The new variant of SARS-CoV-2 in UK causing a surge of COVID-19. An interesting article published January 4 in The Lancet Respiratory Medicine Journal by Tony Kirby looked at the effects of lockdowns and the new variant.
For most of November 2020 England was in lockdown to force down the incidence of COVID-19 cases that had steadily increased in the late summer and autumn. Other countries in the United Kingdom, Wales, Scotland and Northern Ireland had also been re-imposing and subsequently lifting restrictions, since each of the four nations is in charge of its own COVID-19 control plans.
For a while, the strategy in England appeared to have worked, with many areas that previously had had high cases seeing rates drop sharply during November – including Northwest England and Yorkshire, areas which had previously seen some of the highest incidence rates in the United Kingdom.
However, it soon became apparent that the English lockdown had not had the same effect in every region. In Kent, a large county in the southeast, cases actually continued to increase a people as possible.
The reason: A new variant of SARS-CoV-2, which various modelling exercises have estimated to be up to 70% more transmissible than the previously circulated form of the virus. In September 2020, this variant represented just one in four new diagnoses of COVID-19, whereas by mid December, this has increased to almost two thirds of new cases in London.
Boris Johnson decided with his scientific advisors that he had no alternative other than to impose even stricter restrictions on those parts of England, creating a new tier 4 – this meant the closure of all non essential shops and gyms and people were asked to stay at home wherever possible.
However, until mid late December, 2020, the proportion of cases caused by the new variant were much lower in other parts of the country, with the Northwest region including Liverpool and Manchester recording only 1 in 20 new cases of COVID-19 that were due to the new variant.
As a result, many parts of England continued in the lower tier of restrictions, until on December 30, 2020, Johnson in response to surging numbers of new diagnoses, including an all time high of 53,000 on December 29, 2020, decided to move all parts of England into tier 3 or 4. However, the latest data from early January 2021 shows that cases due to the new variant are increasing in all areas of the country, although the South and Southeast continue to be the worst affected. It had been questioned the logic of this move and it was called instead for an England wide lockdown and this subsequently occurred.
According to research published on December 29, 2020 by Public Health England the new variant appears to be no worse than the previous dominant strain of SARS-CoV-2 in terms of the risk of hospital admission, severity of the illness or mortality. It now remains essential to vaccinate as many of the vulnerable population as possible and to then go on to the general population.
The London General Practice commends the vaccination schedule, agrees that it should be available by need not by profit and looks forward to all vulnerable groups being vaccinated.
Dr Paul Ettlinger
BM, DRCOG, FRCGP, FRIPH, DOccMed