Covid-19 Indian variant: More transmissible but is it a real concern?

Amid the general euphoria and optimism around the easing of Covid-19 restrictions, there is one "fly in the ointment" – the variant of the virus first identified in India and now taking off in parts of the UK.

With cases of the B1617 variant doubling weekly in England, some experts there have called unsuccessfully for the easing of restrictions in the UK to be delayed. In Ireland, there have been similar calls, along with suggestions of a mandatory hotel quarantine requirement (MHQ) for travellers crossing the Irish Sea.

But is the Indian variant a real cause for concern here in Ireland? Or can we rely on mass vaccination to negate any harms it might inflict, as is happening with other forms of the virus?

The short answer is that we don’t yet know. The data from Britain suggests this variant is more transmissible than others, even the UK variant that spread across Ireland so quickly over Christmas. This is to be expected with viruses as they mutate and adapt to the human host.

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But there is no evidence it can inflict any greater harm, or evade vaccines, and there is some data to suggest it may be burning itself out.

Foothold in Ireland

Ireland has had 41 cases of the main sub-type of concern of the Indian variant, and 20 cases of a second sub-type, which is also of concern. That may not sound like much, but the UK variant also started small last Christmas, and within weeks was responsible for thousands of cases daily.

The figures date from last week, before the Health Service Executive cyberattack interrupted Covid-19 surveillance work. And because the process around sequencing of virus cases to identify variants takes up to three weeks, these figures are already out of date by the time they are published.

So B1617 has established a foothold in Ireland, and is making inroads on the dominance of the UK variant. But will it survive in the aftermath of the introduction of MHQ for travellers from India on May 4th?

Other variants of concern, ones that originated in South Africa and Brazil, appear to have been suppressed after MHQ was introduced for those countries earlier in the spring. Something similar may happen with the Indian variant, whose growth in some parts of England has slowed following the UK's introduction of MHQ for India.

Wave of infection

British scientists have tentatively suggested B1617 is 50 per cent more transmissible than the UK variant and that this could give rise to a further wave of cases in summer.

While Ireland is starting from a much lower base of cases, it has far fewer people vaccinated. But the difference in vaccine rates will diminish quickly in the coming months, given the current pace of rollout.

Now that most older people in Ireland have been immunised, vaccination needs to be targeted on those who need it most, because of where they live (local outbreaks) and how they live (cramped conditions), and to go the extra mile to try to overcome vaccine hesitancy.

With the Indian variant now present in over 50 countries, some hard decisions are going to have to be made about restarting international travel later in the summer. But with current data so flimsy, it might be best to wait a while before making those decisions.

Current trends in relation to the Indian variant are a foretaste of what is to come with Covid-19. The future will see recurrent outbreaks generated by a mutating virus, but with mass vaccination as our main defence, these should remain localised and containable.