Arrival of India’s ‘double mutation’ adds to variant woes, but threat posed remains unclear

Paul Nuki
·4 min read
A health worker takes a nasal swab sample of a woman to test for COVID-19 at a test center in Bangalore, India - JAGADEESH NV/EPA-EFE/Shutterstock 
A health worker takes a nasal swab sample of a woman to test for COVID-19 at a test center in Bangalore, India - JAGADEESH NV/EPA-EFE/Shutterstock
Coronavirus bar portal embed V2
Coronavirus bar portal embed V2

How worried should we be about the sudden surge in reporting of new variants of Covid-19 here and abroad? It’s a difficult question and the honest answer is that we will only know for certain in a couple of weeks.

On Monday, the government started surge testing across three big London boroughs after a significant community cluster of the South African variant was detected in Lambeth. Now more than a million Londoners have been asked to come forward and be tested in a bid to stamp it out, plus others living in certain postcodes in and around Birmingham.

Adding to our variant woes, Public Health England’s (PHE) latest data show the arrival of B.1.617 in Britain. Otherwise known as the Indian variant, this version of Covid is thought to be responsible for a sharp surge in cases, which has taken large parts of India to the brink – cases jumped by 70 per cent last week, with a whopping 873,296 new infections.

Coronavirus India Spotlight Chart - Cases default
Coronavirus India Spotlight Chart - Cases default

Although only currently designated a “variant under investigation” by PHE (as opposed to “variant of concern”), it has attracted widespread press coverage not least because it is said to possess a scary sounding “double mutation”.

Altogether, 77 cases of B.1.617 have been found scattered across England, the first case dating back to February. Two notable mutations in the spike protein – E484Q and L452R – are thought by some in India to confer on it the ability to dilute vaccine effectiveness and reinfect people, although this is not yet proven.

The same or similar mutations have been seen elsewhere – E484Q is similar to the “Eek” mutation, which is found in the variants first found in South Africa and Brazil, while L452R has been identified in a separate strain currently circulating in California.

“Whether as a combination they impair vaccine efficacy is not yet known, but could be a concern,” said Prof Beate Kampmann, director of the Vaccine Centre at the London School of Hygiene and Tropical Medicine.

“However, the vaccines should still prevent severe infection. This is probably what matters most, as the whole concept of achieving herd immunity might not really hold up if we have to deal with lots of circulating variants.”

Officials at PHE also point out that what a variant does in one part of the world is not necessarily what it does in another.

People take part in coronavirus surge testing on Clapham Common, south London - Kirsty O'Connor/PA Wire
People take part in coronavirus surge testing on Clapham Common, south London - Kirsty O'Connor/PA Wire

Nevertheless the government and independent experts are concerned. The Telegraph understands that NHS Test and Trace is working on a plan to ask all those who receive a positive PCR test result to take an antibody test within 10 days, in a bid to better understand exactly how widespread different variants are becoming.

In cases where the antibody test also comes up positive – indicating a previous infection with Covid or vaccination – this would send a strong signal that the current infection is caused by a new variant which is capable of overcoming the individual’s existing immune response.

It is the ability of new variants to evade existing antibodies – naturally occurring or vaccine induced - which is at the heart of nearly all expert concern.

The AstraZeneca vaccine is the UK’s workhorse vaccine and will account for 70 to 80 per cent of all vaccinations by the summer. But if it proves vulnerable to new variants, as some research suggests, it may not provide strong protection against a third wave of the virus.

Recent modelling published by the Government's Sage advisory group showed relatively small differences in a vaccine’s ability to reduce transmission could make the difference between a third wave which spikes at between 150 and 250 deaths a day and one which – like the January peak – results in the daily death toll exceeding 1,000.

Latest UK vaccine numbers: rollout figures
Latest UK vaccine numbers: rollout figures

“If you put [all the mutations] together in a UK context, the picture you get is a downward shift in our level of protection,” Prof Danny Altmann, professor of immunology at Imperial College London, told The Telegraph.

“This is especially so when you consider that, though we’ve been proud of our vaccine rollout, it's terribly incomplete – most have had only one dose. So, yes, increased susceptibility and transmission as a consequence can significantly upset our roadmap.”

For the moment there is no cause for panic, just caution. Surge testing for the South African variant only started on Monday and the extent of its spread will not be known for at least another seven days.

With luck, case numbers will be small and NHS Track and Trace will be able to contain those that it does pick up without the need for further restrictions.

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