Just as the UK seemed to be winning the virus-vaccine race, a potential obstacle emerged in late April 2021-in the form of the “Indian” Covid-19 variant B.1.617.2. Spikes of cases infected with the new variant were detected during May 2021 in the north-west of England (Bolton, Blackburn with Darwen, Sefton), Bedford, the East Midlands (Leicester, Nottingham), and several boroughs of London (Croydon, Hillingdon, Hounslow, Tower Hamlets. In some of these instances, it is unclear whether this is because the new variant is actually more contagious or simply that infections carried back from India by returning travellers may have spread more readily within large multi-generational extended family households.
The story begins in India, where the variant B.1. 617 was first detected in October 2020, the result of genomic surveillance of Covid-19 by INSACOG (Indian SARS-Cov-2 Consortium on Genomics), a consortium of ten national laboratories. A sub-variant, B.1. 617.2, was detected in December 2020 and then isolated from samples collected in the western Indian state of Maharashtra between January and March 2021. This sub-variant was erroneously described in the Indian press as the “double mutant”, referring to mutations E484Q and L452R on the outer viral spike protein, even though it actually featured at least fifteen new mutations.
New variants of Covid-19 are initially regarded as “variants under investigation”. Some become “variants of concern” when they are shown to be more contagious and readily transmissible, to cause more severe disease in those infected, and to evade the body’s defensive neutralising antibodies, which are acquired after past infection or vaccination.
It was not long before Public Health England dubbed the sub-variant B.1.617.2 a variant of concern, on 7 May, thereby including it alongside the Brazilian “Manaus” (P.1), UK “Kent” (B.1.1.7), and South African (B.1.351) variants. The parent B 1.617 variant was itself deemed a “variant of concern” by the WHO on 10 May. On 14 May, the Chief Medical Officer for England reported the SAGE advisory committee’s “confidence” that the new variant was more transmissible than the prevalent UK “Kent” variant.
The news about B.1.617.2 came at a particularly challenging time. As various experts speculated about the transmissibility of the new variant and its ability to evade currently available vaccines, gloomy scenarios emerged, claiming that the new strain would become the dominant one in the UK and even predicting a third wave of the pandemic. While indoor mixing resumed on 17 May, there thus remains some uncertainty over the planned relaxation of all restrictions on social contact on 21 June. In the meantime, surge testing (mobile testing units; door-to-door testing; contact tracing) and surge vaccination programmes (accelerated second doses; vaccine buses and tents) have been launched in hotspots, with local lockdowns a distinct possibility if all else fails.
There’s no escaping politics when it comes to Covid-19. Prime Minister Boris Johnson has been criticised in some circles for an apparent tardiness in responding to the latest threat. India was only added to the “red list” of restricted countries from 23 April, more than two weeks after neighbouring Pakistan and Bangladesh (from 9 April). It was alleged that the announcement was deliberately delayed to 19 April so as not to jeopardise impending trade talks with India, for which reason Mr Johnson was due to fly to India in late April. During a period of just over three days, between announcement and imposition of the travel ban, thousands of passengers arrived in the UK from India without restriction.
The story of the “Indian” variant is yet another example of the many uncertainties when it comes to dealing with Covid-19, and the political ramifications of policy decisions related to control of the pandemic and the reopening of the economy. It is the hope that the “Indian” variant eventually proves to be less transmissible and lethal than previously thought, and that vaccination will serve to keep it under control.
Ashis Banerjee