Johnson gambles on the vaccines to win out against the Indian variant

Health correspondent Shaun Lintern considers the factors at play in decisions over lockdown and the Indian variant

The prime minister Boris Johnson has said easing of restrictions will go ahead (PA)

The Indian Covid variant’s rapid increase in numbers, nearly a tripling of cases in a week from 520 to 1,313, has sparked widespread alarm and speculation about whether it could derail the plans to ease lockdown restrictions across the UK.

Briefing the nation from Downing Street, Boris Johnson was clear he didn’t believe now was the time to abandon the roadmap and plans to re-open indoor entertainment on Monday would be going ahead. But he signalled caution on the plans to end lockdown fully next month.

Some scientists have already said the precautionary principle should apply and Monday’s re-opening should be shelved.

Chief medical officer, Chris Whitty, was certainly alarmed and was clear he believes the Indian variant was more transmissible than the Kent variant – and growing at an exponential rate. He also expects this to become the dominant strain of Covid in time.

To understand the concerns, consider the emergence of the Kent variant last year and how rapidly it ripped through the southeast of England leaving hospitals in desperate situations. The Indian variant in that context is terrifying; the latest Sage papers released on Friday said it was thought to be 50 per cent more transmissible.

The minutes of the meeting on Thursday, released after the Downing Street briefing, warned: “If this variant were to have a 40-50 per cent transmission advantage nationally” compared to [the Kent variant] then pressing ahead with releasing lockdown “would lead to a substantial resurgence of hospitalisations (similar to, or larger than, previous peaks)”.

Sage also warned that the genetic make-up of the virus was significantly different to the original Covid-19 virus that “there may be some reduction in protection given by vaccines or by naturally acquired immunity from past infection”.

There are still millions of unvaccinated people who, if infected, will generate more than enough hospital admissions to overwhelm the NHS.

This makes for grim reading.

But confidence is high that the vaccines will give some protection, and at the very least reduce the severity of the disease and death. It is possible the vaccines will take the edge off this variant in a way that we just didn’t have last year when the Kent variant emerged.

So far, the rise in infections identified in parts of Bolton and Blackburn with Darwen are concentrated in the younger age groups who are yet to be fully vaccinated.

What we don’t yet know is whether the vaccine is protecting those in the older age groups or if this is just a delay and we will see rises in coming weeks as the variant defeats the vaccine. The numbers are currently small and concentrated in specific local areas.

As we have painfully learnt over the last 12 months, Coronavirus exploits any weaknesses and gaps and we know Bolton and the other affected areas have significant pockets of deprivation, ethnic minorities, and housing with multiple generations of the same family. All of which are linked to a lower uptake of vaccines and an increased likelihood of being exposed to the virus itself.

The Royal Bolton Hospital has reported a rise in patients being admitted with Coronavirus in the last few days and the medical director pointed out many were eligible but not yet vaccinated.

There are many possible factors in why the cases are rising in these local pockets. What is needed is rapid local action to trace anyone at risk of infection and to get as many people as possible vaccinated.

It’s time to throw everything we can at the areas affected. Extensive on the ground contact tracing to track down and isolate anyone at risk of having or spreading the infection. Public messaging on social distancing needs to be ramped up and the vaccination campaign must be taken to the people, targeted at those most at risk either by their age or clinical condition or the socio-economic position.

Inevitably more data will emerge in coming days and weeks to sharpen the focus on exactly what is happening and whether this variant is as dangerous as some fear.

In the past year at various stages the government pressed ahead with little in its armoury. This time Johnson is gambling on science and the vaccine to keep things on track with a more robust surveillance system that can sound the alarm earlier.

Should the worst happen, and the variant prove to be unstoppable, then restrictions will need to follow swiftly. Delays will be unacceptable after a year of missteps and 150,00 deaths.