Covid variants in the UK: Everything you need to know from symptoms to cases as strains renamed

CORONAVIRUS variants have previously been referred to by their country of origin, whether it's the Indian variant, the Kent strain or the South African variant.

But some variants have now been renamed with experts referring to them by their Greek names.

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The so-called Indian variant – now called the Delta variant was added to the UK’s catalogue of strains being closely monitored by health officials in April.

At the time, Public Health England (PHE) said there were 77 cases of it in the UK – there is now 12,431 cases – as infections caused by the variant doubled in a week.

Professor Neil Ferguson, from Imperial College London, whose modelling was instrumental to the UK locking down in March 2020 today said that the strain is still spreading.

Speaking to BBC radio 4's Today Programme he said: "We're certainly getting more data. Unfortunately, I mean, the news is not as positive as I would like on any respect about the Delta variant.

"The best estimate at the moment is this variant may be 60 per cent more transmissible than the Alpha variant."

Paul Hunter, a professor in medicine at the University of East Anglia previously said it was “not surprising” that the variant had come from India.

“If you think about where the main variants have arisen – South Africa, the UK, California, Brazil, and now India – all of these are countries that have really struggled to keep case numbers down.

“So it’s not surprising. India has got a huge pandemic, and therefore that’s where you’re going to be getting the variant.”

As scientists work out more to understand new variants, common symptoms of the coronavirus to keep looking out for are a cough, high temperature, loss of taste and smell, fatigue and a headache.

The mutations in new coronavirus strains give them an edge over the "original" strain that popped up first in Wuhan.

They can either make them more able to spread, cause severe disease, reinfection, or weaken vaccine efficacy.

But mutation of the virus is natural, and there are thousands of other strains in circulation that are not of concern.

Vaccines have been hailed as the way out of the pandemic and health officials say although the vaccines will still work to prevent severe disease, it is likely the jabs will need to be tweaked in the future to fight new coronavirus variants.

There are still a number of unanswered questions about each new variant, as scientists carry out vital research.

So what do we know so far?

INDIAN VARIANT- DELTA

Official name: B.1.617 or VUI-21APR-01 (variant of concern).

Cases of the Indian variant have almost doubled in the past week – rising by 5,472 to 12,431, with areas hardest hit by the variant now being some of the most infected in the country.

The strain which is circulating in the UK is the B.1.617.2 strain.

While the Indian (Delta) variant is believed to be more transmissible, tests have shown that vaccines already being rolled out across the country do work against the variant.

The variant has two mutations of concern – E484Q and L452R.

Some experts have described this as a “double mutation”. But all variants have a number of mutations.

What is unclear is how these two work together, and what it might mean for the behaviour of the virus.

Prof Ferguson explained: "There's some uncertainty around that depending on assumption and how you analyse the data, between about 30 per cent and maybe even up to 100 per cent more transmissible.

"Certainly substantially more transmissible."

He added that 60 per cent was currently the best estimate and said that the majority of people currently being hospitalised with the variant are unvaccinated.

UK/KENT VARIANT – ALPHA

Official name: B.1.1.7 or VOC-202012/01 (variant of concern).

The UK strain first emerged in Kent in September and caused cases to surge despite the national lockdown in November.

It's up to 70 per cent more contagious than the original strain, which emerged in Wuhan, China.

It was in part responsible for the third national lockdown in England after the tiers system was unable to control the spread.

The Kent strain has been found to be up to twice as deadly by the University of Essex, and between 30 per cent and 70 per cent more deadly by the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) – a sub-group of Sage.

But there is no evidence to indicate existing treatments, such as dexamethasone, will not be effective against it.

The three main symptoms of coronavirus to watch out for, according to the NHS, are a new persistent cough, a loss of taste and smell (anosmia) and a high temperature.

However it was revealed that people suffering with the Kent mutation are more likely to get a cough, sore throat, tiredness and muscle pain, and less likely to have a loss of taste and smell.

SOUTH AFRICAN VARIANT – BETA

Official name: 501Y.V2 B.1.351 or VOC-202012/02 (variant of concern).

The Health Secretary revealed the new and “highly concerning” strain had entered Britain during a press briefing on December 23.

The strain was announced by the South African government on December 18.

In order to contain the strain all flights from South Africa were stopped and anyone who had visited South Africa in the past two weeks, or been in contact with someone who has, had to quarantine immediately.

But it has still managed to spread in the UK and scientists say detected cases of this strain are likely to be the "tip of the iceberg" because the usual Covid testing does not distinguish it from other strains – it must be genetically sequenced in a laboratory.

Surge testing has been carried out in multiple locations in England – including in London, Leeds and Liverpool.

The South African strain is thought to be up to 50 per cent more transmissible.

But although scientists say there is a "hint" it is more deadly from studies in South Africa, where the strain is more dominant, there has been no clear evidence of this yet.

The South African variant carries the E484K mutation which experts suggest may be better at evading the human immune response.

Studies for the Pfizer and Moderna vaccines indicate a reduction in antibodies against the strain, up to six-fold lower.

Johnson & Johnson’s vaccine had 57 per cent efficacy in South Africa versus 72 per cent in the US, and Novavax’s vaccine had 49 per cent efficacy in South Africa versus 90 per cent in the UK.

A study suggested that the Oxford/AstraZeneca jab was not effective at preventing mild illness caused by the more infectious South African mutation in young people.

But the jab will protect against deaths and severe disease amid the spread of the South African variant, according to researchers.

Researchers have said that even if antibodies are reduced, T-cells still remain potent enough to prevent severe disease.

It is not yet known if the South African strain has any different symptoms than the three standard ones highlighted by health officials.

BRAZILIAN VARIANT – GAMMA

Official name: P1 or VOC-202101/02 (variant of concern).

In early March, health bosses revealed they had detected six cases of a Brazilian strain – three in England, and three in Scotland.

One patient has not been identified because they're testing details were not filled out properly. A hunt was launched to find "Patient X'", which eventually led back to Croydon, south London.

Surge testing was carried out in South Gloucestershire, where the other two cases in England were found. One was a traveller from Brazil, and the other a household member.

The strain, called P.1, emerged in the Brazilian city of Manaus in December.

 

The P.1 variant is associated with a surge of cases in Manaus late last year, which led to a severe second wave of Covid-19.

Because the city had a high level of immunity, due to its first wave of Covid, scientists were concerned because this raised the possibility it is able more easily re-infect patients due to the mutations it carries.

Research by the University of São Paulo, in collaboration with British universities, found an estimated 20 to 60 per cent of people who have recovered from Covid are “susceptible” to getting sick again with P1.

The team also said the strain was between 40 per cent and 120 per cent more transmissible, and may have a higher mortality rate.

The Government has not specified what the symptoms of the new strain from Brazil are.

Another Brazilian variant

Official name: P2 or VUI-202101/01 (variant under investigation).

Another Brazilian variant, called P2, has been detected in the UK.

It has been reported to be spreading in the Rio de Janeiro State, and is associated with two independent reinfection cases in Brazil, according to the Covid-19 Genomics UK (Cog-UK) consortium.

But experts say it is not a cause for concern.

While it also carries the E484K mutation, P2 does not contain the other important mutations carried by the more concerning variant (P1).

More than 50 cases of this variant have been found in the UK so far, dating back to January 15.

 

Bristol variant

Official name: B.1.1.7 with E484K or VOC-202102/02 (variant of concern).

The Kent strain mutated again at the start of this year to mimic the South African variant.

It has a mutation known as E484K, which is already present in both South African and Brazilian coronavirus variants.

Laboratory studies have shown that antibodies are less able to bind to a part of the virus known as the spike protein, in order to stop it from unlocking human cells to gain entry.

When the new strain first emerged experts said the symptoms were the same to variants already in circulation.

Cases of this variant were first detected in February in Bristol, therefore it got nicknamed the "Bristol variant".

Liverpool variant

Official name: A.23.1 with E484K or VUI-202102/01 (variant under investigation).

This variant is the original strain of the coronavirus, from Wuhan, with the addition of the E484K mutation – found in the South African and Brazilian variants.

It was dubbed the “Liverpool variant” because regional health officials first detected it in the city among staff at Liverpool Women's Hospital in January.

Extra surge testing was not used in the city and surrounding areas because the variant was not deemed a variant of concern, like the South African or Brazilian variants.

But blitz testing was already being used to search for other new coronavirus variants., and health officials urged people to get a free NHS test even if they had just a runny nose.

A woman who caught the variant in January revealed the symptoms she experienced, saying the early signs were different to the classic ones.

She told the Liverpool Echo she first started feeling unwell with symptoms of the common cold.

It was after this that she lost her sense of taste and smell – a sign that was identified as a Covid symptom last year.

She said: "I had a streaming cold and then lost my sense of taste and smell in January.”

PHILIPPINES VARIANT – THETA

Official name: P.3 or VUI-21MAR-02 (variant under investigation).

Two cases of a Covid strain first reported in the Philippines were identified in the UK in mid-March, which has since gone up to five.

PHE said one of the cases was linked to international travel and the other is still being investigated, but did not confirm where either had been found.

It added the variant contains a number of notable mutations, including the E484K spike protein.

It was first reported on March 9 by the Philippines, when 33 cases were recorded.

B.1.525

Official name: B.1.525 or VUI-202102/03 (variant under investigation).

PHE confirmed on February 16 that a new variant, known as B.1.525, had been found in the UK.

Initially 33 cases had been found by genetically sequencing more than 70,000 positive test results. This has since increased to more than 300.

B.1.525 has also been detected in 10 countries including Denmark, the US, France, Spain and Australia.

It is not known where it originated, but the roots of the variant go back as far as late December in Nigeria and the UK. 

It is one of the seven new variants reported in the US, leading to Dr Anthony Fauci to plead with Americans not to "let your guard down."

The strain was first described by researchers at the University of Edinburgh, and has similarities to the Kent strain, but with several additional mutations.

One of these is the E484K mutation, also found in the South African and Brazilian variants, and scientists believe it could make vaccines less effective.

Professor Yvonne Doyle, Medical Director at PHE said: “There is currently no evidence that this set of mutations causes more severe illness or increased transmissibility.

"PHE is monitoring data about emerging variants very closely and where necessary public health interventions are being undertaken, such as extra testing and enhanced contact tracing.”

B.1.1.318

Official name: B.1.1.318 or VUI-202102/04 (variant under investigation). 

PHE said on March 4 that 16 cases of a new Covid strain have been detected since February 15, which has now reached 113.

This variant’s location of first detection is to be confirmed, as PHE said the cases were geographically spread across the UK.

Mass testing will not be used to find more cases of the variant, as this is only done for variants of concern (VOC).

It is understood to be an evolution of the UK variant, containing the E484K mutation, and similar to the one found in Liverpool earlier this year.

But it doesn't feature the N501Y mutation, found in all variants of concern (VOCs.

All individuals who tested positive and their contacts have been traced and advised to isolate.

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