Lessons from the UK on a more contagious Covid-19 variant

“Since this version of the virus was discovered, we have increasingly led two separate pandemics,” said Jason Leitch, National Clinical Director for Scotland. “That’s a warning to other countries.”

British scientists discovered the new variant in November and followed its first appearance in the UK to the southern England county of Kent in early December, in September. The land was shut down in November to quell a deadly wave of infections that had developed since the fall. British public health officials were baffled by the continued spread of the virus in southern England despite those restrictions.

When scientists examined the variant’s genome, they found an unusually large number of mutations, some of which pointed to the possibility that the new variant could spread more quickly than pre-existing versions. Further sequencing – and a testing quirk that served as a reliable proxy for the presence of the variant – revealed how quickly the variant dominated.

When the lockdown was lifted in early December, the new variant became national. The total number of cases per 100,000 people increased fivefold in London, and the new variant was soon discovered in almost every corner of the UK. Another, tougher nationwide lockdown was imposed on Jan. 4 to stop its spread. The caseloads have since relapsed and the government has published plans for a phased reopening in the coming months.

Public health officials began investigating the contact patterns of people known to be infected with the new variant, now commonly known as B.1.1.7. They found evidence that people infected with the variant infected more people than those infected with the previously dominant species. That finding reinforced the genetic analysis that pointed to a more transmissible version of the pathogen.

“We have never seen anything like the British variety in terms of growth rate, in terms of transferability,” said Nick Loman, a professor of microbial genomics and bioinformatics at the University of Birmingham.

Even more troubling, when public health officials and teams at British universities began examining clinical data on those known to be infected with B.1.1.7, they discovered signs that the variant may be linked to a higher risk of death.

A preliminary analysis, from Scotland, suggested that infection with the variant would be 65% more likely to be hospitalized and 37% more likely to die than contracting the older version of the virus. Scientists say these findings are not definitive, and some studies suggested that the association with higher mortality was weak or that the variant may even be associated with a lower risk of death.

Still, the evidence was sufficient for a panel of scientists who advised the UK government this month to say that B.1.1.7 is likely to carry a greater risk of both hospitalization and death than the established versions.

Patient surveys conducted by the UK Office for National Statistics between November and January yielded a different finding: Infection with the B.1.1.7 can result in slightly different symptoms, allowing doctors to spot possible cases.

The classic symptoms of Covid-19 – fever, cough, and shortness of breath – were slightly more common in those with the new variant than the old one. Patients reporting a loss of taste or smell were less common. And gastrointestinal complaints were more common with the new variant.

Cold comfort for the UK, according to public health officials, is that the new variant is now so dominant and so transferable that other variants of concern for epidemiologists, such as those in South Africa and Brazil, have not gained much traction. . Another reason for optimism is that laboratory tests and some clinical studies – as well as real vaccination in the UK – suggest that the variant could be neutralized by the current line of vaccines.

Dr. Philip Dormitzer, Pfizer Inc.’s

Chief Scientific Officer of viral vaccines, told British lawmakers Wednesday that the company saw protection against the British variant in real-world data from Israel and the UK “equivalent to the protection we saw in controlled studies before that variant circulated.”

Still, the variant’s rapid emergence and unusual features keep it a concern, disease experts say, especially if vaccine rollouts don’t keep pace.

“It’s a new beast,” said Eric Topol, a professor of molecular medicine at Scripps Research in California. He said he didn’t think it was widely appreciated that the new variant could cause another pandemic, one “driven by a more difficult-to-fight virus.”

—Jason French, Andrew Levinson, Max Rust, Josh Ulick, Dov Friedman, and Randy Yeip contributed to this article.

Write to Jason Douglas at [email protected] and Joanna Sugden at [email protected]