UK PHE: `Indian' Variant B.1.617.2 Reclassified As a Variant of Concern (VOC)

 

#15,945

Earlier this week the CDC added 4 new VOIs (Variants of Interest), all belonging to the `Indian' B.1.617.x lineage, and all being closely watched for signs they may pose a greater threat than other `wild type' COVID strains. 

For now, most of what we know about these variants - and their contribution to COVID crisis in India - is anecdotal.  But the CDC's initial assessment (see chart below) suggests potential reduction in neutralization by some EUA monoclonal antibody treatments and Slightly reduced neutralization by post-vaccination sera.

 

The UK's PHE added two variants of the B.1.617 lineage to their watchlist (see UK PHE COVID Variant Update - Adds 12th & 13th Variant To Watchlist) a week ago, as VUI's (Variants Under Investigation). 

Today, only hours after the British media reported on `leaked' documents, the PHE has published the following update reclassifying B1.617.2 as a VOC.

VUI-21APR-02 reclassified as a Variant of Concern (VOC)

Following a rise in cases in the UK and evidence of community transmission, PHE has reclassified VUI-21APR-02 (B.1.617.2, classified as a Variant Under Investigation (VUI) on 28 April) as a Variant of Concern (VOC), now known as VOC-21APR-02.

This is based on evidence which suggests this variant, first detected in India, is at least as transmissible as B.1.1.7 (the Kent variant). The other characteristics of this variant are still being investigated.

There is currently insufficient evidence to indicate that any of the variants recently detected in India cause more severe disease or render the vaccines currently deployed any less effective. PHE is carrying out laboratory testing, in collaboration with academic and international partners to better understand the impact of the mutations on the behaviour of the virus.

Cases of VOC-21APR-02 have increased to 520 from 202 over the last week and almost half the cases are related to travel or contact with a traveller. The cases are spread across the country, however, the majority of the cases are in 2 areas – the North West (predominantly Bolton) and London – and this is where we are seeing the greatest transmission.

PHE health protection teams are working with local authorities, Directors of Public Health (DsPH) and NHS Test and Trace to detect cases and limit onward spread.

Surge and community testing is an effective way of finding and isolating new cases of variants and will be deployed where there is evidence of community transmission. This is in addition to the comprehensive work that is already underway to trace and test all contacts of cases.

Everyone in the affected areas will be asked to get a test, even if they don’t have symptoms. If someone tests positive, they must isolate to stop the spread.

In partnership with local DsPH, additional measures are being implemented across the country where there are clusters, to contain the spread. These include:

• enhanced contact tracing for those testing positive with a VOC to define locations they may have acquired or transmitted infection to focus further testing
• enhanced community and surge testing in areas defined by the local authorities and regional teams
• working closely with communities and community leaders to ensure that individuals have the right support to test and isolate
• increased community engagement, including ensuring that messages are accessible in languages that are used by communities and provided by trusted community representatives

Where clusters of other VOCs are detected, PHE will continue to take all appropriate public heath action to break the chains of transmission.

Understanding how this virus behaves in the community is key to assessing its transmissibility, severity and whether it responds to the vaccines currently in use, all of which help to determine the risk to the public from this variant. While overall rates of COVID-19 remain low, there are actions that everyone can take to reduce spread.

PHE is encouraging the public to continue to:

• work from home where you can
• follow the current guidance on mixing with others
• take up the universal, free offer of twice weekly LFDs tests
• if positive, order a confirmatory PCR test kit and stay at home
• get vaccinated when you are called to do so

Dr Susan Hopkins, COVID-19 Strategic Response Director at PHE, said:

The way to limit the spread of all variants is the same and although we are all enjoying slightly more freedom, the virus is still with us. Keep your distance, wash your hands regularly and thoroughly, cover your nose and mouth when inside and keep buildings well ventilated and meet people from other households outside. If you are told to get a test, if you have any symptoms at all or have been in contact with someone who has tested positive, please make sure you get tested too.

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.

The current evidence suggests that the other variants detected in India, VUI-21APR-01 and VUI-21APR-03 are not VOCs, but this will be kept under constant review and investigations are ongoing into the reasons behind the different behaviours of these variants.

The UK has pulled itself back from the brink over the past couple of months going from a 7-day average of nearly 60,000 cases in early January to just over 2,000 a day during this first week of May.  

The sudden detection, and rapid spread, of a new variant that is judged by the PHE to be ". . .  at least as transmissible as B.1.1.7 (the Kent variant)", is obviously of considerable concern.

As far as any other traits that might be of concern, we'll need to wait for additional data.