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expert reaction to high number of cases and reported new variant in India

Amid a recent surge in COVID-19 cases, there have been reports that a new “triple mutant” variant of SARS-CoV-2 has been detected in India.


Dr Peter English, Retired Consultant in Communicable Disease Control, Former Editor of Vaccines in Practice Magazine, Immediate past Chair of the BMA Public Health Medicine Committee, said:

“The situation in India is very alarming, with case rates increasing exponentially.

“The more viral replication there is, the more likelihood there is that mutations that give the virus a competitive advantage will arise; and the large number of cases in India means that it is not surprising that this has happened there.

“So far, the vaccines have shown efficacy against variants. The vaccines appear just as effective against the B.1.1.7 (“Kent”) variant as against the original 2019 virus; and the real-world efficacy against some other strains is as yet unclear, but it seems likely that even if the vaccines are not as effective, they will remain effective against severe disease causing hospital admission, need for supplementary oxygen, and deaths. Whether they will maintain efficacy against the new variants springing up in India is not yet clear; but it is at least possibly, probably likely, that they will have at least some efficacy.

“India has so far administered nearly 130 million doses of Coronavirus vaccines – about one dose for every 10 people (according to Our World in Data at 13:36 today, 22 Apr 2021). This means that the variants are not yet under strong pressure from vaccine immunity, so there is no great pressure for vaccine escape mutants to arise.

“The “new ‘triple mutant’ variant of Covid-19” referred to likely refers to variants in which there have been three separate base changes, which will have arisen spontaneously. Base changes which confer competitive advantages are likely to arise spontaneously and independently in different populations.

“Variants which are more transmissible – more likely to spread from one person to another – will have a competitive advantage. They will have a higher R0 value, which – even if vaccines are just as effective against these variants – will mean that a higher proportion of the population will need to be vaccinated to ensure population or herd immunity. India is, as yet, nowhere near herd immunity levels through vaccination; but as their vaccination programme continues, might achieve this in time.”



All our previous output on this subject can be seen at this weblink:



Declared interests

Dr Peter English: “No COI to declare.”

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