Someone somewhere in England is infected with what is understood to be a more infectious variant of COVID-19, and they may not even know it yet. This missing patient is one of six people in Britain – three in England and three in Scotland – to have tested positive in February for the P1 “variant of concern” first detected in Manaus, Brazil.
The unidentified person is thought to have returned a positive result from a home testing kit used on the 12th or 13 of February – but they didn’t complete the registration form properly, so cannot be traced or contacted. Health officials cannot confirm their whereabouts, though Health Secretary Matt Hancock said there was “no evidence” to suggest the infected person is not self-isolating.
Authorities have launched a nationwide hunt for the missing patient, but what could cases of the Brazilian variant and others like it, such as that from South Africa, mean for hopes of the nearing of the end of the pandemic? And can we forget about the end of lockdown and overseas holidays this summer?
Among the most worrying factors is the potential for reinfection with the Brazilian variant among people who have already had COVID-19. Reinfection could indicate that existing vaccines may be less effective against the P1 variant, which had infected more than three-quarters of Manaus’ population by October 2020.
“Potential resistance to current vaccines is an issue,” Lawrence Young, a virologist and professor of molecular oncology at the Warwick Medical School, University of Warwick, told VICE. “We don’t have the data yet, but by analogy with the South African variant, to which it has similarities, the vaccines aren’t as effective. It is likely the vaccines will protect against very serious disease, but it’s not an optimal position to be in because we want the very best vaccine.”
Looking at the situation using the glass half-full, half-empty metaphor, Danny Altmann, a professor of immunology at Imperial College London, says it is somewhere in the middle. “When I look at the data on vaccines, antibodies and new variants I come up with the conclusion that it’s a bit scary and sets us back a little, but it doesn’t scupper us completely,” he told VICE.
There is no indication the Manaus variant is more harmful, Young points out, and the virus changing is nothing new – it’s been doing it from the very beginning of the pandemic. But the only way to stop COVID-19 from adapting further is by stemming its spread. The emergence of new variants has been a wake-up call, but given that we know the virus spreads through person-to-person contact, we still need to remain vigilant.
Both Young and Altmann predict a moderate rise in infections as society opens up again and children go back to school on the 8th of March. It is something we have to recognise and live with, Young says.
“New variants will compound the situation and make it slightly more worrying,” he adds, “but it’s nothing we can’t control if we do things very carefully step-by-step and don’t take our foot off the brake all at once.”
Altmann says measures being introduced as children return to classrooms should help to keep things under control. “We can’t keep kids out of schools forever,” he says. “All the things that are being talked about that we were crying out for a long time ago, like much more serious real-time testing for children going into schools and stricter policies on mask-wearing, will all help enormously [to limit infections].”
The hope is that any new infections can be contained, with new cases identified and isolated quickly. Failing to do so could put Boris Johnson’s four-step roadmap for lifting lockdown – and reopening shops, restaurants, pubs and clubs – in jeopardy.
“The roadmap has four tests that must be met, and two of them are about reduced transmissions and the risk posed by variants,” Young says. “So, if we find more variants spreading and we’re worried about controlling the spread then it will impact the phases on the roadmap. I, personally, don’t think it’ll be a problem... But we can’t afford for things to get out of hand, or it will threaten the entire roadmap. The important thing is that we come out of lockdown securely, so we don’t end up going back into another one.”
Heading abroad for a summer holiday, however, is something we might have to approach with more caution. Both the first and second outbreaks in the spring and autumn of last year in the UK were fuelled by people bringing viruses back from mainland Europe, Young says. Is that something we want to risk happening again? The professor thinks Britain has enough to contend with to get things opened up domestically and to get the economy going.
“We shouldn’t be adding insult to injury by bringing in other variants from abroad,” Young says. “Border control [during the pandemic] has always been an issue for us in this country, we didn’t get it right in the beginning, and now we have to question the value of having 33 red-listed countries when people can travel through airports, congregate on planes and get connecting flights. Would it be sensible for a short period of time to bring in restrictions for everybody travelling into the country?”
Altmann says a serious approach to vaccine passports could help, even given that there are many “scientific, ethical and human rights issues to consider”.
The good news is that scientists are already working to tweak the jabs to fight against new variants and the potential for boosters to tackle them is becoming very real. An even brighter glimmer of hope can be found in the virus’s behaviour.
Because of the way COVID-19 is mutating, Altmann predicts that a future with updated boosters year after year is not on the horizon. We are seeing convergent evolution playing out, meaning the random mutations that are taking hold independently in different parts of the world all share similar traits.
“The reason we’re worried about the Brazilian, South African and Kent variants is because they have multiple mutations in spike and all share one particular feature, the E484K mutation, which makes it quite good at evading immune responses ... But the virus has limited variations up its sleeve, so I don’t think we’re going to be playing catch-up forever. There is an endgame to this.”