New Covid Variants

[hakwright]

Is it just me or do others find the recent explosion of cases in India truly terrifying? The number of new cases and new deaths per day has increased by an order of magnitude in just 6 weeks. I don't think we have seen anything like such a rapid acceleration of the virus in any other country before.

I know the jury is still out on the double-mutation variant that has become dominant there in recent weeks, and whether it is largely responsible for the rapid explosion in cases. But is there any other candidate explanation for the unprecedented acceleration of the numbers in India?

In the UK when the December/January wave rapidly took over, it was clear from the rate of growth that something different was happening, compared to previous UK waves. And soon enough, it was clear that new variants were the main cause. The India curve is so much steeper than anything we've seen before - if it's not a rapidly spreading new variant, what else could cause such a dramatic change in the virus behaviour?

[headshot]

Brazil’s horrendous too, with children and young adults being very badly affected.

[bob sterman]

Is it just me or do others find the recent explosion of cases in India truly terrifying? The number of new cases and new deaths per day has increased by an order of magnitude in just 6 weeks. I don't think we have seen anything like such a rapid acceleration of the virus in any other country before

If you take a look at the following chart - Daily new confirmed COVID-19 cases per million people for UK and India on a log scale - the current rate of increase there doesn't look hugely different to the rate of increase the UK has experieced at times with the Kent variant...

https://ourworldindata.org/explorers/co ... ry=GBR~IND

[JQH]

I know the jury is still out on the double-mutation variant that has become dominant there in recent weeks, and whether it is largely responsible for the rapid explosion in cases. But is there any other candidate explanation for the unprecedented acceleration of the numbers in India?

Some very crowded slums in India. Once the virus gets established it's going to spread like wildfire.

[Gfamily]

Is it just me or do others find the recent explosion of cases in India truly terrifying? The number of new cases and new deaths per day has increased by an order of magnitude in just 6 weeks. I don't think we have seen anything like such a rapid acceleration of the virus in any other country before.

I'm working with teams in India on a number of IT projects, and half of the teams I'm working with have people come down with Covid in the last week. Another person on one of the teams is well, but is having to care for multiple family members with Covid.

Until now, I think there's only been 1 person come down with it since the New Year.

Very worrying indeed.

[Sciolus]

It's not clear how much the spread, and increased infection rate in young people, in India and Brazil is due to new variants, and how much is due to existing health and healthcare deficiencies. But it's decidedly worrying. This is why people have been saying we need a zero-case approach globally. I've said before that if we get a variant that affects young people at the same rate the current UK strain affects old people, we are truly, monumentally f.cked.

[Woodchopper]

Thread split of from the general COVID-19 thread

[Sciolus]

Thanks Chops. I hope you don't mind, hakwright, but I think this is interesting and important enough to deserve its own thread, rather than getting lost in the general megathread.

[hakwright]

Thanks Chops. I hope you don't mind, hakwright, but I think this is interesting and important enough to deserve its own thread, rather than getting lost in the general megathread.

No problem. I know there's a thread on the specific "UK/Kent" variant, but that didn't quite seem right for my post, so I just added to the general thread. Probably just laziness on my part not creating a suitable thread!

Following up on comments: the comparison of UK and India rates per population is interesting, but you can still see the India slope is somewhat larger (less obvious but more impactful given the log scale). I've compared the time taken for new cases to double, and for the UK in Dec/Jan get an average of 14 days, and for India (last month or so) get an average of a little over 11 days. Not a massive difference, but when that rate is sustained for longer periods, the impacts are clearly large.

The slums and population density factor is interesting. But wouldn't that have applied in the same way with India's first wave in Aug/September 2020?

There is clearly *something* different happening in India now compared with last year. I heard that within a matter of a few weeks, there should be enough evidence to make an assessment of the new India variant and whether it really is more contagious.

[Woodchopper]

‘It is much worse this time’: India’s devastating second wave
New variant suspected of stoking surge that is overwhelming hospitals and crematoriums

[...]

Both the number of new cases and the percentage of positive tests are climbing at the fastest rate in the world, with the latter jumping from 3 per cent last month to 16 per cent.

[...]

The sick are overwhelming hospitals in many parts of the country. The rate of ICU patients in Nagpur at 353 per million is higher than it was anywhere in Europe during the pandemic. Mumbai, the financial capital, has 194 ICU patients per million.

To meet surging demand, authorities have set up emergency coronavirus hospitals in banquet halls, train stations and hotels. India has taken emergency measures to secure oxygen supplies, boost production of drugs such as remdesivir and fast-track vaccine approvals. It has frozen vaccine exports, too, a decision that will have profound consequences for the developing world that is depending on Indian manufacturing for its jabs.

A Financial Times analysis also points to under-reporting of deaths. Local news reports for seven districts across the states of Gujarat, Uttar Pradesh, Madhya Pradesh and Bihar show that while at least 1,833 people are known to have died of Covid-19 in recent days, based mainly on cremations, only 228 have been officially reported.

In the Jamnagar district in Gujarat, 100 people died of Covid-19 but only one Covid death was reported.

The situation in Lucknow, the capital of Uttar Pradesh, a state of 200m that is among India’s poorest, highlights how health infrastructure has been pushed to breaking point. Local media reported that at King George’s Medical University, there was a queue of 50 people per hospital bed.

https://www.ft.com/content/683914a3-134 ... e0ba1dc403

In many parts of the country including the capital Delhi, cases are doubling every five days. Compared to the steady rise seen in the first wave last year, the current climbs are almost vertical.

[...]

I collated local news reports (HT @muradbanaji) across seven districts, finding that overall, numbers of Covid victims who have been cremated are 10x larger than official Covid death counts in same areas.

[...]

If applied nationally, that would mean that instead of 1,700 deaths per day, India is currently seeing 17,000.

And as more reports come in, that undercounting estimate has been rising, so the true toll may be higher still.

https://twitter.com/jburnmurdoch/status ... 86497?s=21

[badger]

Thanks Chops. I hope you don't mind, hakwright, but I think this is interesting and important enough to deserve its own thread, rather than getting lost in the general megathread.

No problem. I know there's a thread on the specific "UK/Kent" variant, but that didn't quite seem right for my post, so I just added to the general thread. Probably just laziness on my part not creating a suitable thread!

Following up on comments: the comparison of UK and India rates per population is interesting, but you can still see the India slope is somewhat larger (less obvious but more impactful given the log scale). I've compared the time taken for new cases to double, and for the UK in Dec/Jan get an average of 14 days, and for India (last month or so) get an average of a little over 11 days. Not a massive difference, but when that rate is sustained for longer periods, the impacts are clearly large.

The slums and population density factor is interesting. But wouldn't that have applied in the same way with India's first wave in Aug/September 2020?

There is clearly *something* different happening in India now compared with last year. I heard that within a matter of a few weeks, there should be enough evidence to make an assessment of the new India variant and whether it really is more contagious.

something different indeed - it wasn't that long ago various articles were posted here that looked at how India (and other countries) seemed to be avoiding another wave and tried to work out what might be going on. This one in The New Yorker talks about how emergency mobile units set up around slums were barely used, then taken away again.

[lpm]

In a way, the only question on the India disaster is why it didn't happen a year ago.

Being too poor to lockdown is an awful thing.

[Woodchopper]

SARS-CoV-2 variants of concern and variants under investigation in England
Technical briefing 9

https://assets.publishing.service.gov.u ... ngland.pdf

[Woodchopper]

Thread: https://twitter.com/chrischirp/status/1 ... 7586875396
Variant B.1.617 'Indian' is spreading rapidly in London and displacing B.1.1.7 'Kent'.

This could be due to random drift. Worst case, the Indian variant is much more contagious and causes a renewed outbreak in London and the rest of the UK as restrictions ease. If so we won't see the mortality seen earlier in the year as so many of the most vulnerable have been vaccinated. But hospitals full of very sick younger people will still be bad. If B.1.6.1.7 takes hold elsewhere it'll be a lockdown for the rest of the year until the populations can be vaccinated.

[raven]

f.ck. 10% in London.

And I was worried after I looked at the previous link. It's got a map of confirmed/probable cases and it's pretty widespread patches across England already. Only very low numbers, but still. And just as we're opening up too.

I guess the silver lining globally speaking is we can be the canary in the coal mine: if the Indian variant takes off here it'll be a good real world test of how effective Pfizer and AZ are against it.

[Woodchopper]

f.ck. 10% in London.

And I was worried after I looked at the previous link. It's got a map of confirmed/probable cases and it's pretty widespread patches across England already. Only very low numbers, but still. And just as we're opening up too.

I guess the silver lining globally speaking is we can be the canary in the coal mine: if the Indian variant takes off here it'll be a good real world test of how effective Pfizer and AZ are against it.

It looks like they think that Pfizer will still work: https://www.thenationalnews.com/world/a ... -1.1212637

Biggest issue now is the race to vaccinate before it spreads further.

[OffTheRock]

Does this make the 'replace isolation with LFTs' experiment even dafter than it was before?

[mediocrity511]

Does this make the 'replace isolation with LFTs' experiment even dafter than it was before?

You currently aren't eligible for that trial if you are a close contact of someone with the variant, which is something. But I doubt they could have separate regimes for different variants in the long term.

[OffTheRock]

I suspect that once you start blurring the lines, people start stretching them further. I doubt it'll take long for people to just start taking an LFT and then going out because it's fine for others to do it.

[raven]

I doubt it'll take long for people to just start taking an LFT and then going out because it's fine for others to do it.

Already happening. n=1 and all that, but yeah.

[raven]

It looks like they think that Pfizer will still work: https://www.thenationalnews.com/world/a ... -1.1212637

Biggest issue now is the race to vaccinate before it spreads further.

That article is about Covaxin I think:

Blood serum was collected from 12 people who had experienced symptomatic or asymptomatic infections from the Indian variant and fully recovered. Blood serum was also collected from a range of people who had been vaccinated.
All samples were tested to see how well they neutralised the Indian variant and both batches offered high levels of protection. The sera from recovered patients provided 87 per cent immunity and the sera of vaccine recipients 88 per cent.
Covaxin was the drug used in the study but further research is under way in the UK to determine whether a second dose of Pfizer or AstraZeneca works better at neutralising B1.617.

Doesn't say how many vaccinated people were sampled either. But if that 88% tranlsates into real world protection, that's pretty good.

[hakwright]

Still quite tentative, but the Indian government now says the rise is infections is likely to be linked to the double-mutant Covid variant.

They say: there is a correlation, but that the link is not "fully established"

"Its epidemiological and clinical correlation is not fully established… without the correlation, we cannot establish direct linkage to any surge. However, we have advised states to strengthen public health response - increase testing, quick isolation, prevent crowds, vaccination," Sujeet Singh, National Centre for Disease Control said.

https://www.bbc.co.uk/news/world-asia-india-57004764

Have also seen reports of the "Indian variant" having been detected in a number of African countries. Seems inevitable it will spread around the world in the coming months, but as already noted, if the vaccines are still effective against this variant, and if enough folk are vaccinated, that will help to curb its spread.

[jimbob]

SARS-CoV-2 variants of concern and variants under investigation in England
Technical briefing 9

https://assets.publishing.service.gov.u ... ngland.pdf

That's not looking good

[Herainestold]

“B.1.1.7 is really fit so we don’t know how these variants are actually going to play out when they’re in competition with another,” said Muge Cevik, a clinician and researcher in virology at the university of St Andrews.

B.1.1.7 was growing during a time when overall cases were on the rise, whereas B.1.617.2 is spreading at a time when overall numbers are falling, which has led some to fear that the current lockdown measures are not having the same impact.

Scary stuff.

https://www.ft.com/content/8e134734-c3f ... 03e67dadec

[headshot]

Cases are rising because people are acting as if all measures have been lifted.

There’s barely any social distancing taking place any more and the rule of six/two households only is being mostly ignored. Even my usually sensible neighbours had about 12 people from at least four households in their garden for a birthday last week.