VARIANTS update for the UK from PHE data released today (delayed from yesterday due to the local elections).

P.1.617.2 declared a Variant of Concern (in orange bold on the charts). Significant increase in cases.

Cumulative charts that can be affected by surge testing etc.
Here is the data on an exponential chart.

P.1.617.2 declared a Variant of Concern (in orange bold on the charts). Significant increase in cases. This chart includes the B.1.1.7 'Kent' variant.

Cumulative charts that can be affected by surge testing etc.
Here is the data on a heatmap showing new cases detected each week. Variants of concern highlighted.

P.1.617.2 is around 4.4% of the variant cases.

This ratio was around 2.3% last week (which included all cases to that time recorded last week)
It is clear that P.1.617.2 is of concern and it seems appropriate that PHE has designated it as such.

I will update this thread once the technical report is released.
( Just a correction to my first tweet - this is *B*.1.617.2 )
(Just a correction - this is *B*.1.617.2)
Here is the statement from Public Health England

(VUI-21APR-02 is another name for B.1.617.2, one of the variants first detected in India)

gov.uk/government/new…
From the PHE statement on B.1.617.2:

"almost half the cases are related to travel or contact with a traveller"

Which suggests that over half are not (yet) related to travel or contact with a traveller.
The technical briefing has now been published. I will update this thread with my commentary.

assets.publishing.service.gov.uk/government/upl…
PHE have issued their latest briefing. This shows why B.1.617.2 (also called VOC-21APR-02) has been classified as a Variant of Concern.

This is mainly justified on transmissibility.

"Transmissibility appears greater than wild-type SARS-COV-2 ...
" ... B.1.617.2 is assessed as at least as transmissible as B.1.1.7 with moderate confidence. This is biologically plausible based on the mutation profile. This assessment is supported by evidence that it can compete with B.1.1.7 in the population and modelled growth estimates...
" ... suggesting transmissibility at least equal to B.1.1.7."

There are also *LOW CONFIDENCE* concerns in relation to susceptibility and immunity from natural infection
and *LOW CONFIDENCE* concerns in relation to vaccines
However, *IMPORTANTLY*

"There are insufficient data as yet to assess reinfection or vaccine effectiveness through national surveillance."
*NO DEATHS* have yet been associated with B.1.617.2 (VOC-21APR-02)
You can see the increase in prevalence of B.1.617.2 (VOC-21APR-02) in this chart where purple/lilac is B.1.617.2
This is the regional breakdown of the proportion of cases that are B.1.617.2 in each region.

However, cases in the South West are very low, and these are predominanty related to travel.

London appears to be an issue.
Many of these cases are still 'under investigation' (in grey), therefore not (yet) associated with travel or contacts of travellers.
This is the breakdown of where B.1.617.2 has been detected - London; north-west; midland towns; Bristol area.

"Ratio values >1 indicate an increased risk and values <1 indicate lower risk."

Circled areas show the areas where this is statistically significant.
Once again, many thanks to the hard work of @PHE_uk and the groups that support the analysis.
*relative prevalence

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More from @Dr_D_Robertson

6 May
There are several reasons why 'India' variants such as B.1.617.2 (in particular) are a concern.

A short thread.
The first is the growth of detected cases.

This is the data from last week. We were expecting this week's data at around 5pm today, but that was delayed, apparently due to the local elections.

Most of these cases were related to travellers. We have since required quarantine for people that have been in India. So this should (in theory) reduce significantly the import of B.1.617.2
Read 13 tweets
6 May
Analysis of today's PHE surveillance report.

A short thread.

While Covid cases may be low in many parts of the country, there are still rates of over 70 cases per 100,000, in upper tier local authorities
Slow increase in number of outbreaks/incidents
Falling hospitalization rates
Read 10 tweets
28 Apr
gov.uk/government/new…

Conclusions below.
Study document here

khub.net/documents/1359…
"In addition to the direct effects of preventing cases and reducing severity, we have shown that both the ChAdOx1 nCoV-19 and BNT162b2 vaccines are associated with reduced likelihood of household transmission by 40-50% from individuals diagnosed with COVID-19 after vaccination...
Read 6 tweets
26 Apr
Travel is starting to split into countries with low Covid cases and countries without low Covid cases.

A short thread. Image
Singapore and Hong Kong have announced a travel bubble

"All passengers departing from Hong Kong are required to be vaccinated, and passengers from both cities are expected to take a test within three days of departure and again on arrival."

bbc.co.uk/news/business-…
This follows the Australia - New Zealand travel bubble

bbc.co.uk/news/world-aus…
Read 10 tweets
22 Apr
Public Health England have updated their analysis of Variants of Concern and Variants under Investigation. It is great that this expert analysis has been published.

Some commentary.
Firstly, the India variant (B.1.617). This has been split. Only B.1.617.1 with E484Q is a Variant under Investigation.

Variants of Concern remain
B.1.1.7 (UK/Kent)
B.1.351 (South Africa)
P.1 (Manaus)
B.1.1.7 with E484K

Several other variants are being monitored.
This is PHE's chart of variant prevalence. As you can see, B.1.1.7 (Kent variant) dominates (purple)
Read 17 tweets
22 Apr
The latest @PHE_UK variant data has been published for the UK. First, the heatmap of new cases.

Significantly:
P1 (Manaus) has increased from 40 to 60 total cases
B.1.617 (India) has increased from 77 to 132 total cases.
B.1.351 (SA) has increased from 600 to 670 total cases
Here is my Covid variants cumulative chart (excluding UK variant).

Note:
P1 (Manaus, red)
B.1.351 (South Africa, purple)
B.1.617 (India, light blue)

nb cumulative chart that depends on testing intensity, some will be cases at the border
And here is my cumulative chart on a log scale, including B.1.1.7 (UK variant)

There has been a great deal of surge testing that will have enabled greater detection.

However, increases in P1, B.1.351, and B.1.617 are all increases that need to be taken seriously.
Read 5 tweets

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