Matt Hancock: "the way we deal with new variants arising is to respond to them as they arise. The 1st line of defence is to identify & stop spread."

This thinking encapsulates everything that is wrong with the UK strategy.

The 1st line of defence was to prevent these arising

New variants arising were not unpredictable. The D641G variant arose in Feb 2020, was shown to be more transmissible by 20-30% relative to the original virus, and became globally dominant by May/June. We are seeing the virus evolving again & again in regions of high transmission.

We have several variants of virus circulating in the UK - including the so-called South Africa variant, the UK B117 variant, which is continuing to adapt to develop the same mutations of concern (E484K) as the SA variant & the Manaus variant.

Fears about lower vaccine effectiveness against variants with E484K due to lower neutralisation with antibodies directed at previous variants have unfortunately been realised in vaccines trials that have recruited participants in South Africa - for J&J, Novavax & Astra/Oxford

Vaccine effectiveness seems reduced in preventing symptomatic infection. While effectiveness against severe disease may be higher, it's likely that effectiveness in preventing transmission will be lower, as this will likely be the first tier of protection impacted.

Of course govt rhetoric has now shifted to severe disease prevention rather than attainment of herd immunity (reducing transmission). The impact this shift has on population health is not being discussed at all. Vaccines are still being hailed as the silver bullet, despite this.

Despite concerns about vaccine effectiveness against this variant voiced by scientists in Dec, our govt adopted a lax approach to border restrictions & quarantine. The results were entirely predictable. Even as we identified the SA variants within the UK, we still didn't respond.

And now, the rhetoric is that because we have good surveillance, we can identify and contain these variants. Unfortunately, this is not necessarily the case. The SA variant is established in the community. Cases not linked to travel have been identified.

Once a variant is established in the community, it is very hard to contain. The govt must know this, given the door to door testing that is now being undertaken to desperately try to contain spread. Unfortunately, this is once again too little & too late.

JVT today: The variant isn't dominant in the UK, and isn't likely to be for a few months (so no need for concern?). The thinking is that this variant is not more transmissible than B117. The truth is we don't fully understand the transmission dynamics of these competing variants.

Given B117 is evolving to develop mutations associated with escape, it is possible that these mutations are favoured, and may be even more so in an environment where vaccines that are more effective against B117 but not against variants with E484K are deployed.

It is also possible that if transmission is allowed to remain high, or surge due to early easing of lockdown in parallel with vaccination efforts, new variants with additional mutations that favour escape of the virus may emerge- particularly as pressure from vaccines mounts.

The way to deal with the mess we're now in, is not to think:
1. that just because we have good surveillance, we don't need to take tried & tested measures to prevent variants entering the country or emerging within the UK
2. that vaccines alone will take us out of this alone

JVT spoke about vaccines directed against the new variant being possibly available later this yr. The problem is that we will constantly be behind the curve if we allow virus adaptation to continue. What if we have new & variants then that those vaccines aren't effective against?

The only strategy to protect public health & prevent our vaccine resources becoming redundant is to contain transmission & virus adaptation. We've taken several gambles, all of which have failed. Time to stop making the same mistakes over & over again.