At the beginning of vaccination, the United Kingdom chose a risky strategy to mitigate the enormous impact that covid-19 was leaving on its territory: while the European Union was betting on injecting two doses, Boris Johnson’s government decided to administer to the population as a whole a single, especially AstraZeneca, which the country had in good numbers (somewhat suspiciously: Brussels believes that the company diverted vaccines destined for the European Union to London).
Although a single dose does not confer as much protection as the two, the British health authorities chose quantity (of vaccinated) rather than quality. And until a few weeks ago, the play seemed to have gone well for them. The cumulative incidence in the United Kingdom fell to 39 cases at 14 days per 100,000 inhabitants on May 18 (that day, Spain had an incidence of 147) and life in the country, one of the most restrictive, almost returned to normal with the reopening of pubs as a symbol of the new era.
But in just 21 days, everything seems to have changed with the appearance of a new enemy: it is the sublineage B.1.617.2 of the Indian variant, now known as Delta, after the decision of the World Health Organization (WHO) to rename the most widespread variants with names of Greek letters so as not to stigmatize countries or populations. Precisely, the WHO explained last week that of the Indian sublineages, only B.1.617.2 is “worrisome” due to its greater transmissibility and because it has spread to more than 60 countries.
Delta is already the dominant variant in the British Isles, causes 75% of the new cases that are reported every day, that have gone from 3,000 to almost 6,000, has shot the cumulative incidence to 66, can multiply hospitalizations by 2.5 and has forced the Government to change its de-escalation plans. The forecast that the country will reopen without limitations on June 21 is now faltering, as more data on the underlineage is known.
The British Minister of Health, Matt Hancock, revealed this Sunday on the BBC that the Delta variant is 40% more contagious than the Alpha variant (formerly known as British), which in turn was more infective than the previous ones. Delta has between 13 and 15 mutations, but it is the L452R which makes it more contagious and the one that gives it ‘vaccine escape’, that is, the ability of vaccines to be less effective against it. Because that’s the key: If Delta escapes vaccines, the pandemic could almost return to the starting point.
The situation, however, is not apocalyptic. First because The vaccine, even if it loses effectiveness, continues to work. According to a study published in The Lancet, a dose of both the AstraZeneca and Pfizer vaccines is 32% effective against this sublineage and with two doses, the efficacy of AstraZeneca grows to 60% and that of Pfizer, to 88 %. “The vaccine escape is not zero or one hundred,” explains epidemiologist Pedro Gullón. “It is possible that in some cases, the efficacy will decrease, but the important thing is to advance in the vaccination because it will make the impact, even with escape variants, less than it would be if these variants were not present.”
Estanislao Nistal, virologist and professor of Microbiology at CEU San Pablo University, also highlights that “messenger RNA vaccines (Pfizer and Moderna) are easily adaptable to new variants” and is cautious about the impact of Delta. “Based on the information we have now, this variant is not associated with higher mortality or a more severe covid, although it is associated with greater contagiousness”, emphasizes Nistal, who agrees with Gullón when pointing out that the measures to avoid getting infected are the same as since the beginning of the pandemic: mask, social distance and hand washing.
In Spain, the sublineage B.1.617.2 continues to have, according to data from the Ministry of Health, a small presence. In its report last week, the Center for the Coordination of Health Alerts and Emergencies (CCAES) included it in the second risk group, ‘variants of interest’, behind the ‘variants with the greatest impact on public health’, where are the British, South African and Brazilian. The department headed by Fernando Simón affirms that all the Indian variants have “mutations compatible with a possible escape from immunity and with a moderate increase in transmissibility” and “a slight decrease in vaccine effectiveness.” According to their data, 48 samples with B. 1.617.2 have been sequenced in Spain, especially among ship crews, although in reality, there are already several hundred cases of the Indian variant.
The expansion of the Indian variant in the United Kingdom has not made the Spanish Government rethink the total opening of the borders for British tourists. Unlike other European countries, which have begun to establish controls for travelers from the islands, Spain maintains an open-door policy and even the Minister of Tourism, Reyes Maroto, is trying to “convince” to the British authorities to allow their nationals to travel to the Spanish autonomous communities with the lowest accumulated incidence, after the Executive of Boris Johnson has not included Spain as a “green destination.”
However, some voices are beginning to rise calling for more caution regarding the arrival of the British. The Catalan Minister of Health, Josep Maria Argimon, stated last Thursday that it would be “very reasonable” request a negative PCR from travelers coming from the United Kingdom “for epidemiological prudence” due to the Indian variant.
A decision totally contrary to that of Spain was made Germany, which on May 23 closed its borders to the British. “If we want infections to continue to decline, we must prevent the most infectious variants of the virus from putting the progress we have made at risk,” argued the German Ministry of Health.