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