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With the caveat that it is far from clear how much of an increased risk - if any - the AY.4.2 variant of COVID19 poses (or if it can successfully compete with Delta B.1.617.2), this sublineage of Delta - often dubbed Delta Plus - appears to be increasing its global range, and racked up another 7,500 cases in the UK this past week.
Two weeks ago the UKHSA elevated the Delta Sub-lineage AY.4.2 to a Variant Under Investigation, and today there are media reports out of Norway suggesting this variant may be behind a surge of cases in City of Tromsø (see Northern Norway sees major spike in COVID-19 cases).
Although they buried the lede somewhat, today Hong Kong's CHP released a statement about their first detection of this emerging variant, and their ongoing epidemiological investigation. This comes as Hong Kong has ratcheted up their COVID restrictions in a bid to reopen travel between Hong Kong and the Mainland.
CHP investigates one additional confirmed case of COVID-19
The Centre for Health Protection (CHP) of the Department of Health (DH) announced that as of 0.00am, November 5, the CHP was investigating one additional confirmed case of coronavirus disease 2019 (COVID-19), taking the number of cases to 12 361 in Hong Kong so far (comprising 12 360 confirmed cases and one probable case).
The newly reported case is an imported case that involved a mutant strain. The 46-year-old female patient arrived in Hong Kong from a Group A specified place (high-risk) and tested positive during quarantine.
In addition, the CHP provided further updates on a confirmed imported case 12357 involving the L452R mutant strain announced earlier. According to the analysis of the whole genome sequencing with the sample of this case conducted by the Centre's Public Health Laboratory Services Branch, it is confirmed that the virus strain matched the Delta strain (B.1.617.2) sub-lineage AY.4.2.The CHP's epidemiological investigation of the case is ongoing. Under the current arrangement, the CHP follows up on all imported cases involving mutant strains by conducting whole genome sequencing to identify the lineage of the variant strains, including sub-lineage AY.4.2.
AY.4.2 is a newly designated sub-lineage of the Delta strain. According to the World Health Organization, an increase in AY.4.2 viruses has been observed globally since July 2021 and over 26 000 AY.4.2 sequences from 42 countries had been uploaded to the online genome database GISAID by the end of October 2021. The majority (93 per cent) of these sequences were reported from the United Kingdom, where a gradual increase in the proportion of AY.4.2 has been observed. It was reported that AY.4.2 might be more transmissible than other Delta strains, especially among household members. So far, preliminary analysis in the United Kingdom does not find significant reduction in vaccine effectiveness for AY.4.2 compared to other Delta strains.
A total of 48 cases have been reported in the past 14 days (October 22 to November 4) and all of them are imported cases.
The CHP's epidemiological investigations and relevant contact tracing on the confirmed cases are ongoing. For case details and contact tracing information, please see the Annex or the list of buildings with confirmed cases of COVID-19 in the past 14 days and the latest local situation of COVID-19 available on the website "COVID-19 Thematic Website" (www.coronavirus.gov.hk). The DH has also been closely monitoring the mutant strains of SARS CoV-2 and has uploaded the relevant information on Variants of Concern (VOCs) and Variants of Interest (VOIs), based on whole genome sequencing results, to the CHP's website (www.chp.gov.hk/en/statistics/data/10/641/100135/6973.html). The data will be updated regularly.
The spokesman for the CHP stressed, "The global situation of COVID-19 infection remains severe and there is a continuous increase in the number of cases involving mutant strains that carry higher transmissibility, and there are also reports of breakthrough infections in some vaccinated individuals. The CHP strongly urges members of the public to avoid all non-essential travel outside Hong Kong, in particular to specified places with high risk under the Prevention and Control of Disease (Regulation of Cross-boundary Conveyances and Travellers) Regulation (Cap. 599H)."
The spokesman reminded, "If travel is unavoidable, the CHP highly recommends the public to be fully vaccinated with COVID-19 vaccines before their departure. They should avoid participating in non-essential mass gatherings or events held outside Hong Kong. They should continue to wear a surgical mask and maintain strict personal and environmental hygiene at all times. Parents are also urged to avoid taking unvaccinated children travelling."
The Government has launched the COVID-19 Vaccination Programme. Members of the public are encouraged to get vaccinated. Details of the programme can be found at the designated website (www.covidvaccine.gov.hk). Generally speaking, COVID-19 vaccination can prevent COVID-19 infection, and if infected, reduce the risk of severe disease and death from COVID-19.
The CHP called on members of the public to pay attention to their health condition, seek medical advice early and undergo COVID-19 nucleic acid testing as soon as possible if respiratory symptoms develop. They should also maintain strict personal and environmental hygiene at all times to protect themselves against infection and prevent the spread of the disease in the community. For more related health advice, please refer to the website www.coronavirus.gov.hk/eng/health-advice.html.
In recent weeks we've seen skyrocketing cases in Eastern and Central Europe, Russia, the Baltic region, and Scandinavian countries (see chart below), which has sparked media speculation that the AY.4.2 variant might be part of the cause.
Credit Our World In Data
Regardless of the reasons, the trend in Europe is decidedly in the wrong direction, and with winter approaching, the rest of the world is watching closely to see what this pandemic virus does next.
