True Covid death toll passes 117,000

The B.1.1.7 aka 501Y.V1 Kent variant of SARS-CoV-2 has 23 mutations and is at least 70% more transmissible, according to most scientific commentators.  By December 20th, it accounted for 60% of Covid cases in London.

The alarming rise in death rates since the appearance of this new variant has been confirmed by the Office for National Statistics (ONS).

A total of 117,378 deaths where Covid-19 was mentioned on the death certificate had occurred in the UK by January 22, the ONS has reported.

So far there have been 14 consecutive days in January – from January 7 to 20 – when the daily death toll was above 1,000.

This could change as more deaths will be registered for the second half of the month.

There is no doubt that a factor in the present horrific death rate was the bizarre relaxation of precautions, encouraged by the London government over the “festive season”.

During the first wave of the virus in April 2020, there were 23 consecutive days when the death toll – based on death certificates – was above 1,000.

The London government has now ordered door-to-door testing in several English districts for the emerging 501Y.V2 or South African variant. 

The two variants share the N501Y mutation, and it has been known for some days that the South African strain includes mutations known as E484K and K417N. Since then Dr Jeremy Wilson, virologist, confirmed on BBC Evening News South East on February 3, that the Kent variant also definitely has the E484K mutation, which is the one most potentially dangerous for vaccine efficacy.

Both variants mean that the multiple changes to their spike protein are likely to cause problems for the vaccines.

As of January 30, a total of 105 cases of the South African variant have been identified across the UK.

The fact is that, in spite of reassuring statements from the government and its SAGE advisors, Scientists at Porton Down are still researching whether vaccines will be effective against these new Covid variants. 

Yet already SAGE scientists have attempted to reassure the public that although the vaccines may be less effective against new mutations, they are still expected to be “very worthwhile and very good at preventing severe disease”.

Johnson added, “We are confident that all the vaccines that we are using provide a high degree of immunity and protection against all variants.”

He said the vaccines could be adapted to deal with new variants if necessary.

In fact, there have been a plethora of contradictory statements as to the efficacy and safety of the vaccines on offer: particularly of the AstraZeneca-Oxford vaccine and the Pfizer-BioNTech vaccine. 

Norway’s concerns over the Pfizer vaccine concerning the deaths of over 33 elderly people directly after being given a first dose of the vaccine, drew a swift dismissal from England’s Professor Evans.  This was swiftly followed by Israel’s concerns, which elicited the same hasty unscientific dismissal by Evans.  Israel had already by then given about a quarter of its population the first dose of Pfizer vaccine but warned that it could be as low as 33% effective after the first injection.

The issue appears to be the change from a three-week separation between doses to the adoption of a 12-week gap by the U.K., ostensibly to push for a maximum number programme. The fact is that these vaccines don’t work instantly. It takes a few weeks for the body to build up immunity after receiving a dose. And the vaccines now in use, Pfizer-BioNTech and AstraZeneca-Oxford, both require a second shot to reach full effectiveness.

Stephen Evans, professor of pharmacoepidemiology at London School of Hygiene and Tropical Medicine, said the reports from Israel are “insufficient to provide any evidence that the current UK policy in regard to delaying the second dose of vaccines is in any way incorrect”.

“It is not sensible to compare efficacy derived from an observational study of this type which is subject to many biases, with the efficacy derived from randomised trials,” he said. (Yahoo News 21 Jan)

Some Indian scientists have raised other concerns with the AstraZeneca-Oxford vaccine, developed under the name Covaxin in India, which include the trials, side effects and even an increased risk of contracting the disease. 

Approval of a vaccine without phase III data is “unconscionable,” says Vineeta Bal, an immunologist at India’s National Institute of Immunology. He argues that guidelines from India’s Central Drugs Standard Control Organisation (CDSCO) have also been ignored: these stipulate that vaccine makers must show a minimum efficacy of 50% in a phase III trial for their vaccines to be approved.  Gagandeep Kang, a microbiologist at Christian Medical College, Vellore, and a board member of the Coalition for Epidemic Preparedness Innovations, said, “They [CDSCO] provided the guidance and then went against their own guidance. I don’t know what made them do this.”

Dr Kang adds that AstraZeneca-Oxford adjuvant—an ingredient that bolsters the immune response—is a combination of aluminium hydroxide and an imidazoquinolinone that has never been used in approved vaccines. “I don’t think anyone can guarantee it won’t cause any adverse effects when tens of thousands of people get the vaccine,” she says. The ScienceMag article adds that the company also can’t rule out the possibility that the vaccine makes the disease worse instead of protecting from it, a rare phenomenon seen with a few other vaccines. This is in spite of the fact that the “tried-and-true technology”, according to Bharat Biotech’s chairman, that produced the AstraZeneca-Oxford vaccine, unlike the messenger RNA vaccines produced by Pfizer BioNTech and Moderna, has “a long history of safe use”. 

According to reports in the German tabloids ‘Bild’ and ‘Handelsblatt’ last week, citing unnamed sources, the AstraZeneca-Oxford jab has only been found to be eight to ten per cent effective in the over-65s. Following these claims, the vaccine has not been approved by the German government health authority for use for that age group.  In response to the original reports in the tabloids, a spokesman for AstraZeneca refuted those claims as “completely incorrect” and said data published in November demonstrated “strong immune responses” in older adults, with 100 per cent of second dose recipients generating “spike-specific antibodies”. However, since the decision not to use the vaccine on the over 65s was made official by the German government, AstraZeneca’s response has become somewhat muted, and Professor Evans has uncharacteristically cited the legitimacy of dissenting academic and scientific opinion.

David Kennedy, Evolutionary Microbiologist and Professor at Pennsylvania State University, writes that “the version of the spike protein used by the vaccines was designed to match that of the old virus, not that of the B.1.1.7 [new U.K. or Kent virus, and we can add South African variant and, for that matter, any future variants].  This means that the vaccines might become less effective than expected should this new virus spread widely.”

“The severity of the mismatch matters, but the only way to determine its impact is through scientific study and research, and to my knowledge, no data on that has yet been collected. In other words, it’s too early to say whether and how this new variant will influence the overall effectiveness of the …vaccines.”

So, where does all this leave the intended recipients of these vaccines- that’s us?

Two major developments in the pandemic are becoming clearer daily: the first is the rise of nationalist forces in Europe, exacerbated by the U.K.’s break from the rest of Europe, and the other is the widening gap between the prospects of poorer countries and richer countries in saving lives in the inevitable human catastrophe that this virus has unleashed. 

Given that, it is alarming that the U.K. is fifth in the highest totals of global deaths, and fifth in the highest totals of deaths per million globally.  

Partick Carey


Image: NIAID, published under CC BY 2.0.