While the United Kingdom prepares for the next step to lift lockdown restrictions on Monday, after a rapid vaccination roll-out, the country now finds itself in the same situation as before Christmas when B.1.1.7, the variant first found in Kent, hit the country and threw it into a severe second wave. The new figures of B.1.617, the variant of the novel coronavirus first reported from India, now show a sharp rise from 520 cases to 1,313 cases within a week.
Public Health England (PHE) has designated B.1.617.2 as a variant of concern. It is this variant that is spreading quite rapidly. The other two variants first seen in India (B.1.617.1 and B.1.617.3) remain “variants under investigation”.
With the sharp rise in cases, scientists have warned that B.1.617.2 will become the dominant variant in the UK. Prime Minister Boris Johnson warned on Friday that while the May 17 relaxation of lockdown rules will go ahead, the final stage of the lifting restrictions across England could face a “serious disruption” due to B.1.617.2. In lieu of the increasing threat, Johnson announced the gap between the first and second COVID-19 vaccine jab would be cut from 12 weeks to eight for all over-50s and the clinically vulnerable, admitting: “The race between our vaccine programme and the virus may be about to become a great deal tighter.”
Is the UK once again standing at the crossroads of delayed decisions with serious consequences, as the government was accused of in the previous waves of COVID-19? Why was this delay allowed to happen?
Johnson was scheduled to travel to India on April 25. In late March, Indian health authorities had already said 771 variants of concern had been detected in a small sample of almost 11,000 positive cases. By mid-April, India was recording more than 150,000 cases daily. But the UK government failed to cancel its India trip. To the surprise of the scientific community, Johnson finally cancelled his trip because India’s COVID-19 situation only days before the scheduled date, and then announced that India would be put on the travel ‘red-list’ from April 23 when there were already 103 cases of B.1.617.2 in the UK. Did political and trade interests lead to this delay?
On May 4, Johnson’s office announced that “New commercial trade and investment deals [with India] will create more than 6,500 UK jobs.” “The package contains over £533m of new Indian investment into the UK, which is expected to create more than 6,000 jobs in vital and growing sectors such as health and technology. £200m of these deals will support low carbon growth,” the announcement continued. Part of the investment is by the Serum Institute of India, producer of the AstraZeneca vaccine being sold as ‘Covishield’ in India.
Bangladesh, which reported the B.1.351 variant but not P.1, and Pakistan, which had neither, were added to the red list on April 9. Yet, India, which had reported both of these as well as a new variant, was not added to the list until two weeks later. This despite the fact that on April 9, Pakistan had a week’s average of 21 cases per million, Bangladesh had double of that number and India had four times as many.
Commenting on the delayed decision vis-à-vis India, UK’s former chief scientific adviser Professor Mark Walport was quoted as saying: “These decisions are almost inevitably taken a bit too late in truth.” The UK has already seen four deaths due to B.1.617.2 and number of cases rising sharply.
Professor of clinical microbiology at the Cambridge Institute of Therapeutic Immunology and Infectious Disease at the University of Cambridge, Ravi Gupta, said at a briefing that research suggests that B.1.617.1 does have a greater ability to bypass defences triggered by vaccination or an earlier coronavirus infection. According to him there are signs it is better at spreading among vaccinated people, even though vaccination still appears to protect against severe disease. “In terms of controlling transmission, there may be a degree of compromise,” he said.
The highest number of cases of this variant at the beginning of May were in Bolton, followed by Blackburn with Darwen, Leicester, Nottingham and Bedford, according to the Sanger Institute’s database. Sanger’s data shows only the number of samples of B.1.617.2 which have been found during genomic sequencing in laboratories. The actual number of cases in these areas could be much higher. According to latest figures of the 400 “confirmed or probable” cases of mutations detected in London using genome sequencing, 106 were “cases that have travelled”. They are believed to be largely household clusters linked to people who travelled from India.
The growth of B.1.617.2 – the variant of concern – led Professor Christina Pagel, a member of the Independent Sage group of experts, to tweet that next week’s planned relaxation of measures should be pushed back. She warned that going ahead with the planned easing on Monday could “add fuel to the fire” of B.1.617.2’s spread – and risks “more uncertainty, more damaging closures and longer recovery from a worse situation”.
Chris Hopson, chief executive of NHS Providers, has warned that B.1.617.2 may become a major challenge for already hard-pressed hospitals. He said, “Given the combination of potentially lower vaccine efficacy, seemingly faster transmission of the virus and the fact that many people are still unvaccinated, there is a risk that this variant could lead to a large group of people becoming ill with COVID-19, putting significant pressure on the NHS once more.”
Fearing a summer surge, once again the government is being questioned as to why it didn’t ‘follow the evidence’ and delayed putting India on the travel list. Yvette Cooper, who chairs the home affairs committee, attacked the government on Twitter: “Why did PM not put India on the red list 2 weeks earlier when Pakistan and Bangladesh were added to the red list? And why did they then delay a further 4 days to implement?” In fact, thousands flew into the UK during that window, including rich Indian businessmen who came in on chartered flights. Data shows how this rise could have been controlled if India was put on the red list at the same time as Bangladesh and Pakistan. The two-week delay has resulted in a rapid rise of B.1.617.2 variant cases being brought in by travellers from India.
Cooper further added: “Over 1,000 India variant cases already identified in UK and Government is warning AGAIN about local lockdowns. THIS WAS PREDICTABLE BUT IT WAS NOT INEVITABLE. Over a year on from the start of this pandemic and the Govt has still not learned the basic lessons at the border.” Layla Moran, chair of the All-Party Parliamentary Group on Coronavirus, commented, “Ministers only added India to the red list several weeks after this mutation was identified as a variant of concern, by which time it was too late.”
The question remains: was it so important for the UK to sign trade deals with India that it neglected scientific data during a pandemic?
Nabanita Sircar is a journalist based in London.