UK COVID-19 Update: Concerns Mount Over Virus Variant

Peter Russell

December 21, 2020

These are the UK coronavirus stories you need to know about today.

Growing Concern Over New SARS-CoV-2 Variant

Around 16 million people in South East England were placed in tier 4 after Boris Johnson was shown preliminary modelling data from the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) on Friday.

It suggested that the new variant of SARS-CoV-2, known as VUI-202012/01, or lineage B.1.1.7, could spread significantly more quickly than other strains of the virus.

Following analysis, NERVTAG suggested a growth rate of the new variant that was 71% higher than other variants.

The expert opinion was that the new strain could increase the R number by between 0.39 and 0.93.

In an interview with Sky News, Prof Andrew Hayward, a member of the NERVTAG panel, said: "This is really terrible news in terms of the pandemic.

"If the vaccine was the best news, and still is in this pandemic, this is the worst news that we've had so far, and we really, really need to tighten down the hatches in order to stop the spread of this strain whilst we can get as many people vaccinated as possible."

Prof Hayward, who is director of the Institute of Epidemiology and Healthcare at University College London added that areas that had not seen significant spread of the new variant were "around three weeks behind" those put into tier 4 restrictions over the weekend.

Preliminary work by COG-UK, the COVID-19 Genomics UK Consortium, showed that the new strain carried an "unprecedented" larger than usual number of virus genetic changes.

It said three of these changes had potential biological effects.

Public Health England (PHE) said that there was currently no evidence that the new variant causes more disease or higher mortality. There is evidence that mutations to the spike protein, the part of the virus that makes it infectious, can change how the virus interacts with human cells, although it is not yet known if this is responsible for the increase in transmission.

However, PHE said that infection rates in areas where this particular strain had been circulating have increased faster than expected. Modelling had demonstrated that the new variant had a higher transmission rate than other variants in current circulation.

There was currently no evidence to suggest that the Pfizer/BioNTech vaccine would not protect people against the new strain, although laboratory work was underway on this "as a priority".

Dr Julian Tang, clinical virologist at the University of Leicester, told the Science Media Centre: "New viruses will adapt to a new host over time – with decreasing mortality, and possibly increasing transmissibility.

"It makes no sense for the virus to kill its host – rather better for it to replicate to high levels in the host, causing few symptoms – so that the host can stay mobile and appear well (asymptomatic) – to allow it to mingle further with those who are still susceptible – and spread its genes further.

"We are now likely seeing some of this new host adaptation process in SARS-COV-2, but it remains to be seen whether mortality will be different with this variant than with the previous one."

Peter Openshaw, professor of experimental medicine at Imperial College London, and a member of the NERVTAG panel, commented: "It is a tribute to the genomic surveillance by COG-UK that the variant has been detected so quickly.

"The reasons for the enhanced infectivity are not yet clear. We need to know if it is due to more viral replication or better binding to the cells that line the nose and lung.

"There is currently no direct evidence that the virus is able to evade immunity generated by past infection or by vaccination, but there is good reason to think it won't. All this needs to be investigated."

The tier 4 restrictions introduced in response to the VUI-202012/01 strain mean that people must stay at home unless exemptions apply, such as travelling for work or education, for childcare purposes, and for exercise. Non-essential shops, pubs and restaurants, cinemas, and hairdressers were told to close their doors.

The Prime Minister also announced that the Christmas bubble policy will no longer apply in tier 4.

Dr Jeremy Farrar, director of Wellcome, said: "The new strain of COVID-19 is highly concerning, and it is right to act with urgency as the Government has done."

Travel Restrictions

The Government has sought to allay concerns that restrictions on UK travel to some European countries could affect deliveries of the COVID-19 vaccine.

France, Belgium, Canada, Germany, Ireland, Italy, Russia, and Switzerland were among countries that announced restrictions on UK travel, after the Government revealed details about the more infectious new strain of the SARS-CoV-2 virus that was spreading from South East England.

There are fears that European hauliers will not travel to the UK if they are unable to return home.

Prime Minister Boris Johnson chaired a meeting of the Government's emergency COBRA committee this afternoon. He was expected to host a Downing Street conference on the crisis later.

Earlier, Grant Shapps, the Transport Secretary, said containers unaccompanied by hauliers were still allowed through the port of Dover, which is how most of the vaccine doses arrive from Belgium.

"This won't have an impact on the vaccination programme," Mr Shapps told Sky News.

This afternoon, the French Embassy said on Twitter that the European Union was working "to establish a solid health protocol to ensure that movement from the UK can resume".

Scotland, Wales, and Northern Ireland Tighten Restrictions

First Minister Nicola Sturgeon said she was "genuinely sorry" for the latest measures restricting Christmas celebrations in Scotland.

Planned easing of restrictions around Christmas will be limited to Christmas Day itself, and not the previous 5 day window that was planned, the Scottish Government announced.

From Boxing Day, mainland Scotland will go into lockdown level 4 rules for at least three weeks.

Most of Scotland's children will see the Christmas holiday extended until 11 January.

Northern Ireland also announced that Christmas bubbling would also be reduced to one day only – on a date between 23 and 27 December. The measure was designed to bring flexibility for those who worked on Christmas Day.

Tougher COVID-19 restrictions will be introduced in Northern Ireland from Boxing Day with the closure of hospitality and non-essential businesses for six weeks. Even tougher restrictions will be imposed for one week after Christmas with limited hours for all businesses and a ban on indoor and outdoor gatherings between 2000 and 0600.

Schools in Northern Ireland are set to reopen in the first week of January.

In Wales, level 4 restrictions were introduced on 19 December.

The Welsh Government also announced a change to a relaxation of rules over Christmas, with only two households now allowed to meet over the festive period.

Dr Frank Atherton, chief medical officer of Wales, said the move was necessary "to contain the harm of the pandemic and prevent already strained NHS resources from being overwhelmed".

New Guidance for the Most Clinically Vulnerable

Updated guidance has been issued for the clinically extremely vulnerable in areas in England placed into tier 4 restrictions.

The most vulnerable have been "strongly advised" to stay at home at all times, unless for medical appointments, and not to go to work, even if they are unable to work from home.

The Department of Health and Social Care said the latest advice was the same as that put in place in November.

It said a similar support package would be available for affected individuals.

Doctors' Concern Over NHS Demand

Doctors in England, Wales, and Northern Ireland have expressed concerns that the NHS will be unable to cope with demand because of rising cases of COVID-19.

A British Medical Association (BMA) survey of 7,776 doctors and medical students in the second week of December found that 88% of respondents said they felt uneasy that they could not provide the standard of care they wanted during the pandemic.

Among other findings:

  • 52% of respondents said they had seen a significant increase in the number of cases of COVID-19 in the previous two weeks

  • 34% said current levels were higher than during the same point during the first wave of the pandemic

  • 33% said the level of demand for care of patients without COVID-19 was now considerably higher than before the pandemic began

The survey was conducted before the Government introduced tier 4 measures for large parts of London and the South East of England and scaled back the relaxation of rules over Christmas.

Dr Chaand Nagpaul, BMA council chair, said: "Doctors are telling us they're already seeing significant increases in the number of COVID and non-COVID patients, and that they don't believe their hospitals or practices will be able to cope in the New Year."

One doctor who contributed to the survey commented: "We shouldn't be mixing households at all. We certainly should not be moving out of tiered areas. We should be staying in our own locality. This is going to lead to a third, much worse, wave."

Avoidable Deaths from Heart Conditions

Lower rates of attendance for urgent heart problems at emergency departments (EDs) during the first wave of the COVID-19 pandemic may have contributed to avoidable deaths in England, a preprint of a study has suggested.

The study was published online in the journal Circulation: cardiovascular quality and outcomes.

Lead author Dr Michail Katsoulis from the Institute of Health Informatics at the University of London said: "During the initial phase of the pandemic, between March 12 and April 15, 2020, there was an estimated 2750 fewer ED visits per week for suspected cardiac disease; this is around a 35% decrease compared with the pre-pandemic period this year.

"Our analysis suggested that one cardiac death might have been prevented or delayed for every additional 12 ED visits for suspected cardiac conditions. We estimated that the excess cardiac mortality due to non-attendance at EDs, during the initial phase of the pandemic, may have been as high as 232 deaths per week."

Researchers used data from the Office of National Statistics and Public Health England to reach their conclusions.

The authors said that they assumed that the COVID-19 pandemic only affects excess deaths from cardiac disease through the reduction in ED admissions, and not as a result of other factors, such as increased stress and anxiety.

Prof Chris Whitty Stars in Christmas Novelty Gifts

Source: My Sainted Aunt

The Government's chief medical adviser Prof Chris Whitty has become an unlikely cult hero on novelty mugs, prayer candles, and even beer labels this Christmas.

Few members of the public would have known about Prof Whitty at the start of 2020. However, within weeks he became one of the most recognisable figures in the country through his appearances in Downing Street briefings alongside Boris Johnson.

His unflustered requests of 'next slide please' inspired novelty gift shop Twisted Pickle to produce a range of products featuring his face.

Co-owner Hannah Spiers said that Prof Whitty novelty gifts were proving more popular than those featuring Britney Spears. "Chris Whitty is outselling them all," she told the BBC.

Meanwhile, Kent-based company My Sainted Aunt has been selling Chris Whitty prayer candles and cushions featuring England's chief medical officer cradling a lamb.

Prof Whitty even has his own appreciation society on Facebook, which has attracted more than five thousand fans.

Devotees of Prof Jonathan Van-Tam have not been left disappointed. England's deputy chief medical officer, renowned for his analogies involving football, trains, and yoghurts, has his own novelty candle in which, robed in a gold cloak he clutches a book with a halo of stars around his head.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.