#15,865
In mid-December the UK announced they were tracking their first Variant of Concern (VOC202012/01) aka B.1.1.7, which has now been shown to be both more transmissible than the `wild type' COVID, but also produces more severe illness (see Updated NERVTAG Report On Increased Severity With COVID Variant B.1.1.7).
In the 90 days since, 8 more variants (either under investigation (n=5) or of Concern (n=3), have been identified by UK scientists.
Given their aggressive genomic testing, the UK leads the world in leads the world in finding, and identifying, new COVID variants. While not all of these variants are destined to be game changers, each has one or more mutations that raise concerns that they may be more transmissible, more severe, or might evade some vaccines and antiviral therapies.
Just over a week ago the UK announced they were tracking their 8th variant; VUI-202102/04 (aka lineage B.1.1.318).
This week they've announced yet another; VUI 202103/01 (aka lineage B.1.324.1 with E484K), a mutation linked to antibody escape in other emerging variants (P.1 and B.1.351). Yesterday the PHE published the following notice:
New Variant Under Investigation (VUI) designated in UK
A new variant identified in the UK has been designated a Variant Under Investigation (VUI) by Public Health England.
VUI-202103/01 (lineage B.1.324.1) was designated a VUI on 4 March after 2 cases were found in the South East of England in individuals who had recently travelled to Antigua. Despite the travel history of these cases there is no scientific evidence to determine where this variant first emerged.
The variant contains the spike mutations E484K and N501Y, both usually associated with Variants of Concern (VOC), however it does not feature specific deletions that would lead to a designation as a VOC.
Contact tracing teams have completed thorough investigations to identify and follow up any close contacts and no additional cases have been found to date.
While the significance of this variant has yet to be established, the PHE also updated their investigation into the cluster of P.1 (aka the `Brazilian' variant), which sparked a major public health investigation two weeks ago (see UK PHE: Statement On 6 Cases Of COVID Variant P.1 In the UK).
While there is still a lot we don't know about the P.1 variant, the rapidly deteriorating conditions in Brazil (see FIOCRUZ Weekly Bulletin: Worst COVID Scenario Since The Beginning Of The Pandemic), combined with a high re-infection rate (see The Lancet: Resurgence of COVID-19 in Manaus, Brazil, Despite High Seroprevalence), have raised serious concerns over its international spread.
Yesterday's PHE Update on the P.1 variant follows:
Four more cases of Variant of Concern VOC-202101/02 (P.1) found in England
Four more cases of the Variant of Concern VOC-202101/02, also known as P.1, have been identified in England – 3 in South Gloucestershire and one in Bradford, West Yorkshire.
The cases in South Gloucestershire are all close or household contacts of the 2 existing P.1 cases in the area. They were offered testing in response to the initial cases.
Specialist contact tracing teams have undertaken a comprehensive investigation to identify any further contacts and additional testing has been in place since the initial cases were identified.
The individual in Bradford tested positive for coronavirus (COVID-19) in late February after travelling back from Brazil via Paris on 14 February 2021. Subsequent genomic sequencing confirmed the case as the P.1 variant. Contact tracing teams have followed up close contacts of the individual and advised them to isolate and get a test.
The latest cases bring the total number of P.1 variant cases in the UK to 10 – 7 in England and 3 in Scotland, all of which have links to travel or to a previously confirmed case that has travelled to Brazil.
Beyond these 9 VUI/VOCs, the UK is also monitoring a small, but growing number of other variants, which they list in their SARS-CoV-2 variants of concern andvariants under investigation inEngland technical briefing.
Variants in Monitoring
Variants in monitoring are those which have been identified through horizon scanning, do not have sufficient clear signals of concern to escalate further, but for which case numbers and available data are being monitored regularly. These variants are in the monitoring category:
• B.1.429 first detected in California (10/329,734 UK sequences as of 10 March 2021)
• B.1.1.7 with S494P first detected in the UK (761/329,734 UK sequences as of 10 March 2021)
• A.27 first detected in Mayotte (4/329,734 UK sequences as of 10 March 2021)
• B.1.526 first detected in New York (2/329,734 UK sequences as of 10 March 2021)
While most of these variants are likely to become mere footnotes in the history of the COVID pandemic, we don't know which ones will become contenders, and which will fade away.
Variants that don't appear to have a lot of momentum today, could become much bigger factors in the months ahead as community immunity - due to natural infection or vaccination - alters the playing field.
While we have a pretty good sense of what is going on with COVID's evolution in the UK - and to a lesser extent in the rest of Europe and North America - globally, genomic sequencing is spotty at best, and in some places is virtually non-existent.
As encouraging as some of the vaccine news has been the past couple of months, we are still a long way from being out of the woods with COVID-19.
