Thread by @Alicia1984N

Goed, we duiken de bron in. 🧵

Het SAGE (Scientific Advisory Group for Emergencies) rapport. 30 juli 2021.

gov.uk/government/pub…

Scenario 1

A variant that causes severe disease in a greater proportion of the population than has occurred to date.

Likelihood of:

- Genotypic change in internal genes: Likely whilst the circulation of SARSCoV-2 is high

- Increased severity phenotype: Realistic possibility

Scenario 2

A variant that evades current vaccines. This could be caused by:

- Antigenic ‘shift’:

Likelihood: Realistic possibility.
Impact: High

- A longer-term version of shift whereby SARS-CoV-2 undergoes a reverse zoonotic event
into an animal reservoir(s).

Likelihood: Realistic possibility. Impact: Medium

- Antigenic drift:

Likelihood: Almost certain. Impact: Medium.

Scenario 3

Emergence of a drug resistant variant after anti-viral strategies. This could be caused by:

Emergence of new variants following the administration of directly acting antiviral
therapies.

Likelihood: Likely [...] Impact: medium [...]

Scenario 4

SARS-CoV-2 follows an evolutionary trajectory with decreased virulence. This could be caused by:

Variants arising with increased transmissibility but decreased pathogenesis/virulence as
the virus becomes fully adapted to the human host becoming an endemic infection.

Likelihood: Unlikely in the short term, realistic possibility in the long term.

Hmm.

"Whilst we feel that current vaccines are excellent for reducing the risk of hospital admission and disease, we propose that research be focused on vaccines that also
induce high and durable levels of mucosal immunity in order to reduce infection of >>

and
transmission from vaccinated individuals. This could also reduce the possibility of variant
selection in vaccinated individuals."