end we had to go for a full lockdown.’

‘We’ve got our confidence now in the vaccination programme, that’s rolling out and that is delivering…

‘It is also reducing transmission rates as well as reducing hospitalisations and mortality. ‘That’s got to be our focus.’

SAGE minutes from their meeting on May 5, and published yesterday, show Number 10’s top scientists are already raising concerns over the Indian variant.

They wrote: ‘There has been a significant recent increase in prevalence of the B.1.617.2 variant, including some community transmission. PHE is currently prioritising case finding and containment for this variant.

‘Early indications, including from international experience, are that this variant may be more transmissible than the B.1.1.7 variant.’

PHE said it was monitoring the situation closely in the North West, and intervening to prevent onward transmission of the variant.

They added that all positive cases in the region are being sequenced, to look out for any future outbreaks.

Dr Andrew Furber, the regional director for public health in the North West, said: ‘The gradual easing of restrictions is going well but we must all remain alert as the more opportunities we have to meet others, the more chances the virus has to spread. We should not become complacent.’

He added: ‘Going forward, variants are likely to be part of how we live with Covid.

‘So it’s vital that we adapt and respond to the changing nature of the virus in a way that works for our region and our diverse communities.

‘Taking a targeted and community led approach has proven to effectively suppress and contain variants in other areas of the UK, so we will continue this approach as we carefully progress through the roadmap.’

WHAT DO WE KNOW ABOUT THE INDIA VARIANTS? 

Real name: B.1.617 — now divided into B.1.617.1; B.1.617.2; B.1.617.3

When and where was it discovered? 

The variant was first reported by the Indian government in February 2021. 

But the first cases appear to date back to October 2020. 

Its presence in the UK was first announced by Public Health England on April 15. There have since been at least 500 cases spotted in genetic lab testing.  

What mutations does it have? 

It has 13 mutations that separate it from the original Covid virus that emerged in China — but the two main ones are named E484Q and L452R.

Scientists suspect these two alterations can help it to transmit faster and to get past immune cells made in response to older variants. 

PHE officials said it has split into three distinct virus types, with types 1 and 3 both having the E484Q mutation but type 2 missing the change, despite having all the other hallmarks of the variant. 

Is it more infectious and can it evade vaccines? 

The L452R mutation is also found on the Californian variant (B.1.429), even though the two evolved independently. It is thought to make the American strain 20 per cent more infectious than the original Wuhan version – even with the extra 20 per cent it is likely slower than the Kent variant.

The E484Q mutation is very similar to the one found in the South African and Brazil variants known as E484K, which can help the virus evade antibodies.

The South African variant is thought to make vaccines about 30 per cent less effective at stopping infections, but it’s not clear what effect it has on severe illness.  

Professor Sharon Peacock, of PHE, claimed there was ‘limited’ evidence of E484Q’s effect on immunity and vaccines. Lab studies have suggested it may be able to escape some antibodies, but to what degree remains uncertain.

Early research suggests both the AstraZeneca vaccine, known as Covishield in India, and the Pfizer jab, still work against the variant, as well as India’s own jab, Covaxin. A paper published by SAGE last week suggested two doses of the Pfizer vaccine is good enough to protect against all known variants. 

How deadly is it? 

Scientists still don’t know for sure. But they are fairly certain it won’t be more deadly than the current variants in circulation in Britain.  

This is because there is no evolutionary benefit to Covid becoming more deadly. The virus’s sole goal is to spread as much as it can, so it needs people to be alive and mix with others for as long as possible to achieve this. 

And, if other variants are anything to go by, the Indian strain should not be more lethal.

There is still no conclusive evidence to show dominant versions like the Kent and South African variants are more deadly than the original Covid strain – even though they are highly transmissible. 

Doctors in India claim there has been a sudden spike in Covid admissions among people under 45, who have traditionally been less vulnerable to the disease.

There have been anecdotal reports from medics that young people make up two third of new patients in Delhi. In the southern IT hub of Bangalore, under-40s made up 58 percent of infections in early April, up from 46 percent last year.

There is still no proof younger people are more badly affected by the new strain. 

Should we be worried? 

Scientists are unsure exactly how transmissible or vaccine-resistant the Indian variant is because it hasn’t been studied thoroughly.

The fact it appears to have increased infectivity should not pose an immediate threat to the UK’s situation because the current dominant Kent version appears equally or more transmissible. 

It will take a variant far more infectious strain than that to knock it off the top spot.

However, if the Indian version proves to be effective at slipping past vaccine-gained immunity, then its prevalence could rise in Britain as the immunisation programme squashes the Kent variant.

Why has B.1.617.2 been designated as a variant of concern?

Scientists believe this variant can spread more quickly than two other related variants seen in India.

It is thought to be at least as transmissible as the variant detected in Kent last year, known as B117, which is now dominant in the UK.

Dr Susan Hopkins, Covid-19 strategic response director at PHE, said: ‘We are monitoring all of these variants extremely closely and have taken the decision to classify this as a variant of concern because the indications are that this VOC-21APR-02 is a more transmissible variant.’

PHE said there is currently ‘insufficient evidence’ to indicate that any of the variants recently detected in India cause more severe disease or make the vaccines available any less effective.

How many cases have been detected in the UK?

According to data by PHE released on Friday, there are, at present, 520 confirmed cases of the B.1.617.2 variant in the UK, from 202 over the last week.

The report also showed 261 cases of B.1.617.1 and nine cases of B.1.617.3.

The cases are spread across the country, with the majority in two areas – the North West, mainly in Bolton, and London.

PHE said around half of these cases are related to travel or contact with a traveller.

PHE health protection teams are working with local authorities, public health officials and NHS Test and Trace to detect cases and limit onward spread.

Surge testing is expected to be deployed where there is evidence of community transmission.

Is B16172 variant driving the second wave in India?

India reported 412,262 new Covid-19 cases and 3,980 Covid-19-related deaths on Thursday — both new single-day records.

In the past 30 days, the country has recorded 8.3million cases.

However, it remains unclear whether the new coronavirus variants are driving the second wave.

Experts say large gatherings, and lack of preventive measures such as mask-wearing or social distancing, are playing a key role in the spread of the virus.

Although India has the world’s biggest vaccine making capacity, the country has partially or fully immunised less than 10 per cent of its 1.35billion people. 

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