This is BAD NEWS for other vaccines too, prob incl Ox/AZ, tho protection against severe illness may well be less affected. Risk:benefit of vaccination remains strongly favourable but I’m V concerned policy in UK & elsewhere is under-reacting to non-UK variant emergency. 1/ https://twitter.com/kakape/status/1354900984993083392

My partner flew from SA via Doha to self-policed home quarantine yesterday. I hear (3rd hand) limited community transmission of SA may be occurring in UK but no effective targeted containment.

This is crazy. We are not protecting the vaccines we have worked so hard to make. 2/

501Y.V2/3 is not just in SA/LatAm. There’s community transmission in US & EU too. I'd bet a fair amount people carrying it will arrive in UK from these places today. 3/

https://twitter.com/HarrySpoelstra/status/1352972686708903936

https://scdhec.gov/index.php/news-releases/south-carolina-public-health-officials-detect-nations-first-known-cases-covid-19

Never mind supply shortages. If variant reduces efficacy by nearly half, we might as literally throw vaccines in the bin, rather than strive to make them fast enough.

(Must stress, I'm not suggesting we do! Some effectiveness will remain. I would take any licensed vaccine) 4/

I think it’s quite unlikely UK/EU will have adequate supply of a vaccine highly effective against 501Y.V2/3 til Q3 at earliest.

Novavax is def less efficacious against variant & not here til Q3

It'll take months to update Ox/AZ, mRNA is limited & no data for either vs V2/3
5/

At present the only strategy seems to be...
A) Hope untargeted measures (lockdown) will cause community transmission chains to go extinct, while travel policy permits ongoing import or... 6/

B) Hope existing vaccines UK has access to (mostly Ox/AZ til Q3) remain highly effective against severe disease in vulnerable / elderly. They may well, but at present this is uncertain - a gamble with billions of £££ & thousands of lives. 7/

In my view this isn’t going to work. If we want to re-open (e.g. schools) before autumn with any confidence of not seeing hospitals hit by a wave of V2/3 in vulnerable, we need to do better.

So what can we do?
8/

A) The best border control we can manage. Announced UK policy (geographically targeted hotel quarantine) isn't compatible, in my view, w open schools in Q2/3. If we can’t do 10 day hotel quarantine for ALL arrivals, let’s do 3d, test, 7d properly enforced at home, another test.9/

B) Max testing effort to identify cases with V2/3 spike variants fast enough for targeted containment. Emergency effort to develop same-day spike genotyping for all positive cases. We can do this! 30k PCRs! Implement fast – don’t gold plate – imperfect is better than nothing. 10/

C) Aggressive targeted containment of V2/3 cases, led by the pros - local public health consultants in communicable disease control (who knew, every area in the UK has had a CCDC for decades!!)...
11/

...Treat V2/3 as a different disease. Put serious resource into targeted proper enforcement of existing legal isolation requirements & proper support for those isolated.
12/

And clearly:
D) Development & large-scale manufacture of vaccines including 501Y & 484K needs to be on a war footing.
13/

Yet again, we need to combine the precautionary principle with 'can-do' action & belief.

Don't wait til the evidence of a problem is overwhelming. But don't despair & think that action is futile.

Haven't we learned this yet?
14/end.
(ht @zeynep)

https://www.theguardian.com/education/2021/jan/29/wales-may-begin-reopening-primary-schools-on-22-february