Should the Welsh Government close the stable door before the new Covid variant bolts?

Ifan Morgan Jones

The so-called ‘Indian’ or B.1.617.2 variant of Covid-19 is already in Wales but in small, manageable clusters with little evidence yet of community transmission, according to Chief Medical Officer Frank Atheron.

Speaking at yesterday’s press conference he did, however, argue that “the public should be worried about the resurgence in coronavirus” and there has long been an acceptance that this summer could see a third wave of the virus.

The argument against further restrictions at the moment is that Wales, as the country with one of the highest rates of Covid vaccination in the world, will be able to withstand another wave without too many hospitalisations and deaths.

However, there is room to be concerned that the new variant may well move a few weeks too quickly for the vaccine to give Wales’ population full protection.

Two-thirds of people in Wales have had at least one Covid jab, which is excellent and world-leading and the Welsh Government and NHS can take huge pride in that.

However despite being ahead of other parts of the UK, it remains the case that so far only 31.8% of the population have had their second jab, and as few as 30% of 50-60 year olds.

According to the latest Public Health England report about real-world effectiveness of vaccines against B.1.617.2, some are only 33% effective after the first dose.

Furthermore, the AstraZeneca vaccine is only 60% effective for symptomatic infection against B.1.617.2 two weeks after the second dose, although that rises in subsequent weeks.

Now, this isn’t to say that the vaccines are ineffective – a fully vaccinated individual, after a few weeks, will have a very high degree of protection against this and any other variant of Covid.

The issue really is this – who is going to win this race between fully vaccinating the population, and the time lag after that between that and maximum immunity, and the new 40-50% more transmissible Indian variant? That’s what we don’t know.

‘Too long’

Prof. Christina Pagel, head of the Clinical Operational Research Unit at University College London and a member of Independent Sage, makes the problem clear here.

“We currently have 43% of adults who have received two doses of vaccine,” she says. “Only 33% of those are two weeks out from their second dose.

“Given this new variant, this is not high enough. We are a few months away from offering the second dose to all adults (August if we can accelerate the timetable, September if we can’t).

“Once the large majority of adults are fully vaccinated, we’ll be in a much better position.”

She finishes: “Waiting too long as we did in March, September and December means that restrictions, if they do come, will be longer and harsher. We don’t want to do that again.”

This raises the question of whether it would be better for the Welsh Government to impose some restrictions now, while B.1.617.2 is contained in Wales, rather than waiting for it to start spreading in the community.

At the very least, shouldn’t the Welsh Government impose restrictions on travel to and from parts of England in which the Indian variant is spreading in the community? This is something Health Minister Eluned Morgan said at yesterday’s press conference that they hadn’t come to a decision on.

Scotland have already done this and the UK Government have advised against travel in and out of those areas, but didn’t even announce locally that it had done so.

Of particular concern perhaps is that one hotspot is in the north-west of England, and the north of Wales is likely to be a particularly popular and accessible holiday destination over the summer.

Further blanket restrictions would be politically hard to pull off. Prime Minister Boris Johnson has presented the current unlocking as ‘irreversible’ – a word that was duty-bound to come back to bite him the second he said it.

Vaccinations have also been presented as something of a silver bullet against the virus and explaining why this isn’t necessarily the case will come as a surprise and a shock to many.

This is ultimately a political decision and it is of course politically easier to impose new restrictions once it’s clear to everyone that things are bad and the hospitals filling up.

It’s harder to take such a difficult, unpopular decision to stop a wave before it happens – but in this case, with a fully vaccinated population so close in Wales, another month or so of restrictions may be a price worth paying to avoid more damage down the line.