The EU have undoubtedly been poor in their vaccination programme and EU citizens are sadly facing a further surge and having to deal with the much more transmissible and slightly more lethal “Kent” variant - Remember where we ended up with that one in January!
Granny Jen may not be too worried by variants at the moment but I am very concerned - they may throw overboard a portion of the undoubted gains of the NHS Vaccination programme.
As regards EU travel - not only are the “South African” and “Brazil” variants more frequent in the EU, the sequencing programmes in the EU are very poor, and the EU have very little hope of being able to respond to variants in a timely way.
The South African variant currently appears under control in the UK, being found in just 0.17% of the 158,452 sequenced viruses since it was identified.
In parts of the EU the situation is already rather worrying with figures showing rates of 4.26% in 6,314 sequenced in France, 1.31% in 24,609 in Germany and 0.21% in 5,628 in Italy.
The lack of adequate sequencing effort in the EU is a major weakness. The possibility of established community transmission of these further variants within Europe, (if it hasn’t already occurred,) is very real.
If the EU are not monitoring variants effectively how on earth can they ever hope to control them?
Similarly, the the so-called Brazil variant seems under control in the UK with only six (0.01%) cases in 42,481 sequences.
It too is notably more prevalent in the EU with 2.58% of sequences in Italy, 0.25% in France and 0.19% in Germany.
The present rising number of cases in the EU should not create any sense of UK smugness; it should be a real concern to us.
When coupled with their slow vaccination programme and inadequate sequencing effort the UK should expect to see more new variant cases entering the UK especially if we import these new variants in much larger numbers over the summer!
It is in our own interest that cases are controlled within the EU through lockdowns and an accelerated vaccination programme and we must do our level best not to import these further variants in larger numbers since we need to prevent community transmission becoming established here.
Politicians in the EU and UK who are presently busy appealing to nationalistic sentiments should grow up! - they need to calmly and collectively focus on solving the problem and real risks.
Case control and variant control and import controls are important since the SA and Brazil variants have the potential to undermine the vaccination programme and continuing large case numbers in the EU will speed the development of further variants.
Real world clinical data for effectiveness of available vaccines against variants is presently limited because many of the initial trials were done before the variants emerged.
We had some in vitro antibody neutralisation assay data earlier, but extrapolation to a clinical setting is limited and some of our widely used vaccines may not be as effective as we had hoped for.
Real world clinical efficacy data against variants is now emerging.
It is clear both the AZ and Pfizer vaccines are effective against the Kent variant- their effectiveness is clear from the UK vaccination programme - see Oliver Johnson on Twitter for nice visuals and explanation.
For the AZ vaccine, a trial has been carried out in South Africa where 93% of cases were the B.1.351 (South Africa) variant. The results were published last week (NEJM). The number of cases was relatively small and therefore confidence intervals on efficacy are wide, but an AZ vaccine efficacy of just 10.6% (compared with 75.4% for non-B.1.351 strains) looks pretty worrying if it got established here.
All is not lost as there looks to be more promising data against the SA variant for the single shot Jansson vaccine (FDA data) - so it maybe an autumn “boost” if we get into a mess with the SA variant
The Brazil variant we need to watch closely.
I would not be looking at EU travel this year. I would echo the CMO message that we continue to take sensible preventive measures as we roll out vaccines as quickly as we can and as we very cautiously loosen restrictions.
We need to ignore the “lockdown sceptics” and the new “unlock faster brigade”
Whilst the UK vaccination programme is yielding major benefits and currently saving many lives (including my 97 year old mother who has just had covid without developing significant symptoms (thank you AZ vaccine!), we are still in a very vulnerable stage.
Remember, we imported our first wave mainly from Europe not China. Let’s not import our 3rd wave of SA and Brazil
Variants this summer.
Having seen the heroic response of NHS colleagues during the last 12 months who are now totally burnt out, we need to give them a break ( and pay rise) and avoid another surge in hospitalisations, long covid cases and deaths. Stay in the UK, get a Vaccine when called and continue to use those prevention steps to minimise virus spread.
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