The government has finally designated B1617.2 (the “Indian variant”) a Variant of Concern (VOC). The release of the information that the risk to the public is “high” appears to have been delayed because of the elections.

First published in May 2021.

So it looks like the government has finally designated B1617.2 (the so-called “Indian variant”) a Variant of Concern (VOC).

Public Health England (PHE) appears to have designated that the risk to the public is “high”, but the information appears to have not been released due to the elections!

The Guardian

Some really concerning aspects.

This variant has been growing rapidly in number in the UK, while the overall cases and cases of  B117 (the “Kent” or “British” variant) have been dropping. This is the same pattern we saw with B117 in November 2020, when it was growing with an R=1.5, while R for other variants was inferior to 1.

Variants Under Investigation (VUI) and Variants of Concern (VOC) sequences (most accounted for by B1617.2 at this point) now form 9% of all sequences, and are rapidly rising. The proportion appears to be even higher in London and the South East, where proportion was 11% over a week ago, so probably higher now.

The pattern in India has been very similar, with several states showing B1617.2 becoming dominant against B117 (although sparse sequencing). This means that B1617.2 is likely fitter than B117 in some way – either increased transmissibility or escape, or both.

The rate of growth of B1617.2 against B117 seems to be similar to the rate at which B117 replaced the previous variant. This means that the relative fitness of B1617.2 against B117 may be similar to the relative fitness of B117 against previous variants.

This is concerning because we have seen how quickly a new, more transmissible variant can change the shape of the pandemic and how quickly these can spread.

Currently B1617.2 appears to be doubling every week, so it may become dominant in some parts of the UK in 2-4 weeks.

Public Health England (PHE) appears to have now designated this as a VOC, despite having delayed the release of data due to the elections(!) in the midst of what looks like a public health emergency.

The Guardian

There has clearly been spread in many community settings: 48 clusters and almost 800 cases identified.

Cases have been identified in secondary schools (where government is considering stripping masks on 17 May), care homes, and religious gatherings. Yet, the government, knowing the situation, hasn’t communicated this to the public and presumable to local authorities(?) who could have taken action.

As Professor Christina Pagel puts it “telling the public about a public health emergency should not need to wait for a specific release day or local elections – this should have been communicated earlier, not least to protect communities where the clusters are.”

Bizarrely, the government website today said the delays were due to problems with data processing. According to the Guardian, it appears to have been a deliberate decision to postpone until after the election. Why the lack of transparency?

Variants: distribution of cases data. |

There have been cases in care homes where 15 residents – who had received both doses of AstraZeneca (but the second dose only in the previous week) – got infected and four hospitalised but with non-severe disease. We definitely need more information about vaccination status among those infected overall.

It seems completely bizarre to me that while PHE has designated this a “high risk” threat to public health, they have continued with large “trials”, are considering lifting mitigations in schools (at the same time as the spread is occurring), and done nothing to improve border policy.

What is even worse is that many of us have been warning about these variants for a while – saying that we need to keep transmission down, and have strict border measures during the vaccine roll-out – but there has been no response.

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Many scientists have repeatedly warned that variants were increasing in frequency and could really change the shape of the pandemic – suggesting that we learn from what is happening in other countries – but the risk of this has been consistently minimised in the media, and even by scientists.

It seems that a side effect of the exceptionalism prevalent in the UK is that despite scientific expertise, and scientists raising alarm and advising caution, we only act, when it is very late – again and again.

All of this was entirely predictable and predicted.

We didn’t prevent these variants coming in, we didn’t prevent them growing despite our amazing surveillance systems. What is the point of having these amazing resources that collect data if we never respond to data, and don’t even share it with local authorities who need to know?

Health Sec. Matt Hancock. | Number 10

So while we are in the midst of a public health emergency, where every few months we are seeing one fit variant of virus being replaced by another fitter variant of virus (making pandemic control even harder), rather than focusing on containing transmission and controlling borders:

  • We are doing “trials” with thousands gathering while we have community transmission of a concerning variant happening;
  • We are looking to strip masks from secondary schools, where outbreaks of B1617.2 are ongoing;
  • We are looking to ease rather than strengthen border restrictions;
  • Scientists are talking about how SARS-CoV-2 will mutate into a benign version of the flu or an endemic coronavirus, when all evidence so far points to adaptation in the opposite direction;
  • We are spending £30m on new vaccines for variants but doing nothing to limit their spread.

Every time we let a new fitter variant become dominant, we take a huge risk. A more transmissible variant can make pandemic control much harder. A variant that can escape immune responses and vaccines can threaten our primary pandemic strategy. Why take the risk?

Every variant has the potential to change the shape of the pandemic. This hasn’t happened once – it has happened many times with SARS-CoV-2. The original variant was replaced by D614G early last year, then B117 in the UK, B1351 in South Africa, and P1 in Manaus, Brazil... and now B1617.

Why would anyone think this would change, unless we take action to ensure we contain transmission to prevent mutation and adaptation, and also prevent imports at are borders? We have agency – this isn’t inevitable.

But it is inevitable if we don’t exercise it. 

Going Further:

Dr Deepti Gurdasani, Senior Lecturer in Epidemiology, Statistical Genetics, Machine Learning, Queen Mary University of London.


[This piece was first published as a Twitter thread and turned into the above article on 6 May 2021 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]

(Cover: Flickr/Number 10. - Boris Johnson. | 17 April 2021. / Licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.)

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