THREAD update on variants:

Today PHE released more variant data (& split the B1617 ("Indian") variant into 3 subtypes).

Big increase with 400 overall cases in UK - closing in on B1351 (S.African variant).

Guardian article:
theguardian.com/world/2021/apr…

PHE
gov.uk/government/pub…
The COVID-19 Genomics UK Consortium (COG) release specimen data by date of test taken - so we can track numbers over time.

NOTE: COG specimen data contain some duplicates (ie. more than 1 test per person) but nums consistent w PHE & trends still evident. England data only below
655 spotted tests of S.African & 497 of Indian variant(s) - but clear v rapid increase in Indian variant in 3 wks to 17 Apr

Most are travellers (PHE), but each carries a risk of onward transmission if traveller infects houshold or doesn't isolate

herefordtimes.com/news/national/…
Looking at the subtypes of B1617 (Indian variant) we can see that most are variant subtype 1 or subtype 2 - with subtype 2 really taking off in 2 weeks to 17 April.

They have slightly different mutations but no one quite sure what impact these have.
Certainly, the (v v sparse!) data from India shows subtype 2 rapidly growing there too at the expense of subtype 1.

So what we are seeing in UK could just reflect situation in India as people travelled here (likely), or reflect similar variant behaviour in the community here.
Because India sequences so few cases & because they are under such terrible pressure, definitive evidence about features of B1617 is not going to come soon.

BUT I think enough reason to not risk it spreading in community in UK. Waiting for certainty risks waiting too long.
Border measures in UK are pretty woeful - see evidence given to the parliamentary all party group last week from UK border control (page 22 onwards).

Neg tests on departure cannot be verified, no data on adherence to quarantine, v few checks.

d3n8a8pro7vhmx.cloudfront.net/marchforchange…
Last week, 47 plane passengers from Delhi to Hong Kong tested positive for covid - 22 of whom only tested positive right at end of isolation period (presumably infected on journey).

Are we so sure we would spot these using our system?

independent.co.uk/travel/news-an…
We can't assume we have spotted all cases in UK. We must aggressively trace contacts, surge test, improve border processes.

Regardless of situation here, things are worsening in India. If you feel able, please consider donating to relief efforts /END

e.g
savethechildren.org.uk/how-you-can-he…

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More from @chrischirp

30 Apr
FRIDAY GOOD NEWS THREAD:
how about some positivity?

Here's a brief overview of state of Covid in UK right now.

TLDR: pretty good, couple of things to keep an eye on. 1/13
Case rates are below 50/100,000 people/week in all nations (orange), dropping from prev week (grey) and approaching levels last seen Sept 1 last year (green). 2/13 Image
England is the flattest in terms of case rates and this is reflected regionally (orange and grey dots close together). Yorks & Humber still highest region, confirmed by the ONS infection survey too. 3/13 ImageImage
Read 13 tweets
27 Apr
Short THREAD on Covid-19 Variants in ENGLAND:

The Sanger Institute has just released webpages that let you explore genomes that they sequences every week...

I had a look - two variants are currently growing "S Africa" and "India" but v small numbers. 1/7
This chart show the numbers of potentially worrying variants sequenced each week.

The recent rapid growth of the India variant (B1617) & the highish, steadier, numbers of S African variant (B1351) are clear (not great).

Brazil variant (P1) almost negligible (good!). 2/7
These are small numbers.

But S African & Indian variants are growing in the context of overall numbers going down. So the *proportion* of sequenced cases that are these two variants is going *up* - and for the Indian variant - going up A LOT.

Should we be worried? 3/7
Read 9 tweets
26 Apr
In Dec, SAGE behavioural subgroup warned that people might reduce adherence to measures once vaccination programme under way and recommended a govt communication strategy to pre-empt this...

assets.publishing.service.gov.uk/government/upl… 1/3
However, this has not happened. Govt messaging around a cautious opening has been counterbalanced by the focus on the dates of the roadmap, lack of emphasis on protective behaviours & (partial!) vax numbers.

And sure enough, adherence is dropping - particularly in over 50s. 2/3
Yes, numbers are ok here right now - but soon we open up a LOT more indoor mixing.
Chile shows how opening too fast, even with high vax, can cause bad surges requiring new lockdown.

We need better communication - esp after THAT daily express letter.

theguardian.com/world/2021/apr… 3/3
Read 4 tweets
23 Apr
SHORT THREAD on JAPAN / OLYMPICS:

Japan is going through a major new Covid wave and this potentially puts the Olympics later this summer at real risk... (and of course Japan's large population!) 1/4
The sequencing data for Japan is sparse, but it does seem as if B117 (the "Kent, UK" variant) has become dominant there over last couple of months and that this might be behind the recent increase. 2/4

reuters.com/business/healt…
The other thing is that Japan is being very slow to vaccinate compared to other high income regions - Just over 1% of its population has received one dose of Covid vaccine so far.

This leaves it more exposed to surges from B117 (vaccines work brilliantly against B117). 3/4
Read 4 tweets
18 Apr
THREAD on VARIANTS, VACCINES & POTENTIAL FUTURES:

I’ve been looking at data on sequenced variants. I’ve also been thinking about our vax programme & India.

TLDR: the Indian variant needs to trigger surge testing in England. And India needs to be on red list. 1/23
Some dates: while over 60% of adults have had 1 dose of vax, we've got another ~15 weeks before *all* adults could have immunity from at least 1 dose.

And another 20+ weeks before all adults could be fully vaxxed. And we don't yet know what uptake will be in younger adults. 2/23
So what can variants do while we are vaxxing people?

We already know that B117 can infect some partially vaccinated people and (far far) fewer but still some fully vaccinated. edition.cnn.com/2021/04/14/hea… 3/23
Read 26 tweets
15 Apr
The latest PHE variant of concern update is out...

TWO KEY things:

1) B1351 ("South African") variant continuing to spread (as we've seen in the headlines!)

2) 77 cases (!) of the new B1617 "double mutant" variant discovered in India .

B1617 is worrying because... 1/3
It has some potentially worrying mutations NOT seen in SA, Kent or Brazil strains.
forbes.com/sites/williamh…

This variant *might* escape both T-cell and antibody action. India going through a big surge - mix of B117 & new B1617 (location dependent)
science.thewire.in/health/sars-co… 2/3
As I tweeted yesterday, India should be on the red list (as should many other countries that currently aren't btw) *and* Johnson should *not* go on a trip to Delhi this month! madness!

Read 4 tweets

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